Choi, T.Y., Kim, J.I., Lim, H.J., & Lee, M.S. (2016). Acupuncture for managing cancer-related insomnia: A systematic review of randomized clinical trials. Integrative Cancer Therapies. Advance online publication.
STUDY PURPOSE: To evaluate the efficacy of acupuncture to relieve cancer-related insomnia
TYPE OF STUDY: Systematic review
PHASE OF CARE: Not specified or not applicable
Two trials compared acupuncture to sham acupuncture in patients with breast cancer: one trial showed positive effects as reported in a sleep diary, and one trial did not show that acupuncture was beneficial as measured by the Pittsburgh Sleep Quality Index (PSQI). Three trials compared acupuncture to sleeping medications: two trials showed improved sleep with acupuncture as measured by PSQI when compared to drugs, and one trial did not show a benefit. One trial that compared acupuncture to hormone therapy in patients with breast cancer showed improved sleep with acupuncture. Overall, the trials had a low risk of bias, except for participant and personnel blinding, because of the nature of acupuncture. Few adverse events were reported with acupuncture but included fatigue, pruritis, and nausea.
Mixed evidence about the effectiveness of acupuncture to relieve cancer-related insomnia compared to medications exists. In the current review, acupuncture may be superior to sham acupuncture, conventional drug therapy, and hormone therapy for the management of cancer-related insomnia. The level of evidence is low because of a limited number of trials and total sample size.
Acupuncture has been examined as an intervention to relieve cancer-related insomnia, and a small number of studies show mixed evidence about its effectiveness. Additional trials that report standard acupuncture methodology and use objective sleep outcome measures are needed before nurses can recommend acupuncture as an effective treatment to relieve insomnia.