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Acupuncture for insomnia among individuals with substance use disorder: a systematic review and meta-analysis
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Miaomiao Li1, 2, Puchen Huang1, 2, Yunshan Liang1, 2, Mengyu Yang1, 2, Fuyuan Deng1, 2, Kaisong Ji3, Ling Chen4, Chao Liu4, 5, 6, 7, *, Peijing Rong8, Hye Won Lee9, Liming Lu1, 2, *, Jingchun Zeng10, 11, *
Acupuncture and Herbal Medicine | 2026, 6(3) : 358 - 371
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Acupuncture and Herbal Medicine | 2026, 6(3): 358-371
• Original Articles •
Acupuncture for insomnia among individuals with substance use disorder: a systematic review and meta-analysis
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Miaomiao Li1, 2, Puchen Huang1, 2, Yunshan Liang1, 2, Mengyu Yang1, 2, Fuyuan Deng1, 2, Kaisong Ji3, Ling Chen4, Chao Liu4, 5, 6, 7, *, Peijing Rong8, Hye Won Lee9, Liming Lu1, 2, *, Jingchun Zeng10, 11, *
Affiliations
  • 1Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
  • 2South China Research Center for Acupuncture and Moxibustion, Guangzhou University of Chinese Medicine, Guangzhou, China
  • 3The First Clinical School of Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
  • 4Guangzhou Key Laboratory of Forensic Multi-Omics for Precision Identification, School of Forensic Medicine, Southern Medical University, Guangzhou, China
  • 5National Anti-Drug Laboratory Guangdong Regional Center, Guangzhou, China
  • 6State Key Laboratory of Bioactive Molecules and Druggability Assessment, Guangdong Basic Research Center of Excellence for Natural Bioactive Molecules and Discovery of Innovative Drugs, Jinan University, Guangzhou, China
  • 7Guangdong Province Key Laboratory of Pharmacodynamic Constituents of TCM and New Drugs Research, College of Pharmacy, Jinan University, Guangzhou, China
  • 8Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
  • 9Korean Medicine Convergence Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
  • 10Rehabilitation Center, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
  • 11Guangdong Clinical Research Academy of Chinese Medicine, Guangzhou, China
Published: 2026-09-25 doi: 10.1097/HM9.0000000000000206
Outline
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Objective

Insomnia is a common comorbidity and a recognized risk factor among individuals with substance use disorder (SUD). It is imperative to consider nonpharmacological adjunct therapies for bidirectional effects when treating insomnia in individuals with SUD. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of acupuncture for treating insomnia in individuals with SUD.

Methods

Electronic databases were searched from inception to December 2024 to identify relevant randomized controlled trials (RCTs) comparing needle acupuncture with sham acupuncture, conventional care, non-acupuncture active treatment, or waitlist controls in patients with insomnia and SUD. The primary outcome was sleep quality, which was measured using the Pittsburgh Sleep Quality Index (PSQI) (lower scores indicate better sleep quality). Pooled effects were estimated using random-effects models. The certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework. Trial sequential analysis (TSA) was used to assess the risk of false-positive and false-negative results.

Results

Eighteen RCTs with 1,750 participants met the inclusion criteria. All the RCTs were conducted in China. Sixteen RCTs had a moderate-to-high risk of bias. The pooled results showed that manual acupuncture (MA) yielded a better total PSQI score than sham acupuncture (mean difference [MD], -2.15 [95% confidence interval [CI], -2.93 to -1.38], P < 0.00001; minimal clinically important difference (MCID): -1.25), with low-certainty evidence. The TSA results suggested that the required information volume had been reached, indicating that additional trials may not be necessary in terms of sample size. Subgroup analyses revealed that acupuncture interventions had a greater effect among individuals with opioid use disorder (OUD) (MD, -1.93 [95% CI, -2.61 to -1.25], P < 0.00001) than on those with alcohol use disorder (MD, -1.49 [95% CI, -2.12 to -0.87], P < 0.00001) or new drug use disorder (MD, -3.94 [95% CI, -7.99 to 0.12], P = 0.06). However, the evidence regarding the efficacy of other forms of acupuncture and the comparative effectiveness between various forms of acupuncture was limited.

Conclusions

A review of 18 RCTs provides low-certainty evidence that MA may be more effective than sham acupuncture for improving sleep quality in individuals with SUD, with the effect potentially stronger among those with OUD. Given that most of the included studies exhibited a moderate-to-high risk of bias, the strength of the conclusions should be interpreted with caution. Therefore, additional research on the use of acupuncture to alleviate insomnia and reduce SUD withdrawal symptoms is warranted.

