Placebo effect of acupuncture on insomnia: a systematic review and meta-analysis
Liu C, Xi H, Wu W, Wang X, Qin S, Zhao Y, Zheng S, Wan Q, Xu L. · Annals of Palliative Medicine · 2020 January
DOI 10.21037/apm.2019.11.15
Objective
To clarify whether acupuncture treatment of insomnia is only due to its placebo effect, a systematic review and a meta-analysis were designed based on the comparison between acupuncture and sham acupuncture.
Conclusions
Compared to the sham groups, acupuncture significantly decreased the Pittsburgh Sleep Quality Index (PSQI) score. In addition, a significant difference was detected in the change of Insomnia Severity Index (ISI) scores between acupuncture and sham acupuncture. The authors concluded that acupuncture treatment of insomnia is efficacious, not because of its placebo effect.
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Insights
Acupuncture treatment of insomnia is efficacious, not because of its placebo effect.
Acupuncture is a common alternative therapy for clinical treatment of insomnia. As the underlying mechanism is yet unclear, its efficacy is often considered as placebo effect. To clarify whether acupuncture treatment of insomnia is only due to its placebo effect, a systematic review and a meta-analysis were designed based on the comparison between acupuncture and sham acupuncture.
Compared to the sham groups, acupuncture significantly decreased the PSQI score (P<0.0001). A subgroup analysis showed that the selection of sham acupuncture methods did not affect the results of PSQI. A subgroup of two trials with a total of 141 participants with major depressive disorder did not show any significant reductions in total PSQI scores (P=0.11). In addition, a significant difference was detected in the change of Insomnia Severity Index (ISI) scores (362 adult patients, 4 trials) between acupuncture and sham acupuncture (P<0.0001). The PSG and actigraphy data from acupuncture and the sham did not reveal any significant differences in the sleep structure changes.
For the selection of sham acupuncture, both methods performed similarly in a clinical setting. Moreover, insomnia patients with major depression disorder were not recommended to use only acupuncture treatment.
