Abstract
Objectives The effectiveness of auricular acupuncture (AA) for insomnia is far from uniform. The aim of this overview was to summarize and critically evaluate the evidence from systematic reviews (SRs)/meta-analysis (MAs) and provide an overall verdict about the therapeutic value of AA for insomnia. Methods A search of relevant literature for SRs/MAs was performed on major medical databases. The methodological quality was assessed using the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2) and the evidence quality was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Results Seven SRs/MAs were deemed eligible for the present overview. According to the evaluation results of AMSTAR-2, the methodological quality of all included SRs/MAs was critically low. Consistent methodological deficiencies were item 2 (the lack of a protocol), item 4 (the lack of a specific search strategy), item 7 (the lack of a list of excluded studies), and item 15 (the lack of an assessment of publication bias). For GRADE, of the 17 outcomes, only 1 (5.9%) was rated of high-quality, 4 (23.5%) were rated of moderate-quality, and the remaining 12 (70.6%) were rated of low-or critically low-quality. Descriptive analysis of the outcomes reveals a positive effect of AA for insomnia. Conclusions AA may be beneficial for insomnia, but the evidence is plagued by important limitations, e.g., the poor quality of SRs/MAs and primary studies.
Highlights
Insomnia is a common disease caused by multiple environmental and psychological factors, which may lead to anxiety, depression, immune functioning, cardiovascular disease, and even suicide, seriously damaging the physical and mental health of patients [1]
auricular acupuncture (AA) may be beneficial for insomnia, but the evidence is plagued by important limitations, e.g., the poor quality of systematic reviews (SRs)/MAs and primary studies
Studies that involved the use of AA or AA plus conventional medication (CM) in the intervention group were included. e following treatments were used in the control group: CM, placebo, cognitive-behavioral therapy, pharmacotherapy, exercise therapy, or other nondrug therapies
Summary
Insomnia is a common disease caused by multiple environmental and psychological factors, which may lead to anxiety, depression, immune functioning, cardiovascular disease, and even suicide, seriously damaging the physical and mental health of patients [1]. Erefore, more researchers were beginning to notice insomnia [4]. The main treatments recommended for insomnia are cognitive-behavioral therapy, pharmacotherapy, and exercise therapy. In spite of the continuous progress in the pharmacotherapy of insomnia, the use of complementary and alternative therapies as a sole treatment or combined with pharmacotherapy is common. Among the complementary and alternative therapies, acupuncture has been regarded as a promising method to treat insomnia, and it has been recommended as a complementary treatment option for insomnia in the latest guidelines by the China Sleep Research Association [5]. Increasing evidence shows that auricular acupuncture (AA) can improve the sleep quality of insomnia. Erefore, this study hopes to evaluate the effectiveness of AA on insomnia and provide new evidence for clinical application Evidence quality has not been evaluated. erefore, this study hopes to evaluate the effectiveness of AA on insomnia and provide new evidence for clinical application
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