Is single acupoint Sanyinjiao (SP 6) effective in managing insomnia? A systematic review of randomized controlled trials

Abstract

Insomnia is a symptom of physical or mental disorder and refers to decreased sleep time and potentially low quality. There is evidence showing that acupuncture could enhance management of insomnia, and Sanyinjiao (SP 6) is one of the promising acupoints. This review aimed to evaluate the effectiveness of stimulating single acupoint SP 6 in managing insomnia. The study was registered under PROSPERO CRD42019140855. English and Chinese databases were searched for randomized controlled trials on single acupoint SP 6 stimulation in management of insomnia. Quality of methodology was assessed by two authors independently using the Cochrane Risk of Bias Tool, and reporting quality was assessed by the STRICTA checklist. The primary outcome was the Pittsburgh Sleep Quality Index (PSQI), and secondary outcomes were improvement in clinical effect and sleep duration assessed by polysomnogram (PSG). The extracted data were pooled and meta-analyzed with RevMan 5.3 software. Four trials involving 288 participants were included in this review. The findings showed that SP 6 stimulation could improve sleep quality (MD -0.30, 95% CI [-0.52, -0.08]), lengthen deep sleep duration (MD 80.46, 95% CI [56.47, 104.45]), rapid eye movement (REM) duration (MD 91.53, 95% CI [68.41, 114.65]), and increase improvement in clinical effect. Quality of reporting and methodology was limited in all included trials. Some limited evidence showed that single acupoint stimulation of SP 6 could improve sleep quality, lengthen deep sleep and REM duration of patients with insomnia. However, the findings in this review should be interpreted with caution due to methodological limitations.

Effect of Comprehensive Care Based on Appropriate Chinese Medicine Techniques on Urinary Retention and Bladder Function Recovery after Total Hysterectomy in Patients with Cervical Cancer

“…Therefore, Sanyinjiao can regulate the liver and spleen and benefit the kidney yin. It has the effects of strengthening the spleen and regulating blood, tonifying the kidney and calming the liver, dredging meridians, and activating collaterals [ 31 ]. Ba GUI is derived from the (Yellow Emperor's Canon of internal medicine).…”

Moxibustion for medical personnel with negative emotion and insomnia during COVID-19 pandemic: A randomized, controlled trial

“…32 A systematic review included 4 studies with 288 participants and showed that SP6 stimulation improved sleep quality, prolonged deep sleep time and prolonged rapid eye movement (REM) duration. 12 Research also showed that stimulation at SP6 improved sleep quality by increasing levels of 5-HT in the hippocampus in the rat model of insomnia. 16…”

“…Moxibustion is effective in treating mental health issues such as anxiety, depression, and insomnia. 12 , 13 , 14 Moxibustion is reported to regulate the hypothalamic-pituitary-adrenal (HPA) axis, hippocampus upregulation, and neurotransmitter synthesis for depression relief. 15 Moxibustion has been shown in studies to improve the sleep state of insomnia rats by increasing 5-hydroxytryptamine (5-HT) and 5-hydroxyindoleacetic acid levels in the hypothalamus while decreasing dopamine and norepinephrine levels.…”