Effectiveness and Safety of Chinese Herbal Medicine in Treatment of Perimenopausal Insomnia: A Systematic Review and Meta-Analysis of Randomized Controlled Trails.
Jianni Cong, Huawei Zhang, Weiying Xing
PMID 40231842WHAT IT FOUND
In perimenopausal insomnia, Chinese herbal medicine alone lowered overall sleep-problem scores more than Western medicine alone.
When Chinese herbal medicine was added to Western medicine, overall sleep-problem scores did not improve more than Western medicine alone.
Key findings
01Chinese herbal medicine alone lowered overall Pittsburgh Sleep Quality Index scores compared with Western medicine alone, with a mean difference of -2.22; higher scores mean worse sleep.
02Adding Chinese herbal medicine to Western medicine did not lower overall Pittsburgh Sleep Quality Index scores more than Western medicine alone, with a mean difference of -1.55 and a 95% confidence interval from -6.45 to 3.35.
03Only 3 of 12 trials comparing Chinese herbal medicine with Western medicine and 3 of 8 trials comparing Chinese herbal medicine plus Western medicine with Western medicine reported adverse events, and reported reactions were more frequent in Western medicine groups.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Many trials only said they randomized; none reported allocation concealment or blinding, so participants and staff may have known which treatment they received. Only a few trials reported adverse events, so safety is hard to judge. The included trials used many different Chinese herbal formulas, often adjusted to symptoms, so results cannot be applied to a specific product. Few studies had long-term follow-up, so long-term benefit is unclear. Sleep could be affected by vasomotor symptoms, anxiety, depression, and osteoporosis, but these were not addressed. The adjunct analysis for the primary outcome was null, so the review does not show that adding Chinese herbal medicine to Western medicine improves overall sleep.
Declared interests
No funding source or author conflict-of-interest statement is given in the supplied text.
The easy way to misread this
Do not conclude Chinese herbal medicine is proven safe and effective for all perimenopausal women. The trials did not report allocation concealment or blinding, only a few reported adverse events, and adding Chinese herbal medicine to Western medicine did not improve the primary overall sleep score.