Up to 60 per cent of cancer survivors are estimated to have some form of insomnia, and it is often underdiagnosed and undertreated. A large randomised trial from New York put two non-drug options head to head: cognitive behavioural therapy for insomnia (CBT-I) and acupuncture. The result is more useful, and more honest, than a simple "acupuncture works".
The trial, run by researchers at Memorial Sloan Kettering Cancer Center and published in the Journal of the National Cancer Institute in 2019, enrolled 160 people who had finished treatment for cancers including breast, prostate, head and neck, blood and colorectal, and who had a diagnosed insomnia disorder. Half had eight weeks of acupuncture and half had eight weeks of CBT-I. Sleep was measured with the Insomnia Severity Index, a questionnaire scored from 0 to 28 where a higher score means worse insomnia.
Insomnia scores fell by an average of 8.3 points with acupuncture and 10.9 points with CBT-I. Both are clinically meaningful changes.
Both groups held on to their improvements when checked again at 20 weeks.
CBT-I produced a larger improvement overall, and the authors concluded it should be the first line of therapy.
Among people with moderate to severe insomnia, response rates were similar: about 75 per cent with CBT-I and 66 per cent with acupuncture.
Among people with mild insomnia, CBT-I did far better in this trial: 85 per cent responded, compared with 18 per cent with acupuncture.
Now patients have more choices to manage their insomnia.
Dr Jun Mao, Memorial Sloan Kettering Cancer Center, as reported by CURECBT-I is the better-supported first step. It is a structured programme that works on sleep timing, time spent in bed, unhelpful beliefs about sleep and sleep habits, and it is usually delivered by a trained clinician or a structured programme. Ask your GP or cancer team how to access it.
Acupuncture is a sensible option if you cannot or do not want to do CBT-I, if you are waiting for it, or if your insomnia is moderate to severe. The trial did not test the two together, so we cannot say whether combining them adds anything.
Poor sleep after cancer can also have medical causes worth checking with your doctor, such as pain, hot flushes, medicines, low mood or sleep apnoea. Please tell your cancer team about any complementary therapy you use.
If you have finished cancer treatment and are struggling to sleep, we would start with a full history: your treatment, medicines, pain, mood and hot flushes. We would check whether you have been offered CBT-I and track your sleep with a simple score so that you can see whether anything is changing. Acupuncture is adapted to your treatment history, so we need to know about low blood counts, blood thinners and any risk of lymphoedema. We work alongside your GP and cancer team, never instead of them. See also our earlier article on cancer-related insomnia.
Book a consultation at AcuRodos in Clonee Village, Co. Meath, to talk about whether acupuncture could support you alongside your medical care.
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