Clinical impact of electroacupuncture on sleep quality and affective outcomes in insomnia: A retrospective study

Background Insomnia is prevalent and linked to cognitive impairment, mood disorders, and reduced quality of life. Electroacupuncture, a safe nonpharmacological intervention, needs further validation of its comprehensive effects on sleep and affective outcomes. Objective To evaluate the clinical efficacy of electroacupuncture in improving sleep quality and affective symptoms in insomnia via retrospective analysis. Methods This retrospective study included 236 insomnia patients (Jan 2023–Apr 2026) who initially met the diagnostic criteria and were assigned to electroacupuncture (n = 119) or conventional therapy (n = 117). After propensity score matching (1:1) on age, sex, duration, and baseline Pittsburgh Sleep Quality Index, 110 patients per group were included in the final analysis. Primary endpoints: Self-Reported Sleep Status (SRSS) and Pittsburgh Insomnia Rating Scale (PIRS). Secondary endpoints: Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAM-D), Epworth Sleepiness Scale (ESS), and polysomnography (total sleep time, efficiency, latency, and rapid eye movement latency). Multivariate regression identified prognostic factors. Results After matching, baseline balanced. Electroacupuncture was associated with significantly reduced SRSS (38.21 ± 5.60 to 26.50 ± 6.20) and PIRS (38.50 ± 6.80 to 22.30 ± 7.50) vs. control (both p < 0.001). Median GAD-7, PHQ-9, ESS, and HAMA decreased from 13, 14, 13, and 18.5 to 6, 7, 6.5, and 10, respectively; HAM-D from 19.30 ± 5.40 to 10.80 ± 4.80 (all p < 0.01 vs. control). Polysomnography showed increased total sleep time (+40.74 min), efficiency (+8.70%), reduced latency (−7.81 min), and increased N3 sleep (+13.19 min, all p < 0.001). Regression confirmed that electroacupuncture improved PIRS (B = −10.46, 95% confidence interval (CI): −12.48 to −8.44) and SRSS (B = −7.55, 95% CI: −9.22 to −5.87). Conclusion Electroacupuncture was associated with better sleep quality, alleviated anxiety/depression, and improved sleep architecture. It may be a beneficial non-pharmacological approach, although safety was not systematically evaluated in this retrospective cohort. Prospective multicenter randomized controlled trials are warranted to confirm efficacy and safety.