Comparative Utility of Acupuncture and Western Medication in the Management of Perimenopausal Insomnia: A Systematic Review and Meta-Analysis

Fei-Yi Zhao; Qiang-Qiang Fu; Gerard A Kennedy; Russell Conduit; Wen-Zhong Wu; Wen-Jing Zhang; Zhen Zheng

doi:10.1155/2021/5566742

Comparative Utility of Acupuncture and Western Medication in the Management of Perimenopausal Insomnia: A Systematic Review and Meta-Analysis

Evid Based Complement Alternat Med. 2021 Apr 26:2021:5566742. doi: 10.1155/2021/5566742. eCollection 2021.

Authors

Fei-Yi Zhao^{1

2

3}, Qiang-Qiang Fu⁴, Gerard A Kennedy^{5

1

6}, Russell Conduit¹, Wen-Zhong Wu⁷, Wen-Jing Zhang², Zhen Zheng¹

Affiliations

¹ School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria 3083, Australia.
² Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China.
³ Department of Nursing, School of International Medical Technology, Shanghai Sanda University, Shanghai 201209, China.
⁴ Yangpu Hospital, Tongji University School of Medicine, Shanghai, China.
⁵ School of Science, Psychology and Sport, Federation University, Mount Helen, Victoria, Australia.
⁶ Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria 3084, Australia.
⁷ Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China.

Abstract

Background: Many women with perimenopausal insomnia (PMI) have sought alternative therapies such as acupuncture because of concerns about risks associated with hormone replacement therapy (HRT) and/or psychotropic drugs. This systematic review aimed to clarify if acupuncture alone or combined with standard Western pharmacotherapy (HRT and/or psychotropic drugs) is more effective in ameliorating PMI in comparison to pharmacotherapy alone.

Methods: Randomized controlled trials (RCTs) of PMI treatment via acupuncture alone or combined with Western pharmacotherapy versus Western pharmacotherapy were searched for from eleven databases from inception to March 2020. Cochrane criteria were followed.

Results: Fifteen studies involving 1410 women were analyzed. Meta-analysis indicated that acupuncture significantly reduced the global scores of Pittsburgh Sleep Quality Index (PSQI) [MD = -2.38, 95% CI (-3.38, -1.37), p < 0.01] and Kupperman Index [MD = -5.95, 95% CI (-10.68, -1.21), p = 0.01], compared with hypnotics. Acupuncture combined with hypnotics was more effective than hypnotics alone in decreasing PSQI scores [MD = -3.13, 95% CI (-5.43, -0.83), p < 0.01]. Too few RCTs were available to investigate the clinical efficacy differences between acupuncture and HRT/psychotropic drugs other than hypnotics.

Conclusions: Despite limited evidence, in comparison to hypnotics, acupuncture was associated with significant improvements in PMI, and reductions of other menopausal symptoms. This finding suggests that acupuncture may be a useful addition to treatment for PMI.

Publication types

Review