To systematically evaluate the clinical efficacy of acupuncture in the treatment of menopausal insomnia.

Databases including PubMed, EMbase, The Cochrane Library , CBM, Web of Science, CNKI, WanFang Data and VIP were searched to collect randomized controlled trials (RCTs) about acupuncture for insomnia in menopause from inception to December 2019. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then meta analysis was performed with RevMan 5.3 software.

A total of 10 RCTs studies involving 708 patients were included. The results of meta-analysis showed that: Compared with the blank control group, the acupuncture group significantly reduced the total pittsburgh sleep quality index(PSQI) score [MD=-3.36, 95% CI (-4.50, -2.22), P=0.000 01], serum follicle stimulating hormone levels, and the Kuppermen score, and the difference was not statistically significant in serum E2 levels. Compared with the placebo group, the acupuncture group significantly reduced the PSQI total score [MD=-3.98, 95% CI(-6.35, -1.61), P=0.001]and insomnia severity index score. In terms of adverse reactions, only one study reported that insomnia had worsened into an adverse event, and the rest did not clearly indicate the occurrence of adverse reactions.

There is currently limited evidence showing that acupuncture has significant clinical effect on menopausal insomnia, which can improve menopausal sleep quality and related symptoms.