Sleep is essential for overall health and normal daily functioning, but rest doesn’t come naturally to everyone. According to the Centers for Disease Control and Prevention¹ (CDC), adults should get at least seven hours of quality sleep every night. Unfortunately, more than 30% of adults² in the United States sleep less than the recommended seven hours.
There are many possible reasons why a person may experience temporary or persistent sleeping problems, and insomnia is a prevalent problem that affects about one-third of adults. People with insomnia may have difficulties falling asleep, staying asleep, or feeling rested (even when they’ve slept).
Acupuncture is widely used in traditional Chinese medicine to treat a variety of ailments — from infertility to chemotherapy-induced nausea and migraines, and many things in between, including insomnia. Is there solid evidence that acupuncture can improve sleep?
This article delves into the scientific literature to assess the value of acupuncture as a therapy for people struggling with insomnia.
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Insomnia is a sleep disorder that may be acute (for a short while or now and then) or chronic (long-term and persistent). According to the American Academy of Sleep Medicine,³ a person has insomnia when they’re experiencing one or more of the following sleep-related issues:
Difficulty falling asleep
Waking often throughout the night (or day for people who work night shifts)
Waking too early and not being able to fall back to sleep
Waking up feeling unrested
Various factors contribute to sleeplessness, and they’re classified into seven distinct groups:
Short-term insomnia may develop in response to environmental stress, such as job dissatisfaction, family problems, financial stress, and so on. This type of insomnia typically lasts a few days or weeks. It affects women more often than men and is more common in older adults.
Sometimes, the cause of insomnia is clear. People with poor sleep habits — those who take too many naps during the day or have an irregular sleep schedule — are more likely to struggle with short- or long-term insomnia.
People who use (legal or illegal) drugs or substances, including caffeine, may have difficulty sleeping. In addition, certain medical conditions, including depression and complications linked to poorly-managed diabetes, can also prevent you from getting a good night’s sleep.
If insomnia is triggered by a medical condition, such as asthma, gastroesophageal reflux (GERD), hyperthyroidism, viral infections, or an autoimmune disease, it can be alleviated or cured using treatments or therapies that improve symptoms of the condition.
This category of insomnias only affects children and occurs when a child can’t sleep without a soother (a bottle, a car ride, or being rocked, for example) or refuses to sleep on time.
Put simply, “idiopathic” means “no known cause.” Sometimes, for no apparent reason, a person develops insomnia as a child, and it never goes away. Idiopathic insomnia is rare, and it’s a lifelong condition.
Something is paradoxical when it’s illogical or self-contradictory. Some people report symptoms of insomnia when there’s no evidence of sleep disturbance or poor quality sleep.
Psychophysiological insomnia is when someone is so stressed or worried about getting enough sleep that they keep themselves awake. For example, if you’ve ever struggled to sleep before an early flight or stressed yourself out about getting enough sleep before an important event and ended up sleeping poorly because of it, you’ve experienced psychophysiological insomnia.
Regardless of its cause, chronic sleep deprivation can affect your cognitive, social, and vocational abilities when overlooked or adopted as your "regular" sleep pattern. A decline in mental clarity and difficulty focusing or handling issues increases stress and, as a result, negatively affects emotional well-being.
Insomnia symptoms range from difficulties falling asleep to only sleeping in brief spurts or waking up for significant periods during the night. When you wake up feeling exhausted, as if you haven't slept, you're not receiving enough restorative sleep, which is bad for your health.
You may have chronic insomnia if you experience sleep-related problems three or more times per week for over three months.
Acupuncture,⁴ a traditional Chinese medicine, involves inserting tiny needles into the skin at precise locations on the body. It is commonly used to relieve pain, but it may also be used to treat various ailments, including insomnia.
Acupuncture has been shown to enhance the body's functioning and facilitate self-healing by stimulating specific anatomic areas known as acupuncture points or acupoints.
The ancient discipline of acupuncture has evolved to embrace a wide range of techniques that aim to re-establish a balanced flow of energy throughout the body. Some practitioners may use heat, pressure, or suction in their practice.
