Efficacy and safety of non-invasive neurostimulation for insomnia in adults: protocol of a systematic review and network meta-analysis.

Researchers are planning a comprehensive review to evaluate whether non-invasive brain stimulation techniques can help adults who struggle with insomnia. Many people have difficulty sleeping, and while medications exist, they often come with side effects or dependency concerns. Non-invasive neurostimulation refers to techniques that use gentle electrical or magnetic pulses to influence brain activity without surgery or needles—methods like transcranial magnetic stimulation (TMS) or cranial electrotherapy stimulation. This study won't conduct new experiments but will gather and analyze all existing research on these treatments to determine which approaches work best and how safe they are. The researchers will examine studies from major medical databases, looking specifically at how well these techniques improve sleep quality (measured by standardized questionnaires like the Pittsburgh Sleep Quality Index), reduce insomnia severity, and affect emotional wellbeing and quality of life. They'll also carefully track any side effects reported. By comparing multiple treatment types simultaneously using advanced statistical methods, this review aims to rank the effectiveness of different neurostimulation approaches. For patients considering complementary treatments like acupuncture for insomnia, this research is relevant because electroacupuncture (acupuncture with electrical stimulation) represents one form of neurostimulation that may be included in such analyses. The findings will help both patients and healthcare providers make more informed decisions about which non-invasive options might work best for improving sleep without medication. When considering acupuncture or electroacupuncture for sleep problems, seek a licensed acupuncturist with specialized training in treating insomnia.

This protocol outlines a systematic review and network meta-analysis examining non-invasive neurostimulation modalities for adult insomnia. The study will search six major databases (PubMed/Medline, Web of Science, Embase, CENTRAL, Scopus, PsycINFO) from inception through August 2025 for relevant RCTs without language restrictions. Primary outcome measures include Pittsburgh Sleep Quality Index (PSQI) scores, with secondary outcomes encompassing Insomnia Severity Index (ISI), emotional symptoms, quality of life, and adverse events. Methodology employs Bayesian random-effects modeling to integrate direct and indirect evidence across interventions, with analysis conducted via R software. Risk of bias assessment and evidence quality evaluation using CINeMA framework will be performed by independent reviewers. This comprehensive analysis aims to establish comparative efficacy rankings among various neurostimulation techniques, potentially including electroacupuncture among the modalities examined. Clinical relevance: This NMA will provide hierarchical evidence for selecting optimal non-invasive neurostimulation approaches in insomnia management, informing evidence-based treatment protocols. No sample sizes or effect sizes are reported as this is a protocol paper.