Exploring the potential transdiagnostic treatment effects of Chinese herbal medicine and acupuncture on insomnia disorder comorbid with chronic pain: A scoping review
Background: Over 20 % of adults with insomnia disorder also experience chronic pain, termed insomnia disorder comorbid with chronic pain (ICCP), increasing risks for physical and mental diseases. Current treatments like cognitive behavioral therapy for insomnia show inconsistent pain relief, and non...
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Elsevier
2025-12-01
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| Series: | Integrative Medicine Research |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213422025000885 |
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| author | Yan Ling Kwok Ran Wang Hiu To Tang Siyu Chen Albert Yeung Zhaoxiang Bian Danny J. Yu |
| author_facet | Yan Ling Kwok Ran Wang Hiu To Tang Siyu Chen Albert Yeung Zhaoxiang Bian Danny J. Yu |
| author_sort | Yan Ling Kwok |
| collection | DOAJ |
| description | Background: Over 20 % of adults with insomnia disorder also experience chronic pain, termed insomnia disorder comorbid with chronic pain (ICCP), increasing risks for physical and mental diseases. Current treatments like cognitive behavioral therapy for insomnia show inconsistent pain relief, and non-opioid analgesics may exacerbate insomnia, underscoring the need for alternative approaches. Chinese herbal medicine (CHM) and acupuncture, guided by traditional Chinese medicine, may offer transdiagnostic benefits for ICCP, but a comprehensive review is lacking. This scoping review evaluates their therapeutic effects and mechanisms for ICCP. Methods: PubMed, Wanfang, ClinicalTrials.gov and Google Scholar were searched up to December 31, 2024, for randomized controlled trials (RCTs) involving adults (≥18 years) with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition-defined insomnia and the International Association for the Study of Pain-defined chronic pain, treated with CHM or acupuncture. Effect sizes (modified Cohen’s d) assessed efficacy of interventions, and the Cochrane Risk of Bias 2 tool evaluated the risk of bias. Results: Six RCTs (487 participants) were included. CHM (modified Guipi decoction) showed medium to large effects for insomnia (d = 0.70–1.17) and pain (d = 0.67–1.42) versus diazepam/estazolam. Acupuncture had medium to large effects for insomnia (d = 0.64–0.99) and pain (d = 0.80–1.33) compared to treatment as usual. Combined CHM (Da Huoluo capsules) and acupuncture showed medium effects (d = 0.72 for insomnia; d = 0.57 for pain) versus multi-medications/traction. Most studies (83.33 %) had high risk of bias. Conclusion: CHM and acupuncture show promise for ICCP management, but high risk of bias warrants cautious interpretation and further high-quality RCTs. |
| format | Article |
| id | doaj-art-2d926430e429405f913bec2ed185ffcd |
| institution | Kabale University |
| issn | 2213-4220 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Integrative Medicine Research |
| spelling | doaj-art-2d926430e429405f913bec2ed185ffcd2025-08-20T05:06:46ZengElsevierIntegrative Medicine Research2213-42202025-12-0114410120810.1016/j.imr.2025.101208Exploring the potential transdiagnostic treatment effects of Chinese herbal medicine and acupuncture on insomnia disorder comorbid with chronic pain: A scoping reviewYan Ling Kwok0Ran Wang1Hiu To Tang2Siyu Chen3Albert Yeung4Zhaoxiang Bian5Danny J. Yu6Vincent V.C. Woo Chinese Medicine Clinical Research Institute, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China; School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, ChinaSleep Research Clinic and Laboratory, Department of Psychology, The University of Hong Kong, Hong Kong SAR, ChinaVincent V.C. Woo Chinese Medicine Clinical Research Institute, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China; School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, ChinaVincent V.C. Woo Chinese Medicine Clinical Research Institute, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China; School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, ChinaDepression Clinical and Research Program, Massachusetts General Hospital, Boston, USAVincent V.C. Woo Chinese Medicine Clinical Research