title: Acupuncture to Reduce Sleep Disturbances in Perimenopausal and Postmenopausal Women: A Systematic Review and Meta-analysis.
abstract: OBJECTIVE
  To examine the association of acupuncture with sleep disturbances and serum sex hormone levels in perimenopausal and postmenopausal women and whether there are associated changes in sex hormone levels.
  
  
  METHODS
  We systematically searched electronic databases (EMBASE, PubMed, PsycINFO, CINAHL, ClinicalTrials.gov, Wanfang Data Chinese Database, and China Knowledge Resource Integrated Database) and the reference lists of the identified studies.
  
  
  METHODS
  Randomized controlled trials that examined the effects of acupuncture on sleep disturbances in perimenopausal and postmenopausal women were included. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement was followed.
  
  
  RESULTS
  We identified 31 randomized controlled trials with 34 effect sizes involving a total of 2,433 participants. Acupuncture is associated with a significant reduction in the likelihood of sleep disturbances (odds ratio [OR] 0.21, 95% confidence interval [CI] 0.14-0.31), a significant increase in the secretion of serum estradiol (pooled difference in means 7.56 pg/mL, 95% CI 4.03-11.08), and reduction in the secretion of serum follicle-stimulating hormone (-6.75 milli-international units/mL, 95% CI -12.16 to -1.34) and luteinizing hormone (-2.71 milli-international units/mL, 95% CI -4.22 to -1.20). Studies with a large effect size of acupuncture-associated changes in serum estradiol had a significantly lower odds of sleep disturbances than did those with a small-to-moderate effect sizes (ORs 0.07 and 0.36, P=.02).
  
  
  CONCLUSIONS
  Acupuncture is associated with a significant reduction in sleep disturbances in women experiencing menopause-related sleep disturbances. Our findings suggest that acupuncture should be adopted as part of a multimodal approach for improving sleep disturbances in perimenopausal and postmenopausal women.
authors: School of Nursing, College of Nursing, Taipei Medical University, and the Sleep Science Center, Taipei Medical University Hospital, Taipei, Taiwan.
authors: Hsiao-Yean
authors: HY
authors: Chiu
authors: Yu-Jung
authors: YJ
authors: Hsieh
authors: Pei-Shan
authors: PS
authors: Tsai
mesh_terms: D015670:Acupuncture Therapy; D005260:Female; D006801:Humans; D047648:Perimenopause / Q000523:psychology*; D017698:Postmenopause / Q000523:psychology*; D016032:Randomized Controlled Trials as Topic; D012893:Sleep Wake Disorders / Q000628:therapy*