Presentation summary

Co-Authors :
Cheng-Hao Huang^1,2, Shun-Ku Lin³, Heng-Jun Lin⁴, Ching-Liang Hsieh^2,5,6,*

¹School of Post-Baccalaureate Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung City, Taiwan

²Department of Chinese Medicine, China Medical University Hospital, Taichung City, Taiwan

³Institute of Public Health, National Yang Ming Chiao Tung University, Taipei City, Taiwan

⁴Management Office for Health Data, China Medical University Hospital, Taichung City, Taiwan

⁵Chinese Medicine Research Center, China Medical University, Taichung City, Taiwan

⁶Graduate Institute of Acupuncture Science, China Medical University, Taichung City, Taiwan

Introduction :
Insomnia has emerged as a significant, modifiable risk factor for stroke. While pharmacologic treatments are common, their adverse effects have prompted growing interest in alternative strategies. Acupuncture, a key modality in traditional Chinese medicine, has demonstrated potential in improving sleep quality. This study aimed to evaluate whether acupuncture treatment is associated with a reduced incidence of stroke among patients with insomnia.

Method :
We conducted a retrospective cohort study using Taiwan’s National Health Insurance Research Database (NHIRD) from 2000 to 2017. To reduce potential confounding, a 1:1 propensity score matching method was applied based on age, sex, comorbidities, and medication use. Participants were divided into two groups: those who received acupuncture treatment and those who did not. The primary endpoint was the occurrence of stroke. All participants were followed until the diagnosis of stroke, death, or December 31, 2018, whichever came first. Cox proportional hazards models were used to estimate adjusted hazard ratios (aHRs), and Kaplan–Meier analysis was used to assess cumulative incidence.

Results :
A total of 108,678 newly diagnosed insomnia patients who received acupuncture treatment were matched to 108,678 insomnia patients who did not receive acupuncture. The incidence rate of stroke was significantly lower in the acupuncture group (4.51 vs. 6.86 per 1,000 person-years). Acupuncture was associated with a 34% reduction in stroke risk (aHR = 0.66; 95% CI: 0.63–0.69; p < 0.001). Subgroup analysis revealed that patients who received ≥30 acupuncture sessions experienced a 42% risk reduction. Kaplan–Meier analysis demonstrated a significantly lower cumulative incidence of stroke in the acupuncture group, confirmed by the log-rank test (p < 0.001).

Conclusion :
Acupuncture treatment was significantly associated with a lower risk of stroke among patients with insomnia. These findings support the role of acupuncture as a promising nonpharmacological preventive strategy for stroke and warrant further prospective research.

Keywords :
Acupuncture; insomnia; stroke risk; retrospective cohort study; National Health Insurance Research Database (NHIRD)