ACUPUNCTURE therapies improved insomnia in patients with breast cancer, with combined mindfulness and acupressure ranking highest.
Acupuncture Therapies Ranked for Sleep Quality
Insomnia remains a common and clinically meaningful symptom among patients with breast cancer, prompting growing interest in nonpharmacologic strategies that may support sleep quality without adding substantial treatment burden. A systematic review and Bayesian network meta-analysis compared multiple acupuncture therapies and related interventions for insomnia in this population, drawing on randomized controlled trial evidence to rank both efficacy and safety.
The analysis included 18 randomized controlled trials comprising 1,399 participants. Investigators searched PubMed, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, China National Knowledge Infrastructure, Wanfang Database, and the Chinese Science and Technology Periodical Database from inception to January 25, 2025. Treatment effects were assessed using mean differences for continuous outcomes and relative risks for dichotomous outcomes, with 95% credible intervals.
Combined Mindfulness and Acupressure Led Efficacy
Several interventions significantly improved Pittsburgh Sleep Quality Index scores compared with control. These included auricular acupressure, mindfulness-based stress reduction, mindfulness-based stress reduction plus acupressure, acupressure alone, intradermal needle therapy, and auricular acupressure combined with wrist-ankle acupuncture.
The greatest improvement was seen with mindfulness-based stress reduction plus acupressure, with a mean difference of -5.04 compared with control. Intradermal needle therapy also improved sleep quality, although the effect was smaller, with a mean difference of -2.34. Based on surface under the cumulative ranking curve values, mindfulness-based stress reduction plus acupressure ranked as the most effective intervention among the options assessed.
Safety Findings Support Clinical Caution
Safety findings were broadly reassuring for most acupuncture therapies and related approaches. However, intradermal needle therapy was associated with a significantly higher incidence of adverse reactions compared with control, with a relative risk of 11.23. This distinction may be important when clinicians weigh sleep benefits against tolerability and patient preference.
Overall, mindfulness-based stress reduction plus acupressure, acupressure alone, auricular acupressure combined with wrist-ankle acupuncture, auricular acupressure alone, and mindfulness-based stress reduction alone improved sleep quality in patients with breast cancer and were considered relatively safe. The findings support further evaluation of acupuncture therapies as part of supportive cancer care, particularly for patients seeking nonpharmacologic approaches to insomnia management.
Reference
Wang Z et al. Comparative efficacy and safety of different acupuncture therapies for insomnia in breast cancer patients: A systematic review and Bayesian network meta-analysis. Complementary Therapies in Clinical Practice. 2026;63:102059.
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