Background Acupuncture has been demonstrated to be a safe and effective treatment for insomnia in patients without cancer. A lack of evidence, however, supports its application in the treatment of cancer-related insomnia (CRI).

Objective To conduct a systematic review and meta-analysis to assess the efficacy as well as safety of acupuncture for alleviating insomnia in patients with cancer.

Methods A systematic search was conducted using four electronic databases (PubMed, EMBASE, Scopus and the Cochrane Library) to select publications published in peer-reviewed journals written in English. The OR was calculated, along with their 95% CIs. We assessed heterogeneity using Cochrane Q, I² statistics and the appropriate p value. The analysis used RevMan V.5.3.

Findings The present meta-analysis comprised 561 individuals from 10 randomised controlled trials (RCTs) across age cohorts. Acupuncture intervention improves Pittsburgh Sleep Quality Index (PSQI) scores and CRI more than control, with a pooled OR of 1.66 (95% CI 1.12 to 2.46), OR of 5.90 (95% CI 2.64 to 13.23) for electroacupuncture, OR of 2.30 (95% CI 1.48 to 3.58) for auricular-acupuncture and 2.72. Acupuncture improved the Insomnia Severity Index (ISI) and CRI more than control approaches, with ORs of 1.31 (95% CI 0.69 to 2.48), 5.29 (95% CI 2.18 to 12.84), 3.17 (95% CI 1.35 to 7.44) and 1.64 (95% CI 1.00 to 2.68).

Conclusion The change in PSQI and ISI scores showed that acupuncture moderately improved insomnia in patients with cancer. Acupuncture is safe and effective, enabling subsequent clinical treatments.