International Guideline Recommends Electroacupuncture and Manual Acupuncture for Chronic Insomnia

A new international clinical guideline has been developed to standardise the use of acupuncture in the management of insomnia, drawing on a systematic review and meta-analysis of randomised controlled trials published up to January 2025. The guideline was shaped by a modified Delphi consensus process involving 26 experts from 11 countries, covering considerations such as patient preferences, cost-effectiveness, and regional availability of services.

Based on moderate-to-low certainty evidence, the guideline conditionally recommends that both electroacupuncture and manual acupuncture may be considered as treatment options for adults with chronic insomnia, particularly in healthcare settings where these therapies are accessible. Electroacupuncture is additionally suggested for patients who have insomnia alongside other health conditions, or who experience notably poor sleep quality.

To support consistent clinical practice, the expert panel established a core set of acupoints — including Baihui, Sanyinjiao, Sishencong, and Anmian — alongside a standardised treatment protocol. This involves needle retention for 30 minutes following the sensation known as ‘de qi’, delivered three times per week for a minimum of four weeks. The guideline acknowledges the variability in evidence quality and is designed to be adaptable across diverse healthcare environments worldwide.

Conclusion: This international evidence-based guideline conditionally supports the use of electroacupuncture and manual acupuncture for chronic insomnia, providing standardised acupoint and treatment protocols to improve consistency across clinical settings.

Source: Wang J, Wang X, Xu X and colleagues. Sleep medicine reviews (2026). View on PubMed (PMID 42030608) · doi:10.1016/j.smrv.2026.102292

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Doctor of Chinese medicine, acupuncture expert and author of My Fertility Guide and My Pregnancy Guide.

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