Institute, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China; School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China; Centre for Chinese Herbal Medicine Drug Development Limited, Hong Kong Baptist University, Hong Kong SAR, China; The Chinese Medicine Hospital of Hong Kong, Hong Kong SAR, China; Corresponding authors at: School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China.Vincent V.C. Woo Chinese Medicine Clinical Research Institute, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China; School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China; Corresponding authors at: School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China.Background: Over 20 % of adults with insomnia disorder also experience chronic pain, termed insomnia disorder comorbid with chronic pain (ICCP), increasing risks for physical and mental diseases. Current treatments like cognitive behavioral therapy for insomnia show inconsistent pain relief, and non-opioid analgesics may exacerbate insomnia, underscoring the need for alternative approaches. Chinese herbal medicine (CHM) and acupuncture, guided by traditional Chinese medicine, may offer transdiagnostic benefits for ICCP, but a comprehensive review is lacking. This scoping review evaluates their therapeutic effects and mechanisms for ICCP. Methods: PubMed, Wanfang, ClinicalTrials.gov and Google Scholar were searched up to December 31, 2024, for randomized controlled trials (RCTs) involving adults (≥18 years) with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition-defined insomnia and the International Association for the Study of Pain-defined chronic pain, treated with CHM or acupuncture. Effect sizes (modified Cohen’s d) assessed efficacy of interventions, and the Cochrane Risk of Bias 2 tool evaluated the risk of bias. Results: Six RCTs (487 participants) were included. CHM (modified Guipi decoction) showed medium to large effects for insomnia (d = 0.70–1.17) and pain (d = 0.67–1.42) versus diazepam/estazolam. Acupuncture had medium to large effects for insomnia (d = 0.64–0.99) and pain (d = 0.80–1.33) compared to treatment as usual. Combined CHM (Da Huoluo capsules) and acupuncture showed medium effects (d = 0.72 for insomnia; d = 0.57 for pain) versus multi-medications/traction. Most studies (83.33 %) had high risk of bias. Conclusion: CHM and acupuncture show promise for ICCP management, but high risk of bias warrants cautious interpretation and further high-quality RCTs.http://www.sciencedirect.com/science/article/pii/S2213422025000885Insomnia disorderChronic painChinese herbal medicineAcupunctureTransdiagnostic effect |
| spellingShingle | Yan Ling Kwok Ran Wang Hiu To Tang Siyu Chen Albert Yeung Zhaoxiang Bian Danny J. Yu Exploring the potential transdiagnostic treatment effects of Chinese herbal medicine and acupuncture on insomnia disorder comorbid with chronic pain: A scoping review Integrative Medicine Research Insomnia disorder Chronic pain Chinese herbal medicine Acupuncture Transdiagnostic effect |
| title | Exploring the potential transdiagnostic treatment effects of Chinese herbal medicine and acupuncture on insomnia disorder comorbid with chronic pain: A scoping review |
| title_full | Exploring the potential transdiagnostic treatment effects of Chinese herbal medicine and acupuncture on insomnia disorder comorbid with chronic pain: A scoping review |
| title_fullStr | Exploring the potential transdiagnostic treatment effects of Chinese herbal medicine and acupuncture on insomnia disorder comorbid with chronic pain: A scoping review |
| title_full_unstemmed | Exploring the potential transdiagnostic treatment effects of Chinese herbal medicine and acupuncture on insomnia disorder comorbid with chronic pain: A scoping review |
| title_short | Exploring the potential transdiagnostic treatment effects of Chinese herbal medicine and acupuncture on insomnia disorder comorbid with chronic pain: A scoping review |
| title_sort | exploring the potential transdiagnostic treatment effects of chinese herbal medicine and acupuncture on insomnia disorder comorbid with chronic pain a scoping review |
| topic | Insomnia disorder Chronic pain Chinese herbal medicine Acupuncture Transdiagnostic effect |
| url | http://www.sciencedirect.com/science/article/pii/S2213422025000885 |
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