Acupuncture:

Insomnia

Insomnia, characterized by difficulty initiating or maintaining sleep, early morning awakenings, or poor sleep quality, affects approximately 25-30% of adults, with 6-10% meeting diagnostic criteria for insomnia disorder. This section synthesizes evidence on acupuncture’s effectiveness for insomnia, including primary, chronic pain-related, and senile insomnia, including a focus on complementary and alternative medicine (CAM) approaches and synergistic nutraceutical strategies.

 

See: Acupuncture Introduction

 

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Definitions and Terms Related to Pain

 

Acupuncture for Insomnia

Introduction

 Primary insomnia is linked to stress or emotional factors, while secondary insomnia often accompanies conditions like chronic pain, depression, or cardiovascular disease. Chronic insomnia, persisting for at least three months, contributes to worsening pain, fatigue, cognitive impairment and mood instability.

For patients with chronic pain, insomnia exacerbates pain perception and reduces quality of life, Acupuncture is presented here as a safe, non-pharmacological intervention to address insomnia, offering potential benefits over conventional treatments like benzodiazepines, which carry risks of dependence and adverse effects.

This section synthesizes evidence on acupuncture’s effectiveness for insomnia, including primary, chronic pain-related, and senile insomnia, including a focus on complementary and alternative medicine (CAM) approaches and synergistic nutraceutical strategies.

Source materials for this review integrates findings from five recent high-quality systematic review publications, supplemented by additional evidence from randomized controlled trials (RCTs).

Acupuncture for Insomnia

Acupuncture, a cornerstone of traditional Chinese medicine, involves stimulating specific acupoints to modulate neurochemical pathways, including serotonin, dopamine, and gamma-aminobutyric acid (GABA). It shows promise for insomnia across various populations, with evidence suggesting improvements in subjective sleep quality and, to a lesser extent, objective sleep parameters.

General and Chronic Insomnia

Acupuncture, including manual and electroacupuncture, improves subjective sleep quality in patients with chronic insomnia disorder (CID), as evidenced by comparison to sham acupuncture studies. Manual acupuncture and electroacupuncture improve sleep efficiency and reduce waking after sleep onset, although benefits for total sleep time are inconsistent.

Intradermal acupuncture, involving prolonged needle retention, also improves sleep compared to sham acupuncture or conventional medications, a technique that is less invasive compared with sustained stimulation. Optimal dosing involves at least three sessions per week for 3-4 weeks, totaling 12-20 sessions, with no additional benefit from extending beyond four weeks.

 

Insomnia in Chronic Pain

Insomnia frequently coexists with chronic pain, amplifying pain perception and reducing treatment effectiveness. Acupuncture addresses this comorbidity by modulating pain-related neural pathways while improving sleep quality. For patients with chronic pain-related insomnia, acupuncture is more effective than sham acupuncture or single-drug therapy, particularly when combined with medications like benzodiazepines. The synergistic effect of acupuncture with analgesia may enhance sleep duration and quality, making it a valuable adjunct. Acupoints are frequently used to address both pain and sleep disturbances, leveraging their anti-inflammatory and neuroregulatory effects.

 

Senile Insomnia

In older adults, insomnia is prevalent due to age-related central nervous system degeneration, with 50% of elderly patients reporting sleep difficulties. Acupuncture is particularly effective for senile insomnia,  improving sleep duration and reducing anxiety. In addition to its effectiveness, acupuncture offers. the elderly a safer alternative to pharmacological treatments which risk side effects such as increase likelihood of falling as well as medication tolerance and dependence.

 

Alternative Treatments (CAM)

Beyond acupuncture, complementary and alternative medical treatments (CAM) approaches provide benefits for insomnia and also offer synergistic benefits when accompanying acupuncture.

Yoga and tai chi, as mind-body practices, improve sleep quality, particularly in older adults, by reducing stress and modulating autonomic nervous system activity. The practice of yoga has been shown to reduces the need for sleep medications. Tai chi also. enhances sleep duration and sleep quality, even compared to other low-impact exercises.

Herbal medicines and nutraceuticals, such as valerian, kava, and L-tryptophan are commonly used effectively, but research provides yield mixed results as to their effectiveness (see CAM options for insomnia). Valerian, for example, shows inconsistent effectiveness and a recent review of some studies reporting no benefit over placebo. L-tryptophan may improve sleep latency (time required to fall asleep) and sleep duration in mild insomnia cases.

