{
  "abstract": "Breast cancer-related insomnia (BCRI) is a common and burdensome sequela. Acupuncture is frequently used, but robust evidence is limited, and previous systematic reviews included few trials yielding imprecise estimates. This updated systematic review and meta-analysis evaluated the efficacy and safety of acupuncture for BCRI. We systematically searched eight databases for randomized controlled trials (RCTs) up to July 1, 2025. RCTs comparing acupuncture with any control for BCRI were eligible. Methodological quality was assessed using the Cochrane Risk of Bias tool (RoB 2.0) and the modified Jadad scale. Meta-analyses employed a random-effects model. Subgroup analyses explored heterogeneity sources, and the GRADE framework rated evidence certainty. Twenty-seven RCTs (n=2,025) were included. Acupuncture significantly reduced Pittsburgh Sleep Quality Index (PSQI) scores (MD= –2.74, 95% CI [–3.92, –1.55], P<0.00001) and increased the overall efficacy rate (RR=1.51, 95% CI [1.27, 1.81], P<0.00001) compared to control, but did not significantly improve Insomnia Severity Index (ISI) scores. Subgroup analyses identified control intervention type and treatment frequency as significant sources of heterogeneity. Adverse events were infrequent and typically mild. GRADE assessments rated the certainty of evidence as low or very low, primarily due to risk of bias and substantial heterogeneity. Current evidence suggests acupuncture may improve sleep in patients with BCRI, with effects moderated by comparator type and treatment frequency. However, conclusions are limited by methodological weaknesses and heterogeneity. Future rigorous RCTs using validated sham controls, standardized protocols, and objective outcomes are needed to confirm efficacy and guide practice. PROSPERO Registration number (ID: CRD42024559828).",
  "authors": [
    {
      "affiliations": [
        "The First Clinical Medical College of Anhui University of Traditional Chinese Medicine, Hefei, Anhui, China"
      ],
      "name": "Hao Zhang"
    },
    {
      "affiliations": [
        "Breast Cancer Center, The First Affiliated Hospital of University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China",
        "Breast Cancer Center, Anhui Provincial Cancer Hospital, Hefei, Anhui, China"
      ],
      "name": "Kuojun Ren"
    },
    {
      "affiliations": [
        "Department of Thyroid and Breast Surgery, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, Anhui, China"
      ],
      "name": "Shengying Wang"
    }
  ],
  "title": "Efficacy and safety of acupuncture for breast cancer-related insomnia: a systematic review and meta-analysis",
  "uid": "f134c1bc-3ff1-5b7b-9f62-e3d3b74eacca"
}