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

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; < 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; < 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; < 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.