What type of study is this?

This is a Systematic Review study (also classified as: Meta-Analysis, RCT).

September 10, 2025Open Access

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

Key Points

Acupuncture significantly improves multiple symptoms of perimenopausal insomnia, leading to enhanced overall sleep quality.
The meta-analysis included nine randomized controlled trials with a total of 968 participants, showcasing positive outcomes with acupuncture.
Quality assessment followed the Cochrane Handbook for Systematic Reviews, ensuring reliability in findings across diverse studies.
Further research is needed to validate findings, especially through large-scale, long-term trials in real-world acupuncture settings.

Abstract

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.

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