Insomnia is a frequent and clinically significant complication for patients newly diagnosed with lung cancer, but a large retrospective cohort study from a major Chinese academic medical center reports that acupuncture substantially lowers the risk of developing insomnia symptoms during cancer care. In propensity score–matched analyses of 918 lung cancer survivors, patients receiving acupuncture experienced less than half the incidence of insomnia compared with those who did not receive acupuncture during follow-up, with the strongest protective effect seen in patients treated frequently and in those receiving more than sixteen sessions. [1]

The study, conducted at Guangdong Provincial Hospital of Chinese Medicine and affiliated institutions of Guangzhou University of Chinese Medicine, analyzed electronic medical records. All included patients were newly diagnosed with lung cancer and had no documented insomnia symptoms at baseline. Insomnia outcomes were defined conservatively, requiring either a psychiatric diagnosis of insomnia disorder or documented clinical complaints such as difficulty initiating or maintaining sleep, early awakening, or dissatisfaction with sleep quality. [1]

After propensity score matching for age, sex, performance status, cancer pathology, cancer therapies, and comorbidities, 459 patients who received acupuncture were compared with 459 non-acupuncture controls. Over a mean follow-up of approximately seven months, insomnia symptoms occurred in 20.9% of the acupuncture group versus 42.2% of controls. Time-to-event analysis demonstrated a markedly delayed onset of insomnia among acupuncture recipients, with median time to insomnia extending from several months in controls to more than two years in the acupuncture group. [1]

Acupuncture exposure was defined pragmatically as real-world inpatient acupuncture delivered for cancer-related indications rather than for insomnia itself. Most treatments were administered for cancer pain, systemic cancer-related symptoms such as fatigue and hot flashes, or respiratory complaints. Body acupuncture was the predominant modality, with limited use of electroacupuncture and scalp acupuncture. Mean treatment frequency in the matched cohort was approximately one session per day, reflecting inpatient clinical practice rather than short experimental protocols. [1]

A clear dose–response relationship emerged. Compared with patients who received no acupuncture, those receiving fewer than three sessions showed modest risk reduction, while patients receiving more than sixteen sessions demonstrated the strongest preventive effect, corresponding to an approximately 85% lower incidence of insomnia symptoms. Daily acupuncture sessions were associated with greater protection than less frequent schedules. [1]

The investigators also conducted a detailed acupoint analysis to identify point selections most strongly associated with remaining insomnia-free. Several points emerged consistently. Sanyinjiao (SP6) showed the highest proportion of patients without insomnia, while Zusanli (ST36), Quchi (LI11), Baihui (GV20), and Jiuwei (CV15) ranked prominently across analytic methods. Specific combinations, particularly Zusanli (ST36) with Lieque (LU7) and Baihui (GV20), demonstrated very high confidence for non-insomnia outcomes in this cohort. [1]

From a procedural standpoint, treatments were delivered as standard body acupuncture during hospitalization courses, with one course defined as all acupuncture sessions during a single inpatient stay. Median session counts ranged from seven to fifteen per course in higher-dose groups. Although the study did not report needle gauge, insertion depth, or electrical parameters, it documented treatment frequency, cumulative sessions, acupuncture type, and point prescriptions in sufficient detail to reflect typical inpatient oncology acupuncture practice at a tertiary Chinese medicine hospital. [1]

Several clinical factors independently increased insomnia risk regardless of acupuncture exposure. Poorer functional status, as measured by an Eastern Cooperative Oncology Group Performance Status score of three to four, opioid use, advanced age, small-cell lung cancer pathology, and pre-existing mental disorders were all associated with higher insomnia incidence. Importantly, the protective association between acupuncture and insomnia persisted even without adjusting for pain, which the investigators identified as a potential mediator rather than a simple confounder. [1]

The authors propose several biologically plausible mechanisms to explain acupuncture’s preventive effect on insomnia in lung cancer patients. Cancer and cancer treatments are known to provoke inflammatory responses and neuroendocrine dysregulation that disrupt sleep. Acupuncture has been shown in prior mechanistic research to modulate hypothalamic–pituitary–adrenal axis activity, reduce cortisol signaling, and influence neurotransmitters such as serotonin, gamma-aminobutyric acid, and melatonin, all of which play central roles in sleep regulation. These effects appear to be acupoint-specific and may be enhanced by repeated stimulation over time. [1]

This study’s strengths include its large sample size, use of real-world clinical data from a major academic hospital system, rigorous propensity score matching, and advanced analytical methods to explore dose–response relationships and acupoint relevance. Limitations include its retrospective design, restriction to inpatient acupuncture data, and lack of standardized insomnia questionnaires. Nonetheless, the findings suggest that acupuncture delivered for routine cancer-related indications may confer a clinically meaningful preventive benefit against insomnia when applied frequently and cumulatively during lung cancer care. [1]

Reference:

1. Ruifang Yu, Xinfeng Guo, Yanjuan Zhu, et al., “Acupuncture reduced incidence of insomnia symptoms in patients with lung cancer: a retrospective cohort study,” Supportive Care in Cancer 34 (2026): Article 45, Guangdong Provincial Hospital of Chinese Medicine and Guangzhou University of Chinese Medicine.