A Meta-Analysis of Alternative and Complementary Medicine for the Treatment of Insomnia

Abstract

Specific Aims: To evaluate three complementary and alternative medicines (CAM), tai-chi, acupuncture, and melatonin, for treating insomnia using meta-analysis assessment of randomized controlled trials. Methods: The electronic database MEDLINE (PubMed) was searched from May of 2012 to November of 2012 by using the terms “sleep initiation and maintenance disorders” AND “tai-chi” OR “melatonin” OR “acupuncture”. All of the searches ended at November of 2012. Data extraction was conducted independently by 2 investigators and any disagreements were resolved by consensus. If the 2 investigators could not agree, the study was reviewed by all 4 investigators. Main Results: Out of 500 studies that were initially retrieved, 12 studies were included; 3 for tai-chi; 4 for acupuncture; 5 for melatonin. We found that the effect of each type of intervention was significantly different than zero, p<0.01 thus all were effective in treating insomnia. From our analysis, acupuncture was the most effective (standard mean difference, SMD=-0.66; p<0.01) followed by tai-chi (SMD=-0.43; p<0.01) whereas melatonin was the least effective (SMD=-0.26; p=0.04) but difference between acupuncture and melatonin was not significant (p=0.15). Conclusion: All three interventions were found to be effective in treating insomnia. However, due to mixed and inconsistent data of the studies, poorly designed trials, and small sample size, further large, well-controlled trials are warranted.