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

Chiu, Hsiao-Yean RN, PhD; Hsieh, Yu-Jung RN, MSN; Tsai, Pei-Shan RN, PhD

doi: 10.1097/AOG.0000000000001268
Contents: Review

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, ClinicalTrials.gov, 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.

Supplemental Digital Content is Available in the Text.Acupuncture is effective in improving sleep disturbances in women experiencing menopause-related sleep disturbances.

School of Nursing, College of Nursing, Taipei Medical University, and the Sleep Science Center, Taipei Medical University Hospital, Taipei, Taiwan.

Corresponding author: Pei-Shan Tsai, RN, PhD, 250 Wu-Hsing Street, Taipei 110, Taiwan; e-mail: ptsai@tmu.edu.tw.

Supported by a grant from the Ministry of Science and Technology, Taiwan (MOST 103-2314-B038-068-MY2).

Financial Disclosure The authors did not report any potential conflicts of interest.

The authors thank Su-Chen Fang and Yu-Lin Wu for providing assistance in preparing the materials used for assessing quality of included studies, and Dr. Bo-Feng Wu and Pan-Jou Yao for their assistance in drawing the pictures of acupoints.

© 2016 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.