{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:53:44Z","timestamp":1785423224518,"version":"3.56.0"},"reference-count":54,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T00:00:00Z","timestamp":1738800000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82274631"],"award-info":[{"award-number":["82274631"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Jiangsu Committee of Science and Technology, China","award":["BE2021751"],"award-info":[{"award-number":["BE2021751"]}]},{"name":"Nanjing Traditional Chinese Medicine Young Talents Project, China","award":["ZYQ20049"],"award-info":[{"award-number":["ZYQ20049"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"\nObjective<\/jats:title>\nThis systematic review aimed to clarify if acupuncture is more effective for menopausal insomnia compared with sham acupuncture, standard care (sedative hypnotics and\/or MHT) or waitlist control.<\/jats:p>\n<\/jats:sec>\n\nMethods<\/jats:title>\nSeven literature databases were searched on April 30, 2024, to identify RCTs assessing the effectiveness of acupuncture. The methodological quality was assessed by the Cochrane Collaboration, and meta-analyses were conducted to calculate comparative effects using Rev Man software.<\/jats:p>\n<\/jats:sec>\n\nResults<\/jats:title>\n28 RCTs were analyzed. Six sham acupuncture-controlled RCTs were notable because of their high quality, and they showed that acupuncture significantly lowered PSQI scores, increased TST, sleep efficiency, and reduced WASO. The effect of acupuncture was maintained at a 4-week follow-up. Sixteen RCTs compared acupuncture with standard care, which showed acupuncture significantly reduced PSQI scores, KI scores, HAMD and HAMA scores. However, the subgroup analysis showed that there was no obviously difference between acupuncture and western medication in the treatment duration >8 weeks. Five RCTs assessed acupuncture combined with standard care and showed a favorable reduction in the PSQI score than standard care. One RCT showed that acupuncture significantly reduced PSQI and KI scores than a waitlist control. The GRADE assessment demonstrated that the level of evidence was very low to moderate, probably for the poor methodological quality and substantial heterogeneity among studies.<\/jats:p>\n<\/jats:sec>\n\nConclusion<\/jats:title>\nThe results showed that acupuncture may play a positive role in patients with menopausal insomnia.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0318562","type":"journal-article","created":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T18:54:40Z","timestamp":1738868080000},"page":"e0318562","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Acupuncture as an independent or adjuvant therapy to standard management for menopausal insomnia: A systematic review and meta-analysis"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3581-2343","authenticated-orcid":true,"given":"Xiaoni","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengyong","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shan","family":"Qin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaoming","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoqiu","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanyuan","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5893-8956","authenticated-orcid":true,"given":"Wenzhong","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,2,6]]},"reference":[{"issue":"286","key":"pone.0318562.ref001","first-page":"1","article-title":"Sleep Duration and Quality Among Women Aged 40\u201359 by Menopausal Status.","volume":"9","author":"V. Anjel","year":"2017","journal-title":"NCHS Data Brief."},{"key":"pone.0318562.ref002","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.maturitas.2020.06.010","article-title":"Insomnia symptoms in relation to menopause among middle-aged Chinese women: Findings from a longitudinal cohort study.","volume":"141","author":"Min Luoa","year":"2020","journal-title":"Maturitas."},{"key":"pone.0318562.ref003","first-page":"1","article-title":"Hot flashes, insomnia, and the reproductive stages: a cross-sectional observation of women from the EPISONO study.","volume":"6","author":"H Helena","year":"2021","journal-title":"J Clin Sleep Med"},{"key":"pone.0318562.ref004","doi-asserted-by":"crossref","first-page":"73","DOI":"10.2147\/NSS.S125807","article-title":"Sleep problems during the menopausal transition: Prevalence, impact, and management challenges.","volume":"10","author":"FC Baker","year":"2018","journal-title":"Nat. Sci. Sleep"},{"key":"pone.0318562.ref005","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.maturitas.2017.11.005","article-title":"Variation in symptoms of depression and anxiety in midlife women by menopausal status.","volume":"108","author":"S Mulhall","year":"2018","journal-title":"Maturitas."