Insomnia is the forgotten partner to many medical problems, not least chronic pain where interference with sleep is a common complaint. However, the relationship is complex: lack of sleep can exacerbate pain through increase in proinflammatory cytokine production. Acupuncture is observed clinically to improve sleeping in chronic pain patients, but reviews are unable firmly to recommend acupuncture for insomnia as many trials are methodologically inadequate, despite most being acupuncture positive. However, there is strong evidence for relief in several chronic pain problems and improvement in these is likely also to restore normal sleeping. So, as the safety profile of acupuncture is excellent, it seems reasonable to utilize acupuncture in a nonpharmacological approach to combating insomnia, despite lack of formal evidence.
Keywords: acupressure; acupuncture; chronic pain; insomnia; safety; serotonin; sleep disturbance.