Intervention effect of nursing techniques of traditional Chinese medicine on post-stroke insomnia: a network meta-analysis

BACKGROUND: Insomnia is a common problem after a stroke, affecting daily life and the recovery process. Among the many Traditional Chinese Medicine(TCM) nursing techniques, it is still unknown which measures are most effective. OBJECTIVE: To evaluate the efficacy of different TCM nursing techniques on post-stroke insomnia(PSI) by network meta-analysis(NMA). METHODS: A search was conducted across ten databases to identify randomized controlled trials (RCTs) investigating TCM nursing techniques for patients with PSI, up to April 25, 2024. The quality of the literature was assessed using the bias risk assessment tool recommended in Cochrane Handbook 5.1.0.The NMA was performed using Stata software. Intervention efficacy was ranked using Surface Under the Cumulative Ranking Curve (SUCRA) values. RESULTS: A total of 4, 334 articles were identified, and 46 studies were finally included. A total of 20 TCM nursing techniques were included. In terms of clinical effectiveness rate, auricular acupressure combined with gua sha performed best (SUCRA = 74.3%), while acupoint application was the best intervention for improving PSQI score (SUCRA = 84.4%). CONCLUSIONS: TCM nursing techniques can effectively improve sleep in patients with PSI. However, caution is warranted due to the heterogeneity of the included studies, risk of bias, and limited sample sizes in some studies. In the future, more large-sample, high-quality randomized controlled studies are needed to provide more evidence-based evidence for clinical healthcare professionals. TRIAL REGISTRATION: The core protocol of this study was registered at PROSPERO database (CRD42024585602) on September 2024.