Background: Acupuncture treatment of chronic insomnia was effective. Anxiety and depression symptoms of the chronic insomnia patients were improved to varying degrees after acupuncture treatment. Corticosterone and 5-hydroxytryptamine are involved in the occurrence and development of comorbidity of insomnia, anxiety, and depression. Whether acupuncture can treat insomnia and accompany anxiety and depression symptoms by regulating corticosterone and 5-hydroxytryptamine is still unclear.
Methods: This was a randomized, single-blind (participant), parallel, placebo-controlled trial. Sixty chronic insomnia patients were randomly divided into acupuncture and sham acupuncture groups, with 30 patients in each group. In the acupuncture group, acupuncture was applied at Baihui (GV20), Yintang (GV29), Shenmen (HT7, bilateral), and Sanyinjiao (SP6, bilateral), while in the sham acupuncture group, superficial needles were used on non-disorder-related acupoints.
Both groups were treated 3 times a week (once every other day) for 4 weeks and at the 3-month follow-up. The patients were assessed using the Pittsburgh Sleep Quality Index (PQSI), Hamilton Anxiety Rating Scale (HAMA), and Hamilton Depression Rating Scale (HAMD). The serum concentrations of corticosterone and 5-HT were also measured before and after treatment.
Results: After treatment, the decrease in serum corticosterone and the increase in serum 5-hydroxytryptamine were significantly greater in the acupuncture group than in the sham acupuncture group. At follow-up, the PSQI, HAMA, and HAMD scores in the acupuncture group were significantly lower than those in the sham acupuncture group.
Conclusions: Elevated serum corticosterone and decreased serum 5-hydroxytryptamine levels may be associated with mood regulation disorders in chronic insomnia patients. Acupuncture can significantly improve the sleep quality, efficiency, and latency of chronic insomnia patients, and it can alleviate anxiety and depression in such patients. Compared with the sham acupuncture group, the acupuncture group showed a stable long-term efficacy.