Systematic review and meta-analysis on the efficacy and safety of acupuncture for perimenopausal insomnia

Background Perimenopausal insomnia is a chronic physical and mental health disorder that plagues women. However, there are no systematic reviews or meta-analyses on the treatment of perimenopausal insomnia with acupuncture alone. Therefore, we conducted a meta-analysis to assess the efficacy and safety of acupuncture alone in improving perimenopausal insomnia. Methods This study searched for randomized controlled trials on acupuncture treatment for perimenopausal insomnia from seven major literature databases in both Chinese and English: Web of Science, PubMed, the Cochrane Library, Embase, China National Knowledge Infrastructure, VIP database, and Wan-fang database. The quality of the studies was assessed according to the Cochrane Handbook for Systematic Reviews of Interventions. Meta-analysis was conducted using Rev Man 5.4 software. Results The study comprised nine randomized controlled trials involving 968 people. The results showed that acupuncture was superior to the control group in improving the effective rate (OR: 3.30; 95% CI: 2.18–4.98; p 0.00001), PSQI score (MD: −3.26; 95% CI: −4.62– −1.90; p 0.00001), FSH (MD: −11.01; 95% CI: −15.39– −6.63; p 0.00001), KMI score ( p 0.05), 5-HT ( p 0.05), NE ( p 0.05), MENQOL score ( p 0.05), early-wake score ( p 0.05), sleep actigraphy monitoring ( p 0.05), and Traditional Chinese Medicine symptom scores ( p 0.05) in patients with menopausal insomnia. The two groups had no significant differences in regulating serum E2 (MD: 7.70; 95% CI: 2.20–13.19; p = 0.06) and LH levels (MD: −5.42; 95% CI: −9.46– −1.37; p = 0.009). Conclusion Acupuncture treatment is significantly effective for patients with perimenopausal insomnia. However, large-sample, multi-center, long-term follow-up trials should be conducted to obtain more reliable results. Considering the particularities of acupuncture treatment, actively constructing a real-world acupuncture clinical research paradigm will bring more authentic, rich, and practical research outcomes to clinical practitioners. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/view/CRD42024621267 , identifier CRD42024621267.