The efficacy and safety stimulating a single acu-point shenmen (HT 7) for managing insomnia: A systematic review of randomized controlled trials

IntroductionInsomnia can occur independently or in conjunction with other diseases, with the common symptom of poor sleep quantity and/or decreasing time asleep. In Chinese medicine, the acu-point HT7 along heart meridian is a very important acu-point for treating insomnia, however no systematic reviews have been carried out to evaluate the effectiveness of stimulating HT7 as a single point for treating insomnia.MethodsA literature search of English and Chinese databases was carried out for randomized controlled trials evaluating the stimulation of HT7 as a sole acu-point for insomnia (irrespective of cause) compared with routine care or placebo. Trial reporting quality was assessed using the Standards for Reporting Interventions in Clinical Trials of Acupuncture (STRICTA) checklist and the Cochrane Risk of Bias Tool (PROSPERO registration numner: CRD42016036191).ResultsFour trials involving 436 participants were included. All trials were limited in their reporting and methodological quality. Statistically significant improvements were shown for HT7 simulation used for patients with insomnia who had coronary heart disease (measured by improvement ratio), and the simulation included acupressure (P < 0.05) and moxa (х2 = 18.98, P < 0.01); Statistically improvements were shown for HT7 acupressure used for insomnia occurred independently (measured by anxiety questionnaires - a sensation of wellbeing and urinary sulphate-melatonin evaluation). No trial reported any adverse events.ConclusionsThere was insufficient evidence to confirm whether HT7 stimulation could improve insomnia but there are some positive indications which warrant further research. These findings should be interpreted with caution due to the poor reporting and methodological quality of included trials.