Medically reviewed by Dominique Fontaine, BSN, RN, HNB-BC, HWNC-BC — Written by Colleen de Bellefonds on May 28, 2021

Acupuncture is a technique that involves inserting needles into the skin to stimulate certain areas of the body.

The practice of acupuncture has grown in popularity as a treatment for a variety of health conditions, like allergies, asthma, stress, depression, and insomnia.

Here’s what the research has to say about the types and benefits of acupuncture for sleep, along with tips for finding a practitioner.

Benefits of acupuncture for sleep

Although experts at the National Center for Complementary and Integrative HealthTrusted Source say there’s evidence to recommend acupuncture for the treatment of chronic pain, they say there isn’t enough research yet on its effects on other health conditions, such as insomnia.

That doesn’t mean acupuncture definitely doesn’t help people to sleep better — or even that it hasn’t been studied.

“Despite the skepticism of some physicians, acupuncture is increasingly an evidence-based medicine,” says Gary Stanton, MD, a neurologist and sleep medicine specialist at Emerson Hospital in Concord, MA.

Stanton is board certified in neurology, sleep medicine, and acupuncture, and he practices acupuncture on his patients.

“I consider it to be one among several treatment options for a variety of problems, pain and sleep,” he says.

Although more research is needed, acupuncture may be a helpful treatment for symptoms of:

Sleep, pain, and anxiety

Tony Chon, MD, a general internal medicine specialist and expert in acupuncture at Mayo Clinic in Rochester, MN, says that, while there’s not enough evidence to prove acupuncture treats insomnia, he performs it on patients with sleep issues related to pain or anxiety.

“The potential gains outweigh the minimal risks,” Chon says. “From clinical experience and anecdotally, acupuncture appears to be very helpful. Many of my patients communicate a sense of calm after acupuncture that helps them sleep better for several days.”

General insomnia

Everyone has trouble sleeping from time to time. You may be among the estimated 1 in 3 people with insomnia if poor sleep affects your ability to function during the day.

Insomnia symptoms can last for a few days to months or longer and include:

  • having a hard time falling asleep

  • waking up during the night and finding it difficult to fall back asleep

  • waking up early

Causes for insomnia vary and may include:

  • medical conditions, such as sleep apnea

  • mental health disorders, such as anxiety

  • chronic pain

  • irregular sleep schedules

  • no known medical, psychiatric, or environmental cause (known as primary insomnia)

For Stanton, acupuncture is an alternative to medications, like benzodiazepines, used to treat insomnia. The U.S. Food & Drug Administration (FDA)Trusted Source warns that benzodiazepines often lead to misuse, abuse, and addiction — even when taken as prescribed.

“Patients appreciate choices,” Stanton says. “Acupuncture is safe, it promotes healing from within, and it poses much less risks to a patient than drug therapy.”

Stanton says there’s some research suggesting that acupuncture may help treat obstructive sleep apnea, insomnia, restless legs syndrome, and anxiety.

“Overall, the evidence shouldn’t be exaggerated. It’s generally mild to modest, but it’s there,” he says.

Primary insomnia

While more research needs to be done, there’s some evidence suggesting that acupuncture can help people with insomnia that’s not attributable to any specific cause.

“Many of my patients with insomnia benefit from it,” Stanton notes.

In a small 2017 study, researchers gave traditional acupuncture or sham acupuncture, where needles are not inserted as far into the skin, to 72 people with primary insomnia. Participants were treated 3 times per week for 4 weeks.

Researchers found that acupuncture was more effective at improving insomnia symptoms, sleep efficiency, and total sleep time during treatment. People’s sleep awakenings and self-rated anxiety also improved significantly 2 and 4 weeks after treatment.

A 2013 double-blind study of 180 people with primary insomnia found that traditional acupuncture was more effective at increasing sleep quality and daytime functioning than sham acupuncture or the sedative medication estazolam.

Sleep apnea

Obstructive sleep apnea (OSA) is a condition where you stop breathing while you’re sleeping. It can result in oxygen deprivation throughout the night that can leave you tired the next day, even if you slept all night.

A 2020 review of nine studies Trusted Source involving nearly 600 people found that acupuncture significantly improved OSA symptoms, ratings of sleepiness, and oxygen saturation levels. This was especially true among people with moderate to severe cases.

