Desperate times call for desperate measures, but is being poked with needles really a fair price to pay for a good night’s rest? According to some, the answer is a resounding yes!
This Traditional Chinese Medicine (TCM) system of healing has been used to treat everything from infertility to nausea induced by chemotherapy, and even migraine headaches. But is there any real evidence that acupuncture can help to improve sleep?
We dug deep into the research on what science has to say about this alternative health approach and how it works to help tackle things like insomnia, sleep apnea, and anxiety. Keep reading for our full guide on acupuncture for sleep, including a DIY non-needle approach that may be just as effective.
What is This Anyway?
The practice of TCM is one of the world’s oldest known medical systems, dating back several thousands of years.  Acupuncture is based on the Chinese philosophy of the relationship between nature and human beings and their two opposing forces, known as yin and yang. Health is thought to be dependent on the flow of energy (spelled “qi” but pronounced as “chee”) along meridian pathways throughout the body.
A continuous flow of qi is said to keep yin and yang in balance, but when this energetic flow is blocked, illness, pain, and other symptoms such as insomnia may follow. According to UC San Diego School of Medicine, “Acupuncture improves the body’s functions and promotes the natural self-healing process by stimulating specific anatomic sites–commonly referred to as acupuncture points, or acupoints.” By stimulating these specific points, the flow of qi is reestablished, initiating the body’s natural healing process.
You may be thinking this all sounds a little unorthodox (like voodoo medicine perhaps), but there is a growing trend in medicine that is taking an integrative approach, combining modern practices with complementary and alternative medicine such as TCM.
In 1997, The National Institutes of Health (NIH) publicly endorsed the safety and effectiveness of acupuncture for treating a wide range of conditions ranging from nausea to musculoskeletal problems, anxiety, depression, infertility, and sleep-related disorders such as insomnia. 
Different Types of Acupuncture
Acupuncture is an ancient practice that has grown to include many different forms of treatment that all have the common goal of restoring the energetic flow of qi along meridians throughout the body. There are pros and cons to each form and practitioners may vary in which style of treatment they offer.
This is what most people think of as traditional acupuncture. This process involves the insertion of tiny needles into meridian points along the body that are thought to promote healing by regulating the flow of energy.
According to TCM, the ear contains acupoints that correspond to every area of the body. Many practitioners incorporate placing needles into the ear, either alone or alongside full body treatment.
This approach uses pressure and massage instead of needles, but focuses on the same meridians and acupoints to achieve healing. Acupressure has grown in popularity since it is an alternative to needle insertion, making it an approach that people can perform themselves at home and a safer option for use on young children.
Usually performed in tandem with acupuncture for treating pain, this approach uses small clips that are placed on top of traditional needles to create an electric current between two needle points. The additional stimulation may help to improve the energetic flow of energy, creating a greater effect than using needles alone.
Cupping is usually performed alongside acupuncture, suctioning small glass or rubber cups onto specific body areas. This is said to create an energetic boost when an area has become stagnant. While this approach may create marks on the body where the cup was placed, they are temporary and usually fade within a few hours of treatment.
This involves using small amounts of herbs that are placed on top of body acupuncture needles and then lit. Moxibustion is believed to improve treatment by providing added warmth.
What Does the Science Say?
According to modern research, acupuncture can create a notable effect on the nervous system, digestive system, cardiovascular system, endocrine system, and immune system. While TCM philosophy believes the positive effects are related to the energetic flow of qi, Western science is divided on exactly how acupuncture works. Some believe that the pain-relieving and sleep-inducing effects may be due to the release of peptides that stimulate opioid receptors in the brain, which is a system that controls pain, reward, and addictive behavior.  Others believe that the needles stimulate neurohormonal pathways, releasing beta-endorphin hormones that can make us feel happy and euphoric. Another theory is that acupuncture decreases pro-inflammatory markers, reducing pain and inflammation.
The lack of consensus on how this process works and no standardization of acupoints for treating specific conditions has made researching acupuncture difficult, and many studies have found mixed results. Some doctors have dismissed this practice entirely, believing any benefits are nothing more than a placebo effect. However, a growing number of randomized, controlled trials (the gold standard of research) have found that acupuncture may have some scientific validity.
For example, a meta-analysis of 29 well-performed studies involving 18,000 patients found acupuncture to be an effective treatment for chronic pain, with the doctors involved noting that the results were more than just a placebo effect.
Another meta-analysis of 5 randomized, controlled trials for the treatment of pre-dementia found that acupuncture produced better outcomes than medical treatment. Even osteoporosis showed improvement using warm acupuncture or electroacupuncture over sole Western medicine in another systematic review and meta-analysis.
