[Auricular acupuncture for primary insomnia: a systematic review based on GRADE system]

Area of Science:

• Integrative Medicine
• Sleep Medicine
• Acupuncture Research

Background:

• Primary insomnia is a prevalent sleep disorder affecting millions globally.
• Current treatment options for insomnia have limitations and potential side effects.
• Auricular acupuncture (AA) is a non-pharmacological therapy with potential benefits for sleep.

Purpose of the Study:

• To evaluate the clinical efficacy and safety of auricular acupuncture (AA) for treating primary insomnia.
• To synthesize evidence from randomized controlled trials (RCTs) on AA for primary insomnia.

Main Methods:

• A meta-analysis was conducted on eligible randomized controlled trials (RCTs) retrieved from domestic and international databases.
• Revman 5.2 software was used for the meta-analysis, and GRADE profiler 3.6 assessed evidence quality.
• Eight articles involving 894 patients were included in the analysis.

Main Results:

• Auricular acupuncture significantly improved the Pittsburgh Sleep Quality Index (PSQI), sleep latency, and reduced sleep awakening times compared to sham AA, placebo, or blank controls.
• AA also showed significant improvements in PSQI compared to Western medication.
• Evidence quality was moderate for AA versus sham/placebo/blank controls, but extremely low for other comparisons. No adverse events were reported.

Conclusions:

• Auricular acupuncture effectively improves sleep quality in patients with primary insomnia.
• The current evidence base has limitations due to low quality, necessitating a cautious approach.
• High-quality, large-sample clinical trials are required to confirm these findings and establish AA's role in insomnia treatment.