![]() However, due to the diversity of acupuncture approach, determining the most effective acupuncture method is intractable, which makes clinicians confused about how to select the optimal acupuncture method for elderly individuals with insomnia disorder. Clinically, multiple acupuncture methods are available for insomnia disorder in the elderly, such as manual acupuncture, electroacupuncture, auricular acupuncture, and auricular acupressure. A growing number of randomized controlled trials (RCT) have indicated that acupuncture could improve sleep quality, prolong sleep time, reduce the severity of insomnia disorder among the elderly. Acupoints on the meridians are stimulated by using disposable sterile acupuncture needles. Consequently, for the elderly, seeking for an effective, simple, safe treatment of insomnia disorder appears to have great significance.Īcupuncture, as an important part of complementary and alternative therapies, has numerous advantages, such as wide indication, reliable curative effect, convenient operation, economic safety, and has been widely accepted and applied worldwide. However, high costs and lack of professionals limit its availability. Among non-pharmacological interventions, cognitive behavioral therapy (CBT) has been recognized as a first-line treatment for insomnia disorder. Therefore, several authors propose that non-pharmacological interventions should be considered as first-line treatment options for insomnia disorder in the elderly. Benzodiazepine receptor agonists as pharmacological interventions have the most evidence for treating insomnia, with serious side effects such as increased risks of falls and hip fractures, over-sedation, and confusion among the elderly. Treatment of insomnia disorder can be divided into pharmacological and non-pharmacological interventions. which seriously affects the quality of life of patients and causes greater psychological and economic burden to patients and their families, and insomnia disorder has become a major public health problem. However, long-term insomnia disorder will not only increase the risk of depression and death in the elderly, but also is an independent risk factor for cardiovascular disease and diabetes. The main symptom of insomnia is difficulty in falling asleep or sleep maintenance disorder. Women have a higher incidence of insomnia disorder than men. It has been shown that more than 50% of the elderly worldwide suffer from sleep disorders, of these, 20% to 40% suffer from insomnia disorder. Insomnia disorder is a common disease worldwide, which is one of the most common sleep disorders among the elderly. The protocol has been registered at OSF ( ) with a registration number. In this study, the results will provide credible evidence to assess the efficacy and safety of acupuncture therapies for elderly patients with insomnia disorder, assisting patients, physicians and clinical research investigators to select the most appropriate acupuncture method. The quality of evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation System (GRADE). ADDIS (Aggregate Data Drug Information System) V.1.16.8 will be used to conduct Bayesian network meta-analysis. The quality of included literatures will be appraised using Cochrane risk-of-bias tool (ROB 2.0). Two reviewers will independently perform study selection, data extraction and risk assessment of bias. The primary outcome is sleep quality measured by the Pittsburgh Sleep Quality Index (PSQI). Randomized controlled trials investigating acupuncture methods for insomnia disorder in the elderly, published in English or Chinese will be included. MethodsĪ systematic search of 8 bibliographic databases will be conducted from their inception to 18 June 2023, including Cochrane Library, MEDLINE (via PubMed), Embase, Web of Science, Chinese National Knowledge Infrastructure (CNKI), Wanfang Database, VIP Database, and Chinese Biomedical Literature Database (CBM). Therefore, this protocol outlined a plan to evaluate and rank the efficacy and safety of various acupuncture approaches for insomnia disorder in the elderly. ![]() Despite that increasing clinical trials have indicated that acupuncture seems to be effective for insomnia disorder in the elderly, comparative efficacy and safety of different acupuncture methods for elderly individuals with insomnia disorder has been unclear. Insomnia disorder remains one of the most common sleep disorders in the elderly, with high prevalence and substantial consequences for patients’ general health.
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