{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:30:26Z","timestamp":1787772626782,"version":"build-2784847793"},"reference-count":63,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurosci."],"abstract":"<jats:p>Acupuncture-related peripheral stimulation is often discussed as a non-pharmacological option for insomnia disorder, but its relevance to sleep neuroscience depends on more than improvement in sleep questionnaires. This critical narrative Review evaluates whether acupuncture and related acupoint-based stimulation methods can serve as testable peripheral models of sleep\u2013wake and hyperarousal circuitry. Across clinical studies, the most consistent signal is improvement in subjective sleep quality and insomnia severity in selected populations. Evidence for objective sleep architecture, multiday sleep\u2013wake stability, relapse prevention, and biomarker-mediated clinical response remains less secure. Human neuroimaging studies provide emerging but still associative evidence involving locus coeruleus, hypothalamic, insular, limbic\u2013prefrontal, and thalamocortical networks. Electrophysiological, autonomic, endocrine, neurochemical, and microbiota\u2013gut\u2013brain findings are biologically plausible, but their proximity to human chronic insomnia disorder varies substantially. Safety is generally favorable when appropriately delivered, although adverse-event reporting remains inconsistent and comparative cost-effectiveness against CBT-I or pharmacotherapy is unestablished. We propose that acupuncture-related stimulation should currently be evaluated as an adjunctive, preference-sensitive, and mechanistically testable approach rather than as a replacement for cognitive behavioral therapy for insomnia. Its translational credibility will depend on credible comparators, objective sleep physiology, expectancy assessment, and prespecified mediation analyses.<\/jats:p>","DOI":"10.3389\/fnins.2026.1884710","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:06:35Z","timestamp":1787771195000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Acupuncture-related peripheral stimulation as a candidate neuromodulatory model of insomnia: clinical evidence, sleep-wake circuitry, and translational limits"],"prefix":"10.3389","volume":"20","author":[{"given":"He","family":"Ming","sequence":"first","affiliation":[{"name":"Key Laboratory of Acupuncture-Moxibustion and Tuina Intelligent Equipment of Chongqing Administration of Traditional Chinese Medicine, Chongqing Three Gorges Medical College","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Yuan","sequence":"additional","affiliation":[{"name":"Shaanxi Provincial Hospital of Traditional Chinese Medicine, Xi'an","place":["Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiao","family":"Liang","sequence":"additional","affiliation":[{"name":"Key Laboratory of Acupuncture-Moxibustion and Tuina Intelligent Equipment of Chongqing Administration of Traditional Chinese Medicine, Chongqing Three Gorges Medical College","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Penglong","family":"Yu","sequence":"additional","affiliation":[{"name":"Key Laboratory of Acupuncture-Moxibustion and Tuina Intelligent Equipment of Chongqing Administration of Traditional Chinese Medicine, Chongqing Three Gorges Medical College","place":["Chongqing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e045961","DOI":"10.1136\/bmjopen-2020-045961","article-title":"Acupuncture-related adverse events: systematic review and meta-analyses of prospective clinical studies","volume":"11","author":"B\u00e4umler","year":"2021","journal-title":"BMJ Open"},{"key":"B2","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1007\/s00441-017-2649-1","article-title":"Locus coeruleus","volume":"373","author":"Benarroch","year":"2018","journal-title":"Cell Tissue Res"},{"key":"B3","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1016\/S1087-0792(97)90012-5","article-title":"Hyperarousal and insomnia","volume":"1","author":"Bonnet","year":"1997","journal-title":"Sleep Med. 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