Comparative efficacy of Qigong exercise and other external treatments of traditional Chinese medicine on insomnia in the elderly: A network meta-analysis

IntroductionInsomnia triggers an enormous burden on peoples physical and mental health, especially for the elderly. Traditional Chinese medicine (TCM) therapies were widely used for curing senile insomnia, while the efficiency among various external treatments of TCM (ETs-TCM) was rarely reported. MethodOur network meta-analysis aims to compare and evaluate the optimal ETs-TCM to cure insomnia in the geriatric population. We systematically searched randomized controlled trials (RCTs) published until April 27, 2023 from nine databases. All participants satisfying the diagnosis criteria were recruited without limiting sex, nationality, or race. ResultFrom the initial 13,846 terms searched, we read 2,936 full-text articles and finally included 85 studies (12,724 participants) in our network meta-analysis. The total effective (TE) rate and Pittsburgh Sleep Quality Index (PSQI) score were selected standards for evaluating the effects of ETs-TCM. Evaluated by TE, Qigong plus acupressure massage has the highest probability (83.5%) of being the most effective treatment from its Surface Under the Cumulative Ranking Curves (SUCRA) at 96.7. Additionally, when evaluated using the PSQI, Acupressure Massage had the highest probability (32.9%) of being the most effective treatment (SUCRA=90.9). ConculsionOur findings suggest that the combination of acupressure massage and Qigong, or either method alone, may be effective treatments for insomnia in the elderly. This study provides valuable insight for future senile insomnia interventions using ETs-TCM, emphasizing the significance of manual therapy and gentle mind-body exercise as an alternative to medication.