OBJECTIVE To systematically evaluate the therapeutic effect of acupuncture on geriatric insomnia.

METHODS Randomized controlled trials(RCTs) on acupuncture in the treatment of senile insomnia were searched in CNKI, VIP, Wanfang, China Biomedical Database, PubMed, Web of science, Embase and Cochrane Library databases from inception dates to June 24, 2024. Literature was screened and data were extracted based on the inclusion and exclusion criteria. The literature quality was evaluated according to the risk of bias table recommended by the Cochrane Collaboration Handbook 5.1.0, and the outcome indicators were graded using the GRADE system for the quality of evidence. RevMan5.4 software was used to evaluate the quality of the included literature, and Stata18.0 software was used to conduct Meta-analysis on the included literature.

RESULTS A total of 18 studies involving 1 399 patients were included.Meta-analysis showed that: compared with the simple western medicine treatment, acupuncture in the treatment of senile insomnia patients could improve the clinical effective rate RR=1.18, 95%CI(1.13, 1.24), P < 0.001, reduce the total PSQI score MD=-1.10, 95%CI(-1.25, -0.96), P < 0.001, daytime dysfunction MD=-1.38, 95%CI(-1.59, -1.16), P < 0.001, sleep latency MD=-0.66, 95%CI(-0.86, -0.47), P < 0.001, sleep duration MD=-0.45, 95%CI(-0.64, -0.25), P < 0.001, sleep efficiency MD=-0.69, 95%CI(-0.89, -0.49), P < 0.001, sleep disorderMD=-1.24, 95%CI(-1.47, -1.01), P < 0.001, sleep quality MD=-0.84, 95%CI(-1.05, -0.64), P < 0.001. GRADE classification showed that the clinical efficacy was advanced evidence; the adverse reactions were intermediate evidence; the total score of PSQI, daytime dysfunction, sleep latency, sleep efficiency, sleep quality and sleep disorder were low evidence; sleep time was extremely low evidence.

CONCLUSION Acupuncture intervention in senile insomnia patients is superior to the control group in clinical efficiency and various PSQI scores.Acupuncture intervention is worthy of further promotion and use in clinical practice as the complementary and alternative therapy for the conventional western medication treatment of senile insomnia.However, the evidence levels of some outcome indicators are relatively low, and more high-quality RCTs with large sample sizes are still needed to increase the strength of evidence.