CAM alternatives potentially may complement acupuncture in a multimodal approach as encouraged  at Accurate Clinic.

 

Comparisons with Standard Treatments

Standard treatments for insomnia include pharmacological options (e.g., benzodiazepines, non-benzodiazepine hypnotics, melatonin agonists) and cognitive behavioral therapy for insomnia (CBT-I). Pharmacological treatments offer short-term relief but risk dependence, drowsiness, and cognitive impairment, particularly in older adults. CBT-I, the first-line treatment for chronic insomnia, is effective but limited by access to trained therapists and high costs.

Acupuncture outperforms sham acupuncture and matches or exceeds single-drug therapy for improving sleep with fewer adverse effects. When combined with medications, acupuncture enhances their effectiveness while allowing s medication dose reduction, particularly important for tapering off benzodiazepines. Compared to CBT-I, acupuncture is more accessible and cost-effective, making it a practical option at Accurate Clinic.

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Synergistic Approaches with Nutraceuticals and Phytonutrients

Nutraceuticals and phytonutrients offer synergistic benefits when combined with acupuncture, addressing underlying neurochemical and inflammatory pathways in insomnia. Below are key agents, their mechanisms, dosing recommendations, and safety considerations. Combining these compounds with acupuncture may enhance outcomes by addressing multiple pathways (e.g., serotonin synthesis, inflammation, GABA modulation). For a more extensive review, See: CAM supplement for sleep).

  • L-Tryptophan: An amino acid precursor to serotonin, L-tryptophan improves sleep latency and duration in mild insomnia. Dosing: 500-1000 mg 30 minutes before bedtime, preferably with a carbohydrate snack to enhance uptake. Safety: Generally well-tolerated, but high doses (>2 g) may cause nausea or serotonin syndrome when combined with SSRIs. Recommended form: L-tryptophan capsules.
  • Valerian: A herbal remedy with sedative properties, valerian shows mixed efficacy for insomnia. Dosing: 300-600 mg of standardized extract (0.8% valerenic acid) 30-60 minutes before bedtime. Safety: Minimal side effects, but long-term use lacks robust evidence. Avoid in patients with liver dysfunction. Recommended form: Valerian root extract capsules.
  • Kava: A herbal anxiolytic, kava may improve sleep quality but is withdrawn in some regions due to hepatotoxicity concerns. Dosing: 100-200 mg of kavalactones daily, under medical supervision. Safety: Monitor liver function; contraindicated in patients with liver disease. Recommended form: Standardized kava extract (pending regional availability). (recently banned in Louisiana.)
  • Magnesium: Enhances GABA activity and reduces neuromuscular excitability. Dosing: 200-400 mg of magnesium citrate or glycinate 1-2 hours before bedtime. Safety: Avoid in renal impairment; high doses may cause diarrhea. Recommended form: Magnesium citrate capsules.
  • Zinc: Modulates neurotransmitter activity and supports immune function, potentially improving sleep quality. Dosing: 15-30 mg of zinc picolinate daily with food. Safety: Long-term high doses (>40 mg) may disrupt copper balance. Recommended form: Zinc picolinate tablets.
  • Curcumin: A polyphenol with anti-inflammatory properties, curcumin may improve sleep by reducing cytokine-mediated sleep disturbances. Dosing: 500-1000 mg of curcumin (with 5-10 mg piperine for bioavailability) daily. Safety: Well-tolerated; avoid in patients on anticoagulants. Recommended form: Curcumin extract with piperine.
  • Quercetin: A flavonoid with antioxidant and anti-inflammatory effects, quercetin may support sleep by reducing neuroinflammation. Dosing: 500-1000 mg daily with food. Safety: Generally safe; may interact with certain medications (e.g., cyclosporine). Recommended form: Quercetin dihydrate capsules.
  • EGCG (Epigallocatechin Gallate): A green tea polyphenol, EGCG may enhance sleep through antioxidant and neuroprotective effects. Dosing: 100-200 mg daily, taken in the morning to avoid caffeine-related stimulation. Safety: Monitor for gastrointestinal upset; avoid with liver sensitivity. Recommended form: Decaffeinated green tea extract capsules.

