Comparative efficacy and safety of different acupuncture therapies for insomnia in breast cancer patients: A systematic review and Bayesian network meta-analysis.
Source: PubMed, NCBI / U.S. National Library of Medicine
Insomnia is a prevalent symptom among breast cancer patients. This study aimed to compare and rank the efficacy and safety of various acupuncture and related therapies for improving sleep quality in this population. A systematic search was conducted across PubMed, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Database, and Chinese Science and Technology Periodical Database (VIP) from inception to January 25, 2025. Effect sizes were calculated as relative risks (RRs) for dichotomous outcomes and mean differences (MDs) for continuous outcomes, with 95% credible intervals (CrIs). The study quality was assessed using the RoB 2 tool, and confidence in evidence was evaluated with Confidence in Network Meta-Analysis (CINeMA). Eighteen randomized controlled trials involving 1399 participants were included. Compared to control, auricular acupressure (AP), mindfulness-based stress reduction (MBSR), MBSR plus acupressure, acupressure alone, intradermal needle (IN), and AP combined with wrist-ankle acupuncture (WAA) all significantly improved Pittsburgh Sleep Quality Index (PSQI) scores. The MD ranged from -5.04 (95% CrI: -8.07 to -1.95) for MBSR plus acupressure to -2.34 (95% CrI: -4.34 to -0.35) for IN. Based on the surface under the cumulative ranking curve (SUCRA), MBSR plus acupressure was the most effective intervention. Regarding safety, only IN (RR: 11.23, 95% CrI: 1.95 to 80.48) significantly i
Abstract
Insomnia is a prevalent symptom among breast cancer patients. This study aimed to compare and rank the efficacy and safety of various acupuncture and related therapies for improving sleep quality in this population. A systematic search was conducted across PubMed, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Database, and Chinese Science and Technology Periodical Database (VIP) from inception to January 25, 2025. Effect sizes were calculated as relative risks (RRs) for dichotomous outcomes and mean differences (MDs) for continuous outcomes, with 95% credible intervals (CrIs). The study quality was assessed using the RoB 2 tool, and confidence in evidence was evaluated with Confidence in Network Meta-Analysis (CINeMA). Eighteen randomized controlled trials involving 1399 participants were included. Compared to control, auricular acupressure (AP), mindfulness-based stress reduction (MBSR), MBSR plus acupressure, acupressure alone, intradermal needle (IN), and AP combined with wrist-ankle acupuncture (WAA) all significantly improved Pittsburgh Sleep Quality Index (PSQI) scores. The MD ranged from -5.04 (95% CrI: -8.07 to -1.95) for MBSR plus acupressure to -2.34 (95% CrI: -4.34 to -0.35) for IN. Based on the surface under the cumulative ranking curve (SUCRA), MBSR plus acupressure was the most effective intervention. Regarding safety, only IN (RR: 11.23, 95% CrI: 1.95 to 80.48) significantly increased the incidence of adverse reactions compared to control. MBSR plus acupressure, acupressure alone, AP combined with WAA, AP alone, and MBSR alone effectively improved sleep quality in breast cancer patients and were relatively safe.