Effectiveness of acupuncture and related therapies for post-stroke insomnia: A systematic review and Bayesian network...

Poststroke insomnia is often associated with poor recovery. Acupuncture (Acu) and related therapies offer have notable advantages as effective and safe treatment for poststroke insomnia. This systematic review evaluated the therapeutic effect of various Acu interventions on poststroke insomnia.

Two researchers independently screened literature and extracted data from 8 databases for randomized controlled trials of Acu and related therapies for poststroke insomnia. The risk of bias was assessed using the "bias risk assessment tool" recommended by the Cochrane Library. R version 4.4.1 and Stata 18.0 were used to conduct a network meta-analysis of relevant outcomes.

A total of 107 articles were included, involving 8062 patients and 14 Acu related therapies. Network meta-analysis revealed that in terms of Pittsburgh Sleep Quality Index total score, Acu related therapies were superior to western medicine and conventional rehabilitation therapy. The combined therapy, Acu + auriculotherapy + electroacupuncture had the best outcomes. Acu alone, Acu + auriculotherapy + point embedding and Acu + western medicine had better effects on prolonging sleep duration and shortening sleep latency. For subjective sleep quality, point embedding achieved the best outcomes. Warm acupuncture demonstrated the best results in improving daily functional dysfunction, while Acu ranked the as the best in reducing the degree of sleep disorder.

Acu and related therapies have a positive effect in ameliorating poststroke insomnia, with the combined therapy having a more significant effect. However, different Acu regimens should be considered for poststroke insomnia patients with different clinical manifestations. More standardized clinical trials are needed to provide higher quality evidence and optimal treatment regimen.