},{"issue":"2","key":"pone.0318562.ref006","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1089\/jwh.2014.4798","article-title":"Symptoms of depressed mood, disturbed sleep, and sexual problems in midlife women: cross-sectional data from the study of Women\u2019s Health Across the Nation.","volume":"24","author":"BA Prairie","year":"2015","journal-title":"J Women Health"},{"key":"pone.0318562.ref007","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.sleep.2015.10.001","article-title":"Autonomic dysfunction in primary sleep disorders.","volume":"19","author":"MG Miglis","year":"2016","journal-title":"Sleep Med"},{"issue":"10","key":"pone.0318562.ref008","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1007\/s11886-023-01939-x","article-title":"Insomnia and Cardiovascular Health: Exploring the Link Between Sleep Disorders and Cardiac Arrhythmias.","volume":"25","author":"B Parjanya","year":"2023","journal-title":"Curr Cardiol Rep."},{"key":"pone.0318562.ref009","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.ijpsycho.2021.02.019","article-title":"Physiological responses to acute psychosocial stress in women with menopausal insomnia.","volume":"164","author":"D Yuksel","year":"2021","journal-title":"Int J Psychophysiol"},{"issue":"3","key":"pone.0318562.ref010","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1080\/13697137.2023.2173569","article-title":"Optimizing sleep across the menopausal transition.","volume":"26","author":"FC Baker","year":"2023","journal-title":"Climacteric"},{"issue":"6","key":"pone.0318562.ref011","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1080\/13697137.2020.1799973","article-title":"Campana Insomnia and menopause: a narrative review on mechanisms and treatments.","volume":"23","author":"P Proserpio","year":"2020","journal-title":"Climacteric"},{"issue":"4","key":"pone.0318562.ref012","doi-asserted-by":"crossref","first-page":"1629","DOI":"10.3390\/jcm12041629","article-title":"Long-Term Use of Insomnia Medications: An Appraisal of the Current Clinical and Scientific Evidence.","volume":"12","author":"CZ Phyllis","year":"2023","journal-title":"J Clin Med."},{"issue":"4","key":"pone.0318562.ref013","doi-asserted-by":"crossref","first-page":"825","DOI":"10.5665\/sleep.5636","article-title":"Prevalence and predictors of prescription sleep aid use among individuals with DSM-5 insomnia: the role of hyperarousal.","volume":"39","author":"V Pillai","year":"2016","journal-title":"Sleep."},{"key":"pone.0318562.ref014","article-title":"Comparative Utility of Acupuncture and Western Medication in the Management of Perimenopausal Insomnia: A Systematic Review and Meta-Analysis.","author":"FY Zhao","year":"2021","journal-title":"Evidence-Based Complementary and Alternative Medicine."},{"key":"pone.0318562.ref015","first-page":"846","article-title":"Systematic evaluation of the efficacy and safety of acupuncture and western medication in the treatment of perimenopausal insomnia","volume":"04","author":"YJ Peng","year":"2021","journal-title":"Journal of guang zhou university of traditional Chinese medicine"},{"key":"pone.0318562.ref016","first-page":"181","article-title":"Meta analysis of acupuncture treatment of perimenopausal insomnia.","volume":"24","author":"WX Zhou","year":"2020","journal-title":"Technology Wind"},{"issue":"4","key":"pone.0318562.ref017","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1016\/j.fertnstert.2012.01.128","article-title":"Executive summary of the Stages of Reproductive Aging Workshop +10: addressing the unfinished agenda of staging reproductive aging","volume":"97","author":"SD Harlow","year":"2012","journal-title":"Fertil Steril"},{"key":"pone.0318562.ref018","volume-title":"Obstetrics and Gynecology.","author":"Le Jie","year":"1998"},{"key":"pone.0318562.ref019","doi-asserted-by":"crossref","DOI":"10.1176\/appi.books.9780890425596","volume-title":"Diagnostic and statistical manual of mental disorders.","author":"American Psychiatric Association.","year":"2013","edition":"5"},{"key":"pone.0318562.ref020","volume-title":"Chinese classification of mental disorders.","author":"Chinese Society of Psychiatry","year":"2001","edition":"3"},{"key":"pone.0318562.ref021","volume-title":"International classification of sleep disorders: diagnostic and coding manual.","author":"American Academy of Sleep Medicine","year":"2014","edition":"3"},{"key":"pone.0318562.ref022","volume-title":"International classification of sleep disorders: diagnostic and coding manual","author":"American Academy of Sleep Medicine","year":"2005"},{"issue":"11","key":"pone.0318562.ref023","article-title":"Acupuncture Improves Peri-menopausal Insomnia: A Randomized Controlled Trial.","volume":"40","author":"C Fu","year":"2017","journal-title":"Sleep"},{"key":"pone.0318562.ref024","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.2147\/NSS.S282315","article-title":"Electroacupuncture versus Sham Acupuncture for Perimenopausal Insomnia: A Randomized Controlled Clinical Trial.","volume":"12","author":"SH Li","year":"2020","journal-title":"Nature and science of sleep"},{"key":"pone.0318562.ref025","unstructured":"Yang WJ. To study the clinical efficacy and neuroendocrine mechanism of acupuncture in the treatment of perimenopausal insomnia from estrogen and its receptor. Master. Thesis, Shanghai University of Traditional Chinese medicine. 