0451 Effectiveness of Traditional Chinese Medicine-Based Lifestyle Intervention for Insomnia: Systematic Review and Meta-Analysis

Abstract Introduction The treatment of Traditional Chinese Medicine-based lifestyle (TCM-L) intervention for insomnia has not yet been thoroughly studied. This study aimed to systematically review and synthesize the existing evidence on the effects of TCM-L intervention for insomnia in adults. Methods A comprehensive search of 11 databases included all records available from inception to September 2025. Randomized controlled trials (RCTs) examining the effect of TCM-L interventions for insomnia were included. The risk of bias was assessed using version 2 of the Cochrane risk of bias tool for randomized trials, and the quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. Meta-analyses were conducted using R (version 4.3.2). Results A total of 14 RCTs involving 1,730 participants were included in this review. Results showed that, compared with usual care or no intervention (k = 11, MD = −4.28, 95% CI [−5.38, −3.18], p < 0.0001, I2 = 96.1%), TCM-L interventions demonstrated significantly greater improvements. For comparisons with lifestyle modifications (k = 1, MD = −1.62, 95% CI [−2.04, −1.20]; p < 0.0001), TCM health education (k = 1, MD = −2.05, 95% CI [−3.01, −1.09]; p < 0.0001), and CBT-I (k = 1, MD = −2.05, 95% CI [−2.60, −1.50]; p < 0.0001), only data from single studies were reported due to the lack of multiple eligible studies for meta-analysis. Subgroup analyses supported the finding that the TCM-L intervention is more effective at improving insomnia among participants recruited from hospitals (k = 8, MD = −4.97, 95% CI [−6.08, −3.86], I2 = 94.6%) than from the community (k = 3, MD = −2.56, 95% CI [−4.11, −1.00], I2 = 96.1%). Sensitivity analysis using the leave-one-out method confirmed the statistical robustness of our findings. There was no evidence of publication bias. Conclusion Our findings provide preliminary evidence supporting the potential benefits of TCM-L interventions for relieving insomnia. Larger, high-quality RCTs are needed to confirm these results. Support (if any) The Chinese Medicine Development Fund supported this project, Hong Kong Special Administrative Region, China (Project No. 24B2/045A_R1).