Acupuncture has been shown⁵ to have a significant influence on the neurological system, digestive system, cardiovascular system, endocrine system, and immunological system.
However, while traditional Chinese medicine philosophy maintains that the good benefits are due to the energy flow of Qi, Western research is split on the concept of acupuncture as a therapy.
While many professionals, patients, and researchers agree that acupuncture can help with insomnia, there’s some debate about how it works. Some researchers⁶ suggest that acupuncture may help people with insomnia by:
Boosting endorphins (hormones linked to stress reduction)
Helping the body make more serotonin (a neurotransmitter that regulates sleep)
Decreasing norepinephrine (a neurotransmitter associated with alertness) in the blood
Moderating adrenocorticotropic hormone (a hormone that plays a role in sleep)
Regulating acetylcholine⁷ (a neurotransmitter that plays a role in sleep)
Increasing melatonin (a hormone that regulates the sleep-wake cycle)
Stimulating gamma-aminobutyric acid (GABA) (a neurotransmitter that improves sleep)
Enhancing the body’s production of nitric oxide (a compound that promotes sleep)
It’s worth noting that some research assessed in the same study reported conflicting results. One team of researchers, for example, found that acupuncture boosts cortisol levels. Cortisol⁸ is a stress hormone that helps you wake up, not fall asleep.
It’s also essential to consider that some researchers and healthcare professionals⁹ reject the idea of acupuncture therapy entirely, suggesting that the results observed can be attributed to the placebo effect — where the mind and body respond to therapy simply because the person receiving treatment believes it’ll work.
Before beginning an acupuncture session, you’ll discuss your problems, diseases, or concerns with your qualified acupuncturist. During the appointment, which typically lasts an hour, the acupuncturist will collect information to compile a detailed case history of your life. For example, they may ask about your home life, work life, wellness habits, diet, and more. Then, they’ll use this information to decide which acupoints to use during your treatment.
Certain acupuncture sites¹⁰ have been shown to influence brain regions that lower sensitivity to pain and stress, promote relaxation, and deactivate the 'analytical' brain, which is responsible for insomnia and anxiety.
You’ll lie on a table facing up or down during your treatment, depending on which acupoints your practitioner plans to use. You may feel a little sting when the needles are inserted, but acupuncture shouldn’t hurt. If it does, let your acupuncturist know.
Consult your doctor before undergoing acupuncture. Even if you’re well-informed, discussing risks and benefits with someone who knows your medical history is a good idea. They may also be able to refer you to a skilled and qualified acupuncturist.
Do not consider seeking treatment from an acupuncturist who is unlicensed. Check for accreditation with The National Certification Commission for Acupuncture and Oriental Medicine¹¹ or The American Academy of Medical Acupuncture.¹²
Many people struggle with falling and staying asleep. While improving your sleep hygiene might help remove some barriers to quality sleep, some people will continue to suffer from chronic insomnia despite adopting good habits. See your doctor rule out any underlying problems if your insomnia persists.
Traditional treatments include cognitive behavior therapy¹³ or drugs, which may result in unpleasant side effects.
If you're considering trying acupuncture, be sure to choose a qualified and licensed practitioner. While additional research is needed, and we don’t fully understand how acupuncture can improve sleep, the research published so far is encouraging.
How much sleep do I need? | Centers for Disease Control and Prevention
Adults | Centers for Disease Control and Prevention
Insomnia | American Academy of Sleep Medicine
What is acupuncture? | Johns Hopkins Medicine
Sleep/wake cycles | Johns Hopkins Medicine
Physiology, cortisol | NIH: National Library of Medicine
Acupuncture for insomnia | New Leaf Acupuncture Clinic
Advancing the evidence-based integration of the practice of medicine and acupuncture | American Academy of Medical Acupuncture
Traditional Chinese medicine: What you need to know | National Center for Complementary and Integrative Health
Drugs inducing insomnia as an adverse effect | Research Gate
What causes insomnia? | Sleep Foundation
Insomnia | Mount Sinai
What are the different types of insomnia | Sleep Foundation