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Chronic Pain1 min read

Effects of acupuncture at ST-36 (Zusanli) on pain and associated sleep disturbance.

Journal of traditional and complementary medicineยทMarch 2026ยทYi-Jou Wu, Pei-Lu Yi, Fang-Chia Chang
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Key Finding

Acupuncture at ST-36 significantly increased both NREM and REM sleep while reducing pain-induced sleep disturbances through activation of opioid receptors in the nucleus tractus solitarius.

What This Means For You

Chronic pain often makes it difficult to sleep, creating a harmful cycle where poor sleep worsens pain and pain disrupts sleep further. While medications can help, they frequently cause unwanted side effects. This animal study examined whether acupuncture at ST-36 (Zusanli), a point on the lower leg, could improve sleep problems caused by chronic pain.

Researchers induced inflammatory pain in rats and then monitored their brain and muscle activity to measure sleep patterns for 72 hours after acupuncture treatment. They tracked both deep sleep (non-REM) and dream sleep (REM) stages. The study also investigated whether the body's natural pain-relief system, involving opioid receptors in a brain region called the nucleus tractus solitarius, played a role in acupuncture's effects.

The results showed that acupuncture significantly improved both types of sleep compared to baseline measurements. Rats receiving acupuncture slept more overall and spent less time awake. Pain levels also decreased, as demonstrated by improved responses to paw withdrawal tests. When researchers blocked opioid receptors in the brain, acupuncture's benefits on both sleep and pain disappeared, suggesting that acupuncture works through the body's natural opioid system.

For patients struggling with chronic pain and sleep problems, this research suggests acupuncture at ST-36 may offer relief without medication side effects. While this was an animal study, the findings support acupuncture as a potential non-drug treatment for pain-related insomnia. If you're considering acupuncture for chronic pain and sleep disturbances, consult a licensed acupuncturist who can develop an appropriate treatment plan for your specific condition.

Clinical Notes for Practitioners

This animal study investigated acupuncture at ST-36 for pain-induced sleep disturbance using adult male Sprague-Dawley rats with complete Freund's adjuvant (CFA)-induced inflammatory pain. Sleep architecture was assessed via EEG/EMG recordings for 72 hours post-treatment, with NREM and REM sleep stages analyzed. Acupuncture significantly increased both NREM and REM sleep duration while reducing wakefulness compared to baseline. Pain thresholds measured through paw withdrawal latency tests showed significant elevation following acupuncture treatment. Mechanistic investigation revealed that naloxone microinjection into the nucleus tractus solitarius completely abolished acupuncture's sleep-promoting and analgesic