2017."},{"issue":"3","key":"pone.0318562.ref026","first-page":"69","article-title":"Effect of electro-acupuncture on sleep and life quality of perimenopausal insomnia patients with yin deficiency of liver and kidney","volume":"39","author":"XT Yu","year":"2022","journal-title":"Information on Traditional Chinese Medicine"},{"issue":"10","key":"pone.0318562.ref027","first-page":"1","article-title":"Acupuncture with the Method of \"Tonifying the Kidney and Calming the Mind\" for perimenopausal insomnia of Kidney Yin Deficiency Type: A Randomized Controlled Trial.","volume":"03","author":"WJ Yang","year":"2023","journal-title":"Chinese Acupuncture and Moxibustion."},{"issue":"5","key":"pone.0318562.ref028","doi-asserted-by":"crossref","first-page":"1120567","DOI":"10.3389\/fpubh.2023.1120567","article-title":"Acupuncture for comorbid depression and insomnia in perimenopause: A feasibility patient-assessor-blinded, randomized, and sham-controlled clinical trial.","volume":"11","author":"FY Zhao","year":"2023","journal-title":"Front. Public Health."},{"issue":"05","key":"pone.0318562.ref029","first-page":"40","article-title":"Clinical observation on the treatment of perimenopausal insomnia with acupuncture method of \"transferring the post and dredging the governor\".","volume":"43","author":"B Yan","year":"2021","journal-title":"Hubei Journal of traditional Chinese medicine"},{"key":"pone.0318562.ref030","unstructured":"Luo L. Rowling Clinical observation on acupuncture therapy of Tonifying the kidney and regulating the heart in the treatment of perimenopausal insomnia with heart kidney disharmony. Master. Thesis, Nanjing University of Traditional Chinese Medicine, 2020."},{"issue":"09","key":"pone.0318562.ref031","first-page":"152","article-title":"Clinical observation on acupuncture treatment of perimenopausal insomnia from liver theory","volume":"35","author":"W Zhang","year":"2017","journal-title":"Sichuan Traditional Chinese medicine"},{"key":"pone.0318562.ref032","unstructured":"Qin YY, Clinical study on acupuncture treatment of perimenopausal insomnia with liver hyperactivity and kidney deficiency syndrome based on the theory of treating insomnia from the liver. Master. Thesis, Chengdu University of traditional Chinese medicine. 2018."},{"key":"pone.0318562.ref033","unstructured":"Ma GG. Clinical Research on Menopausal insomnia Treatment with Jin three needle therapy. Master. Thesis, Guangzhou University of traditional Chinese medicine. 2014."},{"key":"pone.0318562.ref034","unstructured":"Kang H. Clinical observation of scalp cluster acupuncture in the treatment of perimenopausal insomnia with heart gallbladder Qi deficiency. Master. Thesis, Heilongjiang University of traditional Chinese medicine. 2015."},{"issue":"02","key":"pone.0318562.ref035","first-page":"4","article-title":"81 cases of perimenopausal insomnia treated with scalp acupuncture and body acupuncture","volume":"30","author":"JR Yang","year":"2017","journal-title":"Western journal of traditional Chinese medicine"},{"key":"pone.0318562.ref036","unstructured":"Lai XJ. The clinical study of using the Xu Fei Teng Ba needling Shen-Mai and Zhao-Hai point on time intreating the female climacteric insomnia (disharmony between the heart and kidney). Master. Thesis, Chengdu University of traditional Chinese medicine, 2016."},{"issue":"05","key":"pone.0318562.ref037","first-page":"469","article-title":"Clinical study on acupuncture at Wu Zang Shu plus Ge Shu, Shen men point in the treatment of female climacteric insomnia.","volume":"38","author":"OJ Li","year":"2018","journal-title":"Chinese Acupuncture & Moxibustion."},{"issue":"27","key":"pone.0318562.ref038","first-page":"082","article-title":"The Effect of Acupuncture Method of Tiao Ren and Tong Du on the Sleep Quality and Neuroendocrine Level of Patients with Perimenopausal Insomnia.","volume":"18","author":"Q. Guo","year":"2021","journal-title":"Medical Innovation of China."