What the evidence shows
Systematic reviews of acupuncture for insomnia generally conclude that it may be better than no treatment and better than some medications on certain measures, but that the quality of evidence is low to moderate and the comparison with sham acupuncture is often not significant.
That last point matters. Sham needling — at non-traditional points, or with non-penetrating needles — produces measurable effects of its own. So the finding "acupuncture beats sham" is genuinely uncertain, while "acupuncture beats nothing" is more consistently reported. The specific effect of point selection remains unproven, while the non-specific effect — being treated, resting quietly for 30 minutes, having attention paid to your complaint — is real and is not nothing.
Safety and practicalities
- Serious adverse events are rare with a properly trained practitioner using sterile single-use needles. Minor bruising and soreness are common.
- Choose a licensed, registered practitioner with recognised training.
- Courses typically run several sessions per week for a number of weeks — a real commitment of time and money.
- Do not use it in place of assessment for apnoea, restless legs, or mood disorder.
Acupressure instead
Self-administered acupressure — sustained pressure on points rather than needles — has a smaller literature but is free and can be done in bed. Commonly used points for sleep include those on the inner wrist, behind the ear, and on the sole of the foot. The evidence is weak, but the risk is close to zero, and the act of slow sustained pressure is itself settling.
Where it fits
If you have access to a good practitioner, find it helpful, and can afford it, acupuncture is a reasonable adjunct. It should not displace CBT-I, which has substantially stronger evidence, and it should not delay assessment for the conditions that mimic insomnia.
The common thread
Most of the therapies that help with insomnia — acupuncture, hypnosis, meditation, Feldenkrais — share a non-specific core: 20 to 40 minutes of quiet, guided, low-demand attention paid to your body, at a regular time, with an expectation of improvement. That core is worth a great deal, and it is available without needles.