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Ultrasound-Guided Stellate Ganglion Block with Cervicotemporal Myofascial Trigger Point Acupuncture for Insomnia with Comorbid Anxiety and Depression: A Retrospective Observational Study

Year: 2025

Type: article

Abstract: Purpose: Insomnia is a prevalent sleep-wake disturbance that significantly impairs the quality of life and adversely affects physical and mental health. This study aimed to evaluate the clinical efficacy of ultrasound-guided stellate ganglion block (SGB) combined with acupuncture at cervicotemporal myofascial trigger points (MTrPs) in patients with insomnia accompanied by anxiety and depression. Patients and Methods: This retrospective study included 42 patients diagnosed with insomnia and comorbid anxiety and depression who were treated at the Anesthesia and Sleep Clinic of the Shandong Second Provincial General Hospital between November 2024 and April 2025. All patients received ultrasound-guided SGB combined with acupuncture at cervicotemporal MTrPs. Treatment efficacy was assessed by comparing Pittsburgh Sleep Quality Index (PSQI), Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HAMD) scores before treatment initiation and four weeks after completion of the intervention. Results: Compared with baseline, post-treatment PSQI scores (5.00 ± 2.84 versus 17.10 ± 2.61; mean difference, -12.10; 95% Cl, -12.91 to -11.28; P < 0.001), HAMA scores (5.05 ± 2.80 versus 19.00 ± 4.23; mean difference, -13.95; 95% Cl, -15.0912.82 to -12.82; P < 0.001), and HAMD scores (3.41 ± 2.68 versus 15.76 ± 4.43; mean difference, -12.36; 95% Cl, -13.56 to -11.15; P < 0.001) were all significantly reduced after four weeks of therapy. Conclusion: The preliminary study suggests that ultrasound-guided SGB combined with acupuncture at the cervicotemporal MTrPs is an effective, comprehensive intervention for insomnia with comorbid anxiety and depression. The benefits may result from synergistic mechanisms involving autonomic balance regulation, suppression of excessive sympathetic activity, reduction of myofascial tension, and modulation of the sleep-wake cycle. These findings warrant further clinical application and investigation. Plain Language Summary: Sleep problems, such as insomnia, affect many people and can harm both mental and physical health. When insomnia occurs alongside anxiety or depression, the effects can be even more severe. This study examined a combined treatment for people with insomnia, anxiety, and depression. The approach used two techniques. The first was SGB, and the second was acupuncture at cervicotemporal MTrPs. We reviewed the records of 42 patients who received both treatments over four weeks. Before and after treatment, patients completed questionnaires measuring sleep quality, anxiety, and depression. The results showed significant improvements in sleep quality, with anxiety and depression symptoms becoming much milder. Anxiety showed the greatest improvement of the three measures. No patients experienced serious side effects. These findings suggest that combining SGB with acupuncture at MTrPs may help break the cycle in which poor sleep and emotional distress reinforce each other. Although these results are encouraging, the study was small and short-term. Larger, longer studies are needed to confirm these benefits and determine how long they last. Keywords: autonomic nervous system modulation, sleep quality, insomnia, emotional disorders, acupuncture therapy, sympathetic blockade

Source: Nature and Science of Sleep

DOI: 10.2147/nss.s551748