Acupuncture for persistent insomnia associated with major depressive disorder: a randomised controlled trial

1. Standardised acupuncture has only a mild hypnotic effect for residual insomnia associated with major depressive disorder (MDD). Its efficacy does not differ to that of minimal acupuncture or placebo control.
2. The within-group effect size for the primary outcome measure—sleep-diary-derived sleep efficiency—was 0.4 at 1-week post-treatment, but there was almost no change in actigraphy-derived objective sleep parameters.
3. Standardised acupuncture and minimal acupuncture were well-tolerated, with rates of discontinuation (secondary to adverse events) of 5.0% and 3.3%, respectively.
4. Residual insomnia associated with MDD partially responds to non-specific factors of acupuncture, but it fails to attain full remission. Further studies exploring individualised acupuncture, a longer course of acupuncture and cognitive behavioural therapy for this persistent problem are needed.