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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.

Last updated: Jul 25, 2026•1 RCTs•📖 Read as article →

Evidence Score

Evidence Score44/100
Human RCT★★☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Efficacy and Safety of Acupuncture Combined with Estazolam for Insomnia in Hemodialysis Patients: A Single-Center, Randomized Controlled Trial.

observational

Wang P, Wang Z, Li ZX, Ma SH, Li Y, Yu M, Wang J, Li H, Yang C, Liu XT, Li M · Chinese journal of integrative medicine (2026)

Participants: N/A
Duration: 8 weeks
Intervention: Acupuncture combined with 1 mg/d estazolam for 4 weeks
Outcome: Pittsburgh Sleep Quality Index (PSQI), Hamilton Anxiety Scale (HAMA), Chinese Medicine Syndrome Score of Insomnia (CMSSI), clinical effective rate, sleep structure parameters (sleep latency, wake after sleep onset, sleep efficiency, total time in bed, sleep scores, deep sleep duration and proportion, REM duration and proportion, light sleep proportion)
Effect Size: N/A (only P values reported)
Population: End-stage renal disease patients undergoing hemodialysis with insomnia

Result:

PubMed: 42455420DOI: 10.1007/s11655-026-4164-2

Mechanism Graph

Acupuncture may modulate neurotransmitter systems involved in sleep regulation
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Combined therapy may reduce anxiety and improve sleep architecture
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Enhanced deep sleep and REM sleep duration observed
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Result: Improved overall sleep quality and clinical efficacy

Limitations

  • ⚠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.

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References

  1. 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
Disclaimer: This content is for educational purposes only and is not medical advice. Evidence scores reflect the quality and quantity of available research, not clinical recommendations. Always consult a healthcare professional before starting any supplement or intervention.