Conclusion

Acupuncture offers a safe and effective option for managing insomnia, particularly for primary insomnia, chronic pain-related insomnia, and senile insomnia. It improves subjective sleep quality. Intradermal acupuncture and optimal dosing (3 sessions/week for 3-4 weeks, 12-20 sessions) may enhance outcomes when available, especially when combined with medications.

Compared to pharmacological treatments and cognitive behavior therapy, acupuncture provides a cost-effective, low-risk alternative to traditional medications and may have synergistic potential when paired with nutraceuticals like L-tryptophan, magnesium, and curcumin. Further high-quality RCTs are needed to confirm objective sleep improvements and long-term efficacy.

References

The primary sources include systematic reviews and meta-analyses on acupuncture for various insomnia subtypes: general insomnia (Verma et al., 2022), senile insomnia (Lu et al., 2024), chronic insomnia disorder (Yu et al., 2025), intradermal acupuncture (Jing & Feng, 2021), and dose-effect relationships (Zhang et al., 2025). These studies were selected for their rigorous methodology, including RCTs with Pittsburgh Sleep Quality Index (PSQI) or Insomnia Severity Index (ISI) outcomes.

Additional database evidence was drawn from peer-reviewed literature on CAM, nutraceuticals, and phytonutrients relevant to insomnia. The synthesis focuses on clinical efficacy, safety and integrative approaches as part of Accurate Clinic’s pain management program.

  1. Verma K, Singh D, Srivastava A. The impact of complementary and alternative medicine on insomnia: a systematic review. Cureus. 2022;14(8):e28425. doi:10.7759/cureus.28425
  2. Lu G, Chen F, Guo C, Wu J. Acupuncture for senile insomnia: a systematic review of acupoint selection patterns. Arch Gerontol Geriatr. 2024;127:105586. doi:10.1016/j.archger.2024.105586
  3. Yu Y, Li X, Zhu Z, et al. Acupuncture for chronic insomnia disorder: a systematic review with meta-analysis and trial sequential analysis. Front Neurol. 2025;16:1541276. doi:10.3389/fneur.2025.1541276
  4. Jing R, Feng K. Efficacy of intradermal acupuncture for insomnia: a meta-analysis. Sleep Med. 2021;85:66-74. doi:10.1016/j.sleep.2021.06.034
  5. Zhang X, Wang Y, Liu C, et al. The dose-effect relationship between acupuncture and its effect on primary insomnia: a systematic review and meta-analysis. Front Psychiatry. 2025;16:1501321. doi:10.3389/fpsyt.2025.1501321
  6. The Efficacy of Tiaoshen Acupuncture in Traditional Chinese Medicine for Insomnia Treatment- A Systematic Review and Meta-analysis
  7. The Impact of Complementary and Alternative Medicine on Insomnia- A Systematic Review – 2022
  8. A systematic review and meta-analysis of acupuncture combined with Tuina in the treatment of insomnia – 2022
  9. Acupuncture for chronic insomnia disorder- a systematic review with meta-analysis and trial sequential analysi – 2025
  10. Efficacy of intradermal acupuncture for insomnia- a meta-analysis – 2021
  11. Acupuncture for senile insomnia- A systematic review of acupuncture point – 2024

Yeah, yeahEmphasis on Education

 

Accurate Clinic promotes patient education as the foundation of it’s medical care. In Dr. Ehlenberger’s integrative approach to patient care, including conventional and complementary and alternative medical (CAM) treatments, he may encourage or provide advice about the use of supplements. However, the specifics of choice of supplement, dosing and duration of treatment should be individualized through discussion with Dr. Ehlenberger. The following information and reference articles are presented to provide the reader with some of the latest research to facilitate evidence-based, informed decisions regarding the use of conventional as well as CAM treatments.

 

For medical-legal reasons, access to these links is limited to patients enrolled in an Accurate Clinic medical program.

 

Should you wish more information regarding any of the subjects listed – or not listed –  here, please contact Dr. Ehlenberger. He has literally thousands of published articles to share on hundreds of topics associated with pain management, weight loss, nutrition, addiction recovery and emergency medicine. It would take years for you to read them, as it did him.

 

For more information, please contact Accurate Clinic.

 

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