Traditional Chinese medicine therapies for insomnia: An umbrella review and evidence map
Background: An increasing number of systematic reviews and meta-analyses (SR/MAs) suggests traditional Chinese medicine therapies are effective for insomnia. We aimed to synthesize and evaluate the methodological quality of these studies through an umbrella review with an evidence map for improving...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-09-01
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| Series: | Integrative Medicine Research |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213422025000563 |
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| author | Jinxiang Wang Bing Bai Ranran Zhu Xintong Yu Xiaoting Xu Xiaomin Tu Lei Fang |
| author_facet | Jinxiang Wang Bing Bai Ranran Zhu Xintong Yu Xiaoting Xu Xiaomin Tu Lei Fang |
| author_sort | Jinxiang Wang |
| collection | DOAJ |
| description | Background: An increasing number of systematic reviews and meta-analyses (SR/MAs) suggests traditional Chinese medicine therapies are effective for insomnia. We aimed to synthesize and evaluate the methodological quality of these studies through an umbrella review with an evidence map for improving evidence quality. Methods: We searched 10 databases from inception to March 20, 2025, that investigated the effects of TCM therapies on sleep-related subjective or objective outcomes for insomnia. We assessed the methodological quality of included SR/MAs using A Measurement Tool to Assess systematic Reviews (AMSTAR 2) tool, evaluated the certainty of evidence with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool, and visually presented the results as an evidence map. Results: Thirty-six SR/MAs included in this umbrella review described 3 TCM non-pharmacotherapies (i.e., acupuncture, Tuina massage, and Chinese exercises), and Chinese herbal medicine (CHM). The AMSTAR 2 results showed that 20 SR/MAs had high or moderate methodological quality, while the remaining studies were of low or critically low methodological quality. The evidence map showed high-quality SR/MAs supported the effect of acupuncture, Tuina massage, Chinese exercises, and CHM on overall sleep quality, while acupuncture, Tuina massage, and Chinese exercises could also improve anxiety and depression. Moreover, acupuncture and Tuina massage might improve objective outcomes such as polysomnography parameters and 5-hydroxytryptamine level. Conclusions: Acupuncture, Tuina massage, and Chinese exercises are effective in improving overall sleep quality and emotional outcomes and have potential effects on objective sleep parameters. There is sufficient evidence that several CHM formulas could improve sleep quality. However, the methodological quality of SR/MAs needs further improvement. Protocol registration: PROSPERO, CRD42022347769. |
| format | Article |
| id | doaj-art-f4fc0104a8d94b08a1e2a19eef609cf4 |
| institution | Matheson Library |
| issn | 2213-4220 |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Integrative Medicine Research |
| spelling | doaj-art-f4fc0104a8d94b08a1e2a19eef609cf42025-06-29T04:51:55ZengElsevierIntegrative Medicine Research2213-42202025-09-01143101176Traditional Chinese medicine therapies for insomnia: An umbrella review and evidence mapJinxiang Wang0Bing Bai1Ranran Zhu2Xintong Yu3Xiaoting Xu4Xiaomin Tu5Lei Fang6Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, PR ChinaSchool of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, PR ChinaSchool of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, PR ChinaYueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, PR ChinaInstitute of TCM International Standardization, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, PR ChinaSchool of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, PR ChinaYueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, PR China; School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, PR China; Corresponding author: Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, 110 Ganhe Road, Shanghai, 200437, PR China.Background: An increasing number of systematic reviews and meta-analyses (SR/MAs) suggests traditional Chinese medicine therapies are effective for insomnia. We aimed to synthesize and evaluate the methodological quality of these studies through an umbrella review with an evidence map for improving evidence quality. Methods: We searched 10 databases from inception to March 20, 2025, that investigated the effects of TCM therapies on sleep-related subjective or objective outcomes for insomnia. We assessed the methodological quality of included SR/MAs using A Measurement Tool to Assess systematic Reviews (AMSTAR 2) tool, evaluated the certainty of evidence with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool, and visually presented the results as an evidence map. Results: Thirty-six SR/MAs included in this umbrella review described 3 TCM non-pharmacotherapies (i.e., acupuncture, Tuina massage, and Chinese exercises), and Chinese herbal medicine (CHM). The AMSTAR 2 results showed that 20 SR/MAs had high or moderate methodological quality, while the remaining studies were of low or critically low methodological quality. The evidence map showed high-quality SR/MAs supported the effect of acupuncture, Tuina massage, Chinese exercises, and CHM on overall sleep quality, while acupuncture, Tuina massage, and Chinese exercises could also improve anxiety and depression. Moreover, acupuncture and Tuina massage might improve objective outcomes such as polysomnography parameters and 5-hydroxytryptamine level. Conclusions: Acupuncture, Tuina massage, and Chinese exercises are effective in improving overall sleep quality and emotional outcomes and have potential effects on objective sleep parameters. There is sufficient evidence that several CHM formulas could improve sleep quality. However, the methodological quality of SR/MAs needs further improvement. Protocol registration: PROSPERO, CRD42022347769.http://www.sciencedirect.com/science/article/pii/S2213422025000563Traditional Chinese medicineInsomniaUmbrella reviewEvidence map |
| spellingShingle | Jinxiang Wang Bing Bai Ranran Zhu Xintong Yu Xiaoting Xu Xiaomin Tu Lei Fang Traditional Chinese medicine therapies for insomnia: An umbrella review and evidence map Integrative Medicine Research Traditional Chinese medicine Insomnia Umbrella review Evidence map |
| title | Traditional Chinese medicine therapies for insomnia: An umbrella review and evidence map |
| title_full | Traditional Chinese medicine therapies for insomnia: An umbrella review and evidence map |
| title_fullStr | Traditional Chinese medicine therapies for insomnia: An umbrella review and evidence map |
| title_full_unstemmed | Traditional Chinese medicine therapies for insomnia: An umbrella review and evidence map |
| title_short | Traditional Chinese medicine therapies for insomnia: An umbrella review and evidence map |
| title_sort | traditional chinese medicine therapies for insomnia an umbrella review and evidence map |
| topic | Traditional Chinese medicine Insomnia Umbrella review Evidence map |
| url | http://www.sciencedirect.com/science/article/pii/S2213422025000563 |
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