Acupuncture combined with estazolam improves sleep quality and clinical efficacy in hemodialysis patients with insomnia compared to estazolam alone
In a randomized controlled trial of 110 hemodialysis patients with insomnia, those receiving acupuncture plus 1 mg/d estazolam for 4 weeks had significantly lower PSQI, HAMA, and CMSSI scores at 2, 4, and 8 weeks compared to those receiving estazolam alone. The intervention group also showed a higher clinical effective rate (81.82% vs. 41.82%) and improved sleep structure parameters, with no major adverse events.
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Acupuncture combined with estazolam improves sleep quality and clinical efficacy in hemodialysis patients with insomnia compared to estazolam alone The current body of evidence comprises 1 study, including 1 randomized controlled trial. EvidenceHub rates the overall confidence at 44/100 (low).
The Claim
Acupuncture combined with estazolam improves sleep quality and clinical efficacy in hemodialysis patients with insomnia compared to estazolam alone
This conclusion is most relevant to: End-stage renal disease patients undergoing hemodialysis with insomnia.
What the Research Shows
The conclusion draws on 1 linked study. Highlights from the cited literature:
- ▸Efficacy and Safety of Acupuncture Combined with Estazolam for Insomnia in Hemodialysis Patients: A Single-Center, Randomized Controlled Trial. (Chinese journal of integrative medicine, 2026) —
How It Works
The proposed biological pathway:
- ▸Acupuncture may modulate neurotransmitter systems involved in sleep regulation
- ▸Combined therapy may reduce anxiety and improve sleep architecture
- ▸Enhanced deep sleep and REM sleep duration observed
- ▸Result: Improved overall sleep quality and clinical efficacy
Who Might Benefit
Evidence fit by population:
- ▸End-stage renal disease patients undergoing hemodialysis with insomnia
Recommended Dose
1 mg/d estazolam
Limitations & Caveats
Important context when interpreting this evidence:
- ▸Single-center design limits generalizability
- ▸No sham acupuncture control group to account for placebo effects
- ▸Follow-up period only 4 weeks after treatment, long-term effects beyond 8 weeks unknown
Frequently Asked Questions
What is the clinical effective rate difference between the two groups?▼
The intervention group (acupuncture plus estazolam) had a clinical effective rate of 81.82% compared to 41.82% in the control group (estazolam alone) at 4 weeks.
Were there any adverse events reported?▼
No major unfavorable adverse events were reported in either group, indicating good safety.
How long did the treatment and follow-up last?▼
The treatment period was 4 weeks, followed by an additional 4 weeks of follow-up, totaling 8 weeks.
What sleep parameters improved in the intervention group?▼
The intervention group showed shorter sleep latency and wake after sleep onset, higher sleep efficiency, total time in bed, sleep scores, deep sleep duration and proportion, REM duration and proportion, and lower light sleep proportion.
References
- 1.Wang P, Wang Z, Li ZX, Ma SH, Li Y, Yu M, Wang J, Li H, Yang C, Liu XT, Li M. “Efficacy and Safety of Acupuncture Combined with Estazolam for Insomnia in Hemodialysis Patients: A Single-Center, Randomized Controlled Trial..” Chinese journal of integrative medicine, 2026. PMID: 42455420 DOI: 10.1007/s11655-026-4164-2