Current state and future prospects of acupuncture for insomnia: From central mechanisms to peripheral effects

Insomnia significantly impacts mental health and is linked to a range of other health issues, including cardiovascular diseases, depression and anxiety. Acupuncture, a traditional non-pharmacological intervention, enhances sleep quality by modulating neural circuits and neurotransmitter systems within the brain, particularly in regions such as the hypothalamus, brainstem, and limbic system. It can regulate circadian rhythms, facilitate the equilibrium of neurohormones and neurotransmitters, including melatonin, 5-hydroxytryptamine and γ-aminobutyric acid, and mitigate stress responses through the modulation of the hypothalamic-pituitary-adrenal axis. Acupuncture has demonstrated efficacy in alleviating insomnia symptoms with minimal adverse effects. This review highlights the need for a deeper understanding of how acupuncture modulates brain circuits, particularly in the context of personalized treatments and gender-specific responses. Such research offers valuable insights into the neurobiological mechanisms of acupuncture and supports the development of more targeted clinical strategies. Please cite this article as: Zhai SY, Yang SR, Zhang ZY, Zhou H. Current state and future prospects of acupuncture for insomnia: From central mechanisms to peripheral effects. J Integr Med. 2026; 24(4):481-492.