Aim To observe the impact of acupoint massage nursing combined with acupuncture on anxiety, depression, and sleep structure in patients with refractory insomnia. Method This was a retrospective study. A total of 120 patients with refractory insomnia, enrolled from January 2023 to October 2025, were randomly assigned to two groups. The control group received acupoint massage care, while the observation group received acupuncture treatment combined with acupoint massage. Results The observation group showed significantly greater improvements across multiple outcome measures compared to the control group (all p < .05). Postintervention scores for Hamilton Anxiety Scale, Fatigue Scale-14, Hamilton Depression Scale, and Pittsburgh Sleep Quality Index were lower in both groups, with the observation group achieving greater reductions. Similarly, favorable increases in heart rate variability indices (triangular index, standard deviation of average RR intervals, standard deviation of RR intervals, root mean square of successive differences) and serum levels of 5-hydroxyptamine 1A and melatonin were more pronounced in the observation group. In contrast, the low frequency/high frequency ratio and serum levels of 5-hydroxyptamine 2A and excitatory amino acids decreased more substantially in the observation group. Sleep architecture also improved to a greater extent in the observation group, evidenced by larger increases in total sleep time, sleep efficiency, rapid eye movement percent, and N3%, alongside greater decreases in sleep latency and wake after sleep onset. Conclusion The combination of acupoint massage nursing and acupuncture treatment for refractory insomnia can alleviate anxiety and depression and improve sleep architecture, and its mechanism may be related to the regulation of autonomic nervous function and neurotransmitter levels.
Li et al. (Thu,) studied this question.