From Needles to Photons: Clinical Efficacy, Safety, and Mechanistic Insights of Laser Acupuncture in Insomnia Management

Insomnia constitutes a significant worldwide public health burden. Limitations of conventional treatments, such as cognitive-behavioral therapy and hypnotic medications, have fueled growing interest in complementary and alternative medicine approaches, including laser acupuncture (LA). This comprehensive mini-review evaluates LA's effects and mechanisms for insomnia management. Clinical evidence indicates that LA alleviates both primary insomnia and comorbid cases (eg, with cancer, hypertension, and perimenopausal syndrome). LA demonstrates efficacy comparable to traditional needle acupuncture in improving subjective and objective sleep quality, while also reducing affective symptoms and enhancing quality of life. This provides an appealing alternative for needle-phobia patients. LA appears generally safe, with only mild, transient adverse effects reported. Mechanistic investigations suggest that LA may act via neurotransmitter modulation, autonomic nervous system regulation, and alterations in brain wave activity. However, methodological limitations -- particularly small sample sizes, heterogeneous populations, incomplete treatment parameter reporting, and insufficient follow-ups -- compromise the current evidence base. Future research should adopt multicenter, large-scale, placebo-controlled randomized trials, complemented by advanced techniques such as neuroimaging, polysomnography, and neurochemical assays, to further validate the therapeutic potential of LA and elucidate its underlying mechanisms.