Can It Affect Sleep?
Acupuncture has been one of the most popular therapies for insomnia since ancient times in China. Unlike many therapies that target the sleep-wake cycle, this treatment is thought to improve sleep by increasing levels of serotonin in the brain.  Serotonin is a neurotransmitter that also functions as a hormone, and is responsible for regulating many functions including mood and sleep.
Acupuncture may also improve sleep by increasing levels of the amino acid GABA, which also functions as a neurotransmitter and helps to promote relaxation and rest. Some research has found evidence that this type of therapy may reduce glutamate levels, an excitatory neurotransmitter that plays a role in many psychiatric conditions, Alzheimer’s disease, and sleep disorders.
Anyone who has ever suffered from insomnia will tell you that its impacts extend beyond nighttime, impacting job performance, learning, daytime functioning, and even social relationships. Therapeutic interventions like cognitive behavioral therapy can be effective, but require time and are inaccessible to many people.
Bleary-eyed individuals who are desperate for rest may be happy to know that many studies using acupuncture to treat insomnia have found results similar to medication but without the harmful side effects such as tolerance, addiction, neurological toxicity, and excessive sedation. A randomized, controlled study of 62 participants found that acupuncture was effective in improving sleep quality and psychological health in those suffering from insomnia.
One systematic review found that out of 11 studies included, all “reported statistically significant positive results.” And another systematic review including 46 randomized trials with a total of 3,811 patients showed that acupuncture with/without medication was superior to medication alone in increasing total sleep duration, concluding that this may be an effective treatment for insomnia.
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Sleep apnea is a serious medical condition that plagues as many as 12 million American adults, causing them to periodically stop breathing multiple times throughout the night. The resulting lower levels of oxygen in the blood can increase the risk of stroke and sudden cardiac death. The use of continuous positive airway pressure (CPAP machine) is often the recommended treatment, but compliance rates with using these devices are often low.
For more information, visit our best mattresses for sleep apnea page.
A meta-analysis of 6 randomized, controlled trials involving 362 patients found that acupuncture was more effective in improving apnea scores and increasing oxygen saturation than in control groups. Another similar meta-analysis done in 2018 included 703 patients from 10 trials and showed that compared to conventional treatment, acupoint stimulation resulted in significant differences between apnea scores, oxygen saturation, and Epworth Sleepiness Scales.
Get More Info: Complete Sleep Apnea Guide
Menopausal Night Sweats
According to the NIH, insomnia rates during menopause may be as high as 40-50%, often due to symptoms such as night sweats. While hormone replacement therapy (HRT) is the first-line treatment for reducing symptoms, many women are unable to use HRT due to the potential risks including a brain stroke, cardiac arrest, etc. Because acupuncture has the potential to release certain neurotransmitters and hormones that are disrupted during early menopause, it may be a safe and low-risk treatment for women.
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In a randomized, controlled study involving 70 menopausal women who underwent acupuncture for 6 weeks, remarkable improvements were noted in multiple symptoms, including hot flashes, night sweats, emotional well-being, and physical symptoms. Another study of 100 women found an improvement in many menopausal symptoms, including night sweats, using a combination of electroacupuncture (EA), acupoint-injection and fire needle compared to EA alone.
One study found that acupressure may also be a helpful treatment for menopausal night sweats, with significant improvement noted in 70 women in Iran.
Find Out More: Menopause Inosmnia – How to Sleep Better?
Anxiety and Other Mental Health Conditions
Many mental health conditions occur alongside sleep disorders, possibly because similar hormones and neurotransmitters that are responsible for regulating mood and emotions also function to regulate sleep. Insomnia occurs in 50-80% of patients being treated for psychiatric conditions compared to roughly 15% of the general population. 
A study of 18 adults with anxiety found that acupuncture increased melatonin secretion and improved overall sleep. Melatonin is a hormone involved in regulating the sleep-wake cycle and low levels have been found in conditions like insomnia and certain mental health disorders.
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In both a large case series of 500 individuals and a smaller randomized, controlled trial of 40 patients with schizophrenia, significant improvements in sleep were reported following acupuncture treatments. Other studies have also shown similar improvements in patients with depression and Alzheimer’s disease as well, although further research is required.
Read More: Anxiety and Sleep
Is It Right for Me?
If you are considering acupuncture but still have some doubts, it may be worth scheduling a consultation with a licensed acupuncturist to go over any lingering questions or concerns you may have. During these one hour appointments, practitioners will go over your health history, do a full assessment, and help you determine if this type of treatment is right for you. If you have a bleeding disorder, fear of needles, use a pacemaker, or have a seizure disorder, you will likely need to look for another type of therapy.
