Interaction between depression and insomnia under acupuncture treatment: a secondary analysis of a randomized controlled trial
Wang S, Gao J, Wu B, Wu Q, Wen X, Ning B, Liang X, Fu W · Zhongguo zhen jiu · 2024 June 12
DOI 10.13703/j.0255-2930.20230822-k0001
Objective
To investigate the interaction between emotional and insomnia symptom improvement in patients with comorbid depression and insomnia treated with optimized acupuncture.
Conclusions
The optimized acupuncture protocol primarily improves insomnia symptoms and subsequently improves depressive emotions, with greater efficacy than the conventional acupuncture protocol among patients with relatively mild depression and insomnia symptoms.
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Insights
Optimized acupuncture appears to improve depressive emotions chiefly by relieving insomnia, with its clearest advantage among patients with milder combined symptoms.
This secondary analysis used data from a multicentre randomized controlled trial involving adults with coexisting depression and insomnia. Participants received either conventional acupuncture or an optimized regimen that added further acupuncture points and alternating intradermal needling, with treatment delivered twice weekly for six weeks. Depression and sleep quality were assessed before and after treatment using established clinical rating scales. Mediation analysis examined whether sleep improvement explained emotional improvement and vice versa, while latent profile analysis identified symptom-based patient subgroups for comparative effectiveness analyses.
Improvements in sleep quality accounted for most of the optimized regimen’s effect on depressive emotions, whereas emotional improvement explained a substantially smaller part of the sleep benefit. The optimized approach showed superior outcomes over conventional acupuncture only among participants with relatively mild depression and insomnia, suggesting that sleep-focused acupuncture components may be particularly beneficial early or in less severe combined illness.
