Everybody encounters a degree of stress in their lives and experiences the odd night when they lie awake. However, sometimes people may suffer from prolonged anxiety, or find themselves consistently unable to get a good night’s sleep. This can interfere with their ability to function at work, enjoy their social lives, or to manage their emotions.

There are pharmaceutical and herbal remedies for anxiety, low mood and insomnia. However, some patients are concerned about side effects and would rather find an alternative way of managing their symptoms. While anyone with severe psychiatric symptoms should always consult their doctor, acupuncture has been shown to be effective in treating stress, anxiety and sleep issues.

Insomnia

Around a third to one half of the population will experience insomnia at some point. Its incidence increases with age and it is almost twice as common in women (Walker, 2017). It is associated with a reduced quality of life and poor health outcomes. Many people with chronic insomnia also have symptoms of depression and anxiety.

Although NICE recommends advice on sleep hygiene or cognitive behavioural therapy (CBT) as the preferred treatment, CBT is often unavailable. Some people look to alternative medicine to provide relief from insomnia. Circadian rhythms, with the cyclical transition from activity to rest and the release and inhibition of hormones governing myriad physiological processes, can be readily interpreted within the framework of yin and yang. Daytime and activity relate to Yang, and night-time and rest relate to Yin. At night, the yang enters into and is nourished by yin. Having adequate energy during the day, and sufficient sleep at night therefore reflects a healthy balance between yin and yang in the body. Acupuncture aims to use the Chinese channel system to restore equilibrium to the whole person.

The majority of research into the effectiveness of acupuncture in the treatment of insomnia has been conducted in China. Many RCTs and a number of systematic reviews (Yin et al, 2017, He et al, 2019 and Kim et al, 2021) support the claim that acupuncture can effectively restore natural sleep.

Anxiety and low mood

According to the Office of National Statistics (ONS, 2023), in 2022/2023 an average of 37.1% of women and 29.9% of men reported a high level of anxiety. This is a significant increase from data collected in 2012-2015. Anxiety can be a disabling condition, with symptoms ranging from irritability and restlessness to panic, nausea and heart palpitations. It can severely reduce quality of life, and can have consequences for academic and professional achievement. It may lead to social isolation, and frequently coexists with depression and sleep issues. NICE recommends advice on self-help, psychological therapies (CBT) and medication in that order.

Patients commonly report feeling very relaxed after acupuncture treatment. However, the effects have also been subject to scientific research. A systematic review and meta-analysis of RCTs (Xiang-yun et al, 2021) found that acupuncture was more effective than control in treating generalised anxiety disorder (GAD). Similarly, a literature review (Errington-Evans, 2012) concluded that despite the shortcomings of some of the literature, the volume of statistically significant results in the treatment of anxiety disorders was suggestive of the real benefits of acupuncture. A systematic review and meta-analysis of acupuncture for depression (Armour et al, 2019) analysed the results of 29 studies and found that acupuncture showed clinically significant reductions in the severity of depression compared to usual care.

Moreover, meta-analysis indicated that acupuncture could reduce anxiety in a relatively short time-frame (Xiang-yun et al, 2021). This finding is backed up by a recent RCT (Amorim et al, 2022) that used 3 different anxiety scales as well as measurements of salivary cortisol levels to demonstrate the impact of acupuncture in the treatment of anxiety. There was a significant decrease in anxiety levels after only five treatments.

References

Armour M, Smith CA, Wang LQ, Naidoo D, Yang GY, MacPherson H, Lee MS, Hay P. Acupuncture for Depression: A Systematic Review and Meta-Analysis. J Clin Med. 2019 Jul 31;8(8):1140. doi: 10.3390/jcm8081140. PMID: 31370200; PMCID: PMC6722678.

Errington-Evans N. Acupuncture for anxiety. CNS Neurosci Ther. 2012 Apr;18(4):277-84. doi: 10.1111/j.1755-5949.2011.00254.x. Epub 2011 Jun 7. PMID: 22070429; PMCID: PMC6493505.

He W, Li M, Zuo L, Wang M, Jiang L, Shan H, Han X, Yang K, Han X. Acupuncture for treatment of insomnia: An overview of systematic reviews. Complement Ther Med. 2019 Feb;42:407-416. doi: 10.1016/j.ctim.2018.12.020. Epub 2018 Dec 28. PMID: 30670275.

Kim SA, Lee SH, Kim JH, van den Noort M, Bosch P, Won T, Yeo S, Lim S. Efficacy of Acupuncture for Insomnia: A Systematic Review and Meta-Analysis. Am J Chin Med. 2021;49(5):1135-1150. doi: 10.1142/S0192415X21500543. Epub 2021 May 27. PMID: 34049475.

Walker, M. (2017) Why we Sleep: The New Science of Sleep and Dreams, Allen Lane

Yang XY, Yang NB, Huang FF, Ren S, Li ZJ. Effectiveness of acupuncture on anxiety disorder: a systematic review and meta-analysis of randomised controlled trials. Ann Gen Psychiatry. 2021 Jan 30;20(1):9. doi: 10.1186/s12991-021-00327-5. PMID: 33516258; PMCID: PMC7847562.

Yin X, Gou M, Xu J, Dong B, Yin P, Masquelin F, Wu J, Lao L, Xu S. Efficacy and safety of acupuncture treatment on primary insomnia: a randomized controlled trial. Sleep Med. 2017 Sep;37:193-200. doi: 10.1016/j.sleep.2017.02.012. Epub 2017 Mar 8. PMID: 28899535.

ONS. (2023). Public opinions and social trends, Great Britain: personal well-being and loneliness. Retrieved from https://www.ons.gov.uk/peoplepopulationandcommunity/wellbeing/datasets/publicopinionsandsocialtrendsgreatbritainpersonalwellbeingandloneliness[Accessed 28/02/2024]