Acupuncture for insomnia? An overview of systematic reviews

Background : Several systematic reviews of acupuncture as a treatment of insomnia have recently emerged. Their results are far from uniform. Aim : To summarize and critically evaluate these reviews with a view of defining the reasons for their discrepant conclusions and providing an overall verdict about the therapeutic value of acupuncture for insomnia. Methods : Thirteen electronic databases (Medline, Embase, Amed, CINHAL, Health Technology Assessments, DARE, Cochrane, six Korean/Chinese databases) were searched for relevant articles and data from the included reviews were extracted according to pre-defined criteria. Their methodological quality was assessed using the 'Overview Quality Assessment Questionnaire'. Results : Ten systematic reviews of acupuncture for insomnia were published between 2003 and 2010. They differed in numerous respects. Several reviews draw strongly positive conclusions. Owing to these several caveats, the best evidence is, however, not clearly positive. Conclusion: The evidence for acupuncture as a treatment of insomnia is plagued by important limitations, e. g. the poor quality of most primary studies and some systematic reviews. Those that are sensitive to such limitations, fail to arrive at a positive verdict about the effectiveness of acupuncture.