Acupuncture Improves Sleep, Melatonin Levels in Pregnancy-Related Insomnia

Acupuncture improves sleep quality in pregnant women, possibly by increasing melatonin secretion, according to findings published in Nature and Science of Sleep.

Nearly half of pregnant women suffer from poor quality sleep, particularly in the third trimester, and poor sleep is associated with an increased risk of preterm delivery and postnatal depression. Sleep disruption during pregnancy may negatively affect fetal growth.

Saeedeh Foroughinia, MD, of the Obstetrics and Gynecology Department, Shiraz University Medical Sciences, Shiraz, Iran, and colleagues conducted a randomized, parallel, single-blinded, controlled trial on 72 pregnant women with insomnia. The women were randomly assigned to either 10 sessions of acupuncture treatment over a 3 week period or the control group, which received sleep hygiene education and sham acupuncture. The investigators evaluated participants at baseline and post-treatment with the Pittsburgh Sleep Quality Index (PSQI) and urinary 6-sulfatoxymelatonin. 

Overall, 55 patients completed the study, with 26 patients (mean age, 31.7±5.7 years) in the intervention group and 29 patients (mean age, 30.2±3.4 years) in the control group. At baseline, PSQI and 6-sulfatoxymelatonin were not significantly different between the groups. However, by the end of the study, treatment with acupuncture significantly improved both the PSQI score (6.0±1.1 vs 12.1±2.0; P <.001) and 6-sulfatoxymelatonin levels (27.4±6.5 vs 22.8±7.6 ng/mg; P =.020). The effect sizes for those outcomes were 3.7 and 0.6, respectively.

The investigators reported no adverse effects during acupuncture sessions and follow-up visits. Acupuncture treatment resulted in a 6.7 point improvement in total PSQI score, consistent with prior findings. Study limitations included the lack of long term follow-up, and the acupuncturist could not be blinded to the assigned groups because of the nature of the intervention.

“Acupuncture efficacy could be attributable to its regulatory effect on various neuroendocrinological pathways,” the researchers noted, “It has been shown that stimulation of certain acupoints resulted in a change in a wide range of neuroendocrinological mediators, such as norepinephrine, melatonin, gamma-aminobutyric acid, and β-endorphin.”


Foroughinia S, Hessami K, Asadi N, et al. Effect of acupuncture on pregnancy-related insomnia and melatonin: A single-blinded, randomized, placebo-controlled trial. Nature Sci Sleep. 2020;12:271-278.