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Effectiveness of nonpharmacological interventions for menopause-related insomnia: A systematic review and Bayesian network meta-analysis.

MaturitasยทNovember 2025ยทZhongli Wang, Haoyu Yang, Shutong Li et al.
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Key Finding

Acupuncture significantly improved sleep quality in menopausal women with insomnia, though mindfulness meditation ranked as the most effective nonpharmacological intervention overall.

What This Means For You

Menopause often brings sleepless nights, leaving many women exhausted and searching for relief. While sleeping pills are one option, researchers wanted to know which drug-free approaches actually work best for improving sleep during menopause. This comprehensive study analyzed 44 clinical trials involving various natural therapies including acupuncture, yoga, massage, exercise, aromatherapy, relaxation techniques, cognitive behavioral therapy, and mindfulness practices. All eight treatment types showed significant improvements in sleep quality compared to doing nothing. The researchers found that mindfulness meditation was the most effective approach, followed by relaxation techniques and cognitive behavioral therapy. Acupuncture also demonstrated meaningful benefits for menopausal insomnia, with results showing it significantly improved sleep quality. The advantage of these nonpharmacological treatments is they avoid the side effects and dependency risks associated with sleep medications. For women experiencing menopause-related insomnia, this research confirms that acupuncture represents a valid, evidence-based option worth considering. The study's strength lies in its comprehensive comparison of multiple approaches, helping women and their healthcare providers make informed decisions about treatment. Whether used alone or combined with other therapies, acupuncture offers a safe pathway to better sleep during the menopausal transition. If you're considering acupuncture for sleep problems related to menopause, seek a licensed acupuncturist with experience treating women's health conditions.

Clinical Notes for Practitioners

This Bayesian network meta-analysis examined nonpharmacological interventions for menopause-related insomnia by systematically reviewing 44 randomized controlled trials identified from major databases through May 2025. Using random-effects models, researchers calculated mean differences (MD) for sleep quality outcomes measured primarily by validated instruments. Eight interventions demonstrated statistically significant improvements versus control: mindfulness (MD -5.61, 95% CrI: -8.70 to -2.50), relaxation, cognitive behavioral therapy, aromatherapy, acupuncture, massage, yoga, and exercise (MD -2.40, 95% CrI: -4.19 to -0.62). Surface under the cumulative ranking curve (SUCRA) analysis identified mindfulness as most effective, though acupuncture showed meaningful clinical benefit. Quality assessment utilized the Cochrane RoB2 tool. Clinical implications suggest acupuncture represents an evidence-based option within a multimodal treatment approach for menopausal insomnia, particularly for patients seeking nonpharmacological alternatives with established safety profiles.

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