Acupuncture to Reduce Sleep Disturbances in Perimenopausal and Postmenopausal Women A Systematic Review and Meta-analysis

OBJECTIVE: To examine the association of acupuncture with sleep disturbances and serum sex hormone levels in perimenopausal and postmenopausal women and whether there are associated changes in sex hormone levels. DATA SOURCES: We systematically searched electronic databases (EMBASE, PubMed, PsycINFO, CINAHL, [GRAPHICS] , Wanfang Data Chinese Database, and China Knowledge Resource Integrated Database) and the reference lists of the identified studies. METHODS OF STUDY SELECTION: Randomized controlled trials that examined the effects of acupuncture on sleep disturbances in perimenopausal and postmenopausal women were included. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement was followed. TABULATION, INTEGRATION, AND RESULTS: We identified 31 randomized controlled trials with 34 effect sizes involving a total of 2,433 participants. Acupuncture is associated with a significant reduction in the likelihood of sleep disturbances (odds ratio [OR] 0.21, 95% confidence interval [CI] 0.14-0.31), a significant increase in the secretion of serum estradiol (pooled difference in means 7.56 pg/mL, 95% CI 4.03-11.08), and reduction in the secretion of serum follicle-stimulating hormone (-6.75 milli-international units/mL, 95% CI -12.16 to -1.34) and luteinizing hormone (-2.71 milli-international units/mL, 95% CI -4.22 to -1.20). Studies with a large effect size of acupuncture-associated changes in serum estradiol had a significantly lower odds of sleep disturbances than did those with a small-to-moderate effect sizes (ORs 0.07 and 0.36, P=.02). CONCLUSION: Acupuncture is associated with a significant reduction in sleep disturbances in women experiencing menopause-related sleep disturbances. Our findings suggest that acupuncture should be adopted as part of a multimodal approach for improving sleep disturbances in perimenopausal and postmenopausal women.