Advances in Clinical Research on Acupuncture for Chronic Insomnia

Abstract

This review summarizes advances in acupuncture for chronic insomnia from 2020 to 2026. Evidence indicates acupuncture improves sleep quality (e.g., PSQI scores) with fewer adverse events than pharmacotherapy, characterized by a notable “3-week threshold effect.” Randomized controlled trials confirm its efficacy in shortening sleep onset latency and increasing slow-wave sleep, though long-term maintenance requires further study. Combination therapies (e.g., with CBT-I or moxibustion) and specialized techniques (electroacupuncture, “Ghost Point” acupuncture) show synergistic benefits. Mechanistically, acupuncture targets hyperarousal via modulating the HPA axis, balancing neurotransmitters (e.g., GABA, serotonin), remodeling neural circuits, and potentially regulating the gut-brain axis. Future directions emphasize validating hybrid neuromodulation strategies, optimizing precision treatment based on objective phenotypes, and leveraging artificial intelligence for efficacy prediction to transition toward precision medicine.