Are There Side Effects?
Acupuncture is known to be a safe and low-risk therapy, but some mild side effects can occur. The two most common side effects are pain and bleeding at the insertion site, but bruising, dizziness, fatigue, pain, and skin rashes are also possibilities. For an unknown reason, symptoms tend to be worse at the beginning of a course of treatment and improve with subsequent sessions.
What Do I Look for in an Acupuncturist?
First and foremost when you are looking for any new medical practitioner is to find someone that you connect with and that you can trust. If services are covered through your work benefits, you may have certain restrictions in terms of which practitioner you can choose.
Asking friends and family for a referral is always helpful, or you can look into various directories such as the American Association of Acupuncture and Oriental Medicine. Always be sure to verify that they have been certified by the National Commission for the Certification of Acupuncturists. Another possible resource is AcuFinder.com.
How Do I Prepare for My Appointment?
Most acupuncturists will recommend having something to eat within 1-2 hours before your appointment to prevent nausea and feeling lightheaded. They also will advise you to avoid caffeine and alcohol for 24 hours before your appointment. If you will be having your session in a group setting, it may be helpful to wear loose, comfortable clothing, but gowns are typically provided for private sessions.
A Needle-Free Option:
5 Pressure Points for Sleep
If you can’t get passed the idea of having multiple needles placed all over your body, don’t despair. Acupressure is a needle-free alternative that is based on the same philosophy and uses the same acupoints but with fingers instead of needles to improve energetic flow. This DIY option can be performed on yourself or a loved one at home to improve sleep and has the added bonus of being FREE!
Here are 5 acupressure points for sleep: 
Shining Sea Point
Shining Sea Point can be found near the ankle bone and is said to be beneficial for digestive problems, hypertension, anxiety, and insomnia. You can find this point directly below the inside of the ankle-bone. Hold your foot with your fingers while applying firm pressure with your thumb. Breathe deeply while holding this point with a firm and steady pressure.
Third Eye Point
Third Eye Point is one of the most common points for multiple diseases and is said to be is helpful for headaches, anxiety, insomnia, and relaxing the central nervous system. This point can be found between the two eyebrows, directly above the bridge of the nose. Use your thumb or index finger to apply gentle pressure on this point for two minutes.
Spirit Gate Point
Spirit Gate Point is found on the inside of the wrist, across the line of the pinky. This point is thought to help with insomnia, anxiety, cold sweating, and over-stimulation from sleeping disorders. Press your thumb against this point, applying mild pressure and then switch to the other wrist.
Sole of Foot Point
Sole of Foot Point is an important pressure point for insomnia and other sleeping problems. This point is located on the sole of the foot, in the front of the heel and in line with the ankle bone. This can be a sensitive point, so apply only mild pressure with your thumb.
Inner Gate Point
Inner Gate Point may be a helpful point for anxiety, insomnia, palpitations, nausea, and indigestion. This point is located on the inside of your hand, approximately 2-3 centimeters below the crease of the wrist. Use the thumb of the left hand to apply firm pressure to the right side and then switch, holding each point for one minute before releasing.
Unfortunately, insomnia is something almost everyone faces at some point in their lives. If sleeplessness persists, it may be worth a trip to your doctor to rule out underlying causes. Traditional treatment involved cognitive behavioral therapy or the use of medications that often have unwanted side effects.
If you are looking for an alternative solution to help you sleep, acupuncture may offer some help. While more long-term research on this TCM approach is needed to determine its full effect on sleep, the studies we do have are promising. And if needles aren’t your thing, consider trying acupressure for 10-15 minutes before turning in at night.
 The Integration of Traditional Chinese Medicine and Western Medicine, Cambridge University Press
 Acupuncture: In Depth, National Center for Complementary and Integrative Health
 Acupuncture Treatment for Insomnia and Acupuncture Analgesia, Psychiatry and Clinical Neurosciences
 Clinical Observation on the Neurotransmitters Regulation in Patients of Insomnia Differentiated as Yang Deficiency Pattern Treated with Warm Acupuncture and Auricular Point Sticking Therapy, Europe PMC
 Sleep and Mental Health, Harvard Health Publishing
 5 Pressure Points for Sleep, Healthline
RN, RHN, Certified Health Coach
Raina Cordell is a Registered Nurse, Registered Holistic Nutritionist, and Certified Health Coach, but her true passion in life is helping others live well through her website, www.holfamily.com. Her holistic approach focuses on the whole person, honing the physical body and spiritual and emotional well-being.