A 2016 review of six studies Trusted Source came to similar conclusions.

“There are studies that would indicate acupuncture use for sleep apnea, but due to many factors, I would also state not sufficiently rigorous evidence,” Chon says.

Insomnia and mental health disorders

Sleep problems are more common among people with anxiety and depression. There’s limited research suggesting that acupuncture may help.

A 2020 study of 90 people with depression and insomnia found that 3 weekly sessions of electroacupuncture, a type of acupuncture that uses electric currents, for 8 weeks improved:

  • sleep quality

  • sleep efficiency

  • total sleep time

  • depression

These improvements were significantly greater when compared with sham or placebo treatment.

There haven’t been large, quality studies on the effects of acupuncture for people with anxiety and insomnia. However, a 2021 review of 20 studies Trusted Source on acupuncture’s effects on anxiety alone found that it improved anxiety symptoms compared with a placebo.

Insomnia and pain

Some people have trouble sleeping due to chronic pain, which is pain that lasts for at least 3 months.

A 2019 review of nine studies involving nearly 1,000 people with insomnia caused by chronic pain concluded that acupuncture was better at improving sleep quality compared with sham treatment or medication.

The review’s authors noted that past studies were low quality or involved few people.

How does acupuncture work?

While it’s sometimes considered an “alternative” treatment in the United States, acupuncture is a 3,000-year-old practice in Traditional Chinese Medicine (TCM), explains Jessica Sowards, MS, LAc.

Sowards is a board certified acupuncturist and Chinese medicine and acupuncture lead at THE WELL in New York City.

“Chinese medicine looks at the mind, body, and spirit as one interconnected system and strives to understand the root cause of illness or imbalance and to rectify it,” she says.

Acupuncture involves inserting needles into certain points on the body located on what are known as meridians. In Chinese medicine, meridians are pathways in the body where life energy, known as “Qi,” flows, Sowards explains.

“We view each individual body as a network, an electrical highway of points and meridians, which is informed by internal and external stimuli that are always in flux,” she says. “Acupuncture needles tap into this network and can affect immediate and lasting change by redirecting and harmonizing this flow.”

The science

From a biological standpoint, acupuncture is thought to be a neuromodulator. That means it tones down the brain’s perception of sensory signals, including pain, Stanton explains.

“Different areas of the brain light up on a functional MRI, so we can see that the influence of acupuncture on the brain is fairly widespread,” he says.

Related treatments

Ear seeds, acupressure, and reflexology “are all alternative methods of applying pressure and stimuli to acupuncture points,” Sowards says.

  • Acupressure is the method of applying pressure to acupuncture points along meridian pathways.

  • Reflexology is a type of massage that involves applying different amounts of pressure to the feet, hands, and ears.

  • Ear seeds are small metal “seeds” that adhere to the ear to stimulate certain points on the body.

  • Cupping therapy involves placing cups on the skin to create suction.

  • Electroacupuncture is a form of acupuncture using electrical currents.

  • Moxibustion is the practice of burning a small cone or stick made of ground mugwort leaves at certain points.

Auricular acupuncture is a type of acupuncture performed specifically in the ear. “Most commonly today it’s used for treatment of pain and anxiety,” says Stanton. “Increasingly there’s literature to support its use in sleep medicine.”

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What to expect

If you decide to try acupuncture for sleep, expect:

  • a thorough intake from your practitioner, including medical history

  • a roughly 60-minute session

  • 20 to 30 needles inserted in varying points

  • your practitioner may choose to place needles or seeds in the ears

  • your practitioner may choose to supplement with cupping therapy or moxibustion

There are more than 350 acupuncture points on the skin and fascia that correspond to 20 meridians, Sowards says. During each 60-minute acupuncture session, about 20 to 30 needles are inserted into certain points.

Practitioners first diagnose the root cause of a client’s problem. For example, they may determine that sleep problems are related to stress. They’ll then select acupuncture points that correspond to that diagnosis.

“One point can be used for many different issues, so it’s important to provide an individual diagnosis,” Sowards says.

Stanton usually recommends his patients try at least 3 to 6 acupuncture sessions. He adds that it often works best when paired with cognitive behavioral therapy, a type of talk therapy that can aim to treat the underlying causes of insomnia.

“I’ve had many patients who can get off of drugs and feel better,” he says.
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