},{"issue":"9","key":"pone.0318562.ref039","first-page":"91","article-title":"Preliminary fNIRS Study of \u201cTonifying the Kidney and Tranquilizing the Mind\u201dAcupuncture in the Treatment of Perimenopausal Insomnia.","volume":"26","author":"N Dai Yin","year":"2024","journal-title":"Journal of Liaoning University of TCM"},{"issue":"3","key":"pone.0318562.ref040","first-page":"636","article-title":"Clinical Observation of JIN\u2019s Three-needle Therapy for the Treatment of Perimenopausal Insomnia of Incoordination Between Heart and Kidney Syndrome Type","volume":"40","author":"PQ Liao","year":"2023","journal-title":"Journal of Guangzhou University of Traditional Chinese Medicine"},{"issue":"3","key":"pone.0318562.ref041","first-page":"36","article-title":"The Effect of Acupuncture Method of Tongyuan on Perimenopausal Insomnia of Kidney Deficiency and Liver Depression Type.","volume":"39","author":"AP Liu","year":"2023","journal-title":"SHANXI J OF TCM Mar"},{"issue":"15","key":"pone.0318562.ref042","first-page":"127","article-title":"Acupuncture in the Treatment of Perimenopausal Insomnia","volume":"21","author":"M Zhao","year":"2023","journal-title":"Chinese Medicine Modern Distance Education of China"},{"issue":"11","key":"pone.0318562.ref043","first-page":"2255","article-title":"Clinical Observation on Jin\u2019s Three Needle Therapy for Perimenopausal Insomnia with Heart Kidney Disruption Type.","volume":"39","author":"ML Tong","year":"2023","journal-title":"Journal of Practical Traditional Chinese Medicine"},{"issue":"4","key":"pone.0318562.ref044","first-page":"444","article-title":"Observation on the curative effect of acupuncture at Lv\u2032s pair acupoints on perimenopausal insomnia","volume":"25","author":"B Zhang","year":"2024","journal-title":"Journal of Shanxi University of Traditional Chinese Medicine"},{"issue":"26","key":"pone.0318562.ref045","first-page":"2885","article-title":"Observation on the therapeutic effect of Tiao du an shen acupuncture on perimenopausal insomnia","volume":"25","author":"SP Zhu","year":"2016","journal-title":"Modern Journal of Integrated Traditional Chinese and Western Medicine"},{"issue":"01","key":"pone.0318562.ref046","first-page":"88","article-title":"Clinical observation of Pan long acupuncture in the treatment of perimenopausal insomnia.","volume":"34","author":"L Gao","year":"2014","journal-title":"Jilin traditional Chinese medicine."},{"issue":"02","key":"pone.0318562.ref047","first-page":"89","article-title":"Effect of acupuncture combined with western medication on climacteric insomnia and its effect on serum FSH and E2. Influence of water level","volume":"44","author":"WL Ma","year":"2016","journal-title":"Journal of traditional Chinese medicine"},{"issue":"6","key":"pone.0318562.ref048","first-page":"728","article-title":"Evaluation of the therapeutic effect of abdominal acupuncture combined with Tiaoshen Jieyu acupuncture in the treatment of patients with perimenopausal insomnia based on 5-HT, DA, NE, 5-HIAA and sleep quality","volume":"43","author":"YY Han","year":"2023","journal-title":"Jilin Journal of Chinese Medicine"},{"issue":"10","key":"pone.0318562.ref049","first-page":"1712","article-title":"Clinical effect of Jieyu Jianpi acupuncture combined with estazolam tablets on perimenopausal insomnia of liver spleen deficiency","volume":"45","author":"YC Xue","year":"2023","journal-title":"Hebei J TCM"},{"issue":"8","key":"pone.0318562.ref050","first-page":"900","article-title":"Evaluation of the clinical effect of the acupuncture method of transferring the post and dredging the governor on perimenopausal insomnia.","volume":"36","author":"WX Lin","year":"2017","journal-title":"Shanghai J Acu-mox."},{"issue":"11","key":"pone.0318562.ref051","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.1001\/jama.2016.11409","article-title":"Pragmatic trials: practical answers to \u201creal world\u201d questions.","volume":"316","author":"HC Sox","year":"2016","journal-title":"JAMA"},{"key":"pone.0318562.ref052","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1007\/978-1-0716-1566-9_9","article-title":"Meta-analysis of Pragmatic and Explanatory Trials.","volume":"2345","author":"M Lawrence","year":"2022","journal-title":"Methods Mol Biol"},{"issue":"1","key":"pone.0318562.ref053","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1111\/jebm.12589","article-title":"The impact of blinding on estimated treatment effects in randomized clinical trials on acupuncture: A meta-epidemiological study","volume":"17","author":"YL Long","year":"2024","journal-title":"J Evid Based Med"},{"key":"pone.0318562.ref054","doi-asserted-by":"crossref","first-page":"e070533","DOI":"10.1136\/bmj-2022-070533","article-title":"Increasing the usefulness of acupuncture guideline recommendations","volume":"376","author":"YQ Zhang","year":"2022","journal-title":"BMJ"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0318562","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,6]],"date-time":"2025-02-06T18:55:05Z","timestamp":1738868105000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0318562"}},"subtitle":[],"editor":[{"given":"Yuzhen","family":"Xu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,2,6]]},"references-count":54,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,2,6]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0318562","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,6]]}}}