Design: Randomised, sham-controlled trial
Population: 76 women with gynaecological cancer on chemotherapy
Primary outcome: Pittsburgh Sleep Quality Index change at 4 weeks
Effect: Mean difference −3.11 (95% CI −4.11 to −2.11)

In a trial of 76 women with gynaecological cancer receiving chemotherapy, all had four weeks of cognitive behavioural therapy for insomnia (CBT-I), plus either electroacupuncture or a sham.

Sleep quality improved more with electroacupuncture: the Pittsburgh Sleep Quality Index fell 3.11 points further (95% CI 2.11 to 4.11). More reached a low insomnia score (71.1% vs 42.1%) and a low anxiety score (92.1% vs 65.8%). No serious adverse events occurred.

The sham control is a strength. But the trial was small, short and in one population, so it is a reason to look for replication rather than to change referral pathways now. CBT-I itself remains the foundation.

Screen for insomnia and anxiety in patients on chemotherapy — both are common and undertreated
Offer CBT-I as the first-line treatment for insomnia where available
Consider acupuncture as an adjunct only where a qualified service already exists
Avoid starting long-term hypnotics as the default answer in this group

Why it matters

Insomnia and anxiety during chemotherapy are rarely treated, and non-drug options are scarce.

The statistics, in plain English

A 3-point extra fall on the 21-point sleep index is a moderate change. With only 38 women per arm, the percentages could shift substantially in a larger trial.