Acupuncture  /  Insomnia  /  Meta-analysis  /  Sleep disorder  /  Substance dependence  /  Substance use disorder  /  Systematic review
Miaomiao Li, Puchen Huang, Yunshan Liang, Mengyu Yang, Fuyuan Deng, Kaisong Ji, Ling Chen, Chao Liu, Peijing Rong, Hye Won Lee, Liming Lu, Jingchun Zeng. Acupuncture for insomnia among individuals with substance use disorder: a systematic review and meta-analysis[J]. Acupuncture and Herbal Medicine, 2026 , 6 (3) : 358 -371 . DOI: 10.1097/HM9.0000000000000206
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Funding
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  • National Natural Science Foundation of China(82405542)
  • Scientific Research Project of Guangdong Provincial Bureau of Traditional Chinese Medicine(20251110)
  • Guangdong Provincial Medical Research Fund(A2024201)
  • Intelligent Integrated Traditional Chinese and Western Medicine Interventions for Dilated Cardiomyopathy: Efficacy Evaluation and Health Economics Assessment(A1-2601-24-414-110Z77)
  • “Jiebang Guashuai” Project of Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine(A3-0317-25-109-009)
  • Clinical Research Project of LingNan Traditional Chinese Medicine Proven Recipes and Special Techniques under Lingnan Medicine Inheritance Project(2026JS10)
  • First-Class Discipline Capability Elevation Project under the “GuBen” Initiative of Guangzhou University of Chinese Medicine's “Peak Excellence and Elite Advancement” Action Plan(GZY2025GB0216)
  • Guangzhou University of Chinese Medicine Joint Construction Key Project(GZYZS2024U11)
  • Shenzhen Medical Research Fund(C2501027)
  • Sanming Project of Medicine in Shenzhen(SZZYSM202311015)
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Year 2026 volume 6 Issue 3
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Article Info
doi: 10.1097/HM9.0000000000000206
  • Receive Date：2025-08-22
  • Online Date：2026-11-04
  • Published：2026-09-25
Article Data
Affiliations
History
  • Received：2025-08-22
  • Accepted：2026-08-02
Funding
National Natural Science Foundation of China(82405542)
Scientific Research Project of Guangdong Provincial Bureau of Traditional Chinese Medicine(20251110)
Guangdong Provincial Medical Research Fund(A2024201)
Intelligent Integrated Traditional Chinese and Western Medicine Interventions for Dilated Cardiomyopathy: Efficacy Evaluation and Health Economics Assessment(A1-2601-24-414-110Z77)
“Jiebang Guashuai” Project of Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine(A3-0317-25-109-009)
Clinical Research Project of LingNan Traditional Chinese Medicine Proven Recipes and Special Techniques under Lingnan Medicine Inheritance Project(2026JS10)
First-Class Discipline Capability Elevation Project under the “GuBen” Initiative of Guangzhou University of Chinese Medicine's “Peak Excellence and Elite Advancement” Action Plan(GZY2025GB0216)
Guangzhou University of Chinese Medicine Joint Construction Key Project(GZYZS2024U11)
Shenzhen Medical Research Fund(C2501027)
Sanming Project of Medicine in Shenzhen(SZZYSM202311015)
Affiliations
    1Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
    2South China Research Center for Acupuncture and Moxibustion, Guangzhou University of Chinese Medicine, Guangzhou, China
    3The First Clinical School of Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
    4Guangzhou Key Laboratory of Forensic Multi-Omics for Precision Identification, School of Forensic Medicine, Southern Medical University, Guangzhou, China
    5National Anti-Drug Laboratory Guangdong Regional Center, Guangzhou, China
    6State Key Laboratory of Bioactive Molecules and Druggability Assessment, Guangdong Basic Research Center of Excellence for Natural Bioactive Molecules and Discovery of Innovative Drugs, Jinan University, Guangzhou, China
    7Guangdong Province Key Laboratory of Pharmacodynamic Constituents of TCM and New Drugs Research, College of Pharmacy, Jinan University, Guangzhou, China
    8Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, China
    9Korean Medicine Convergence Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
    10Rehabilitation Center, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
    11Guangdong Clinical Research Academy of Chinese Medicine, Guangzhou, China

Corresponding:

* Chao Liu, E-mail: ;
Liming Lu, E-mail: ;
Jingchun Zeng, E-mail: .
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表12种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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