Abstract
BACKGROUND: Insomnia is a common sleep disorder, and this meta-analysis aimed to systematically evaluate the effectiveness of eye acupuncture combined with other therapies in treating insomnia. METHODS: In this comprehensive meta-analysis, we conducted a systematic evaluation of the effectiveness of eye acupuncture as a treatment for insomnia, a widespread sleep disorder. Our literature search spanned multiple databases, including Wanfang, Chinese National Knowledge Infrastructure, Wipo Information Chinese Periodicals Service Platform, China Biology Medicine, PubMed, Cochrane Library, Web of Science, and Embase, covering the period from their inception to February 1, 2024, and including both Chinese and English publications. The article included randomized controlled trials comparing eye acupuncture combined with other treatments versus non-eye acupuncture treatments for insomnia. Data extraction was independently conducted by 2 evaluators, and the risk of bias was rigorously assessed using the Cochrane Risk of Bias Tool. The synthesis of data involved a meta-analysis using RevMan 5.3 software, complemented by sensitivity analysis comparing fixed and random effects models to enhance the robustness of our findings. RESULTS: This study involved 13 clinical studies involving 856 patients with insomnia.The meta-analysis findings indicated that the combined eye acupuncture treatment exhibited significantly superior clinical efficacy compared to either drug treatment or non-drug treatment alone (odds ratio = 3.71, 95% confidence interval [CI]: 2.18-6.32, Z = 4.82, P < .00001). Compared with the control group, the intervention group exhibited a lower Pittsburgh Sleep Quality Index score (PSQI; mean difference [MD] = -2.46, 95% CI [-3.07, -1.85], Z = 7.87, P < .00001). Moreover, the Traditional Chinese Medicine Symptom Score (TCMSS) of the intervention group decreased more than that of the control group (MD = -1.51, 95% CI [-2.80, -0.22], Z = 2.29, P = .02). In the documentation of adverse reactions, a single study reported that 2 patients experienced mild subcutaneous hemorrhage following eye acupuncture treatment, which resolved spontaneously post-treatment. CONCLUSION: The combination of eye acupuncture with other therapies in the treatment of insomnia can enhance clinical efficacy, reduce the TCMSS and the PSQI score, and effectively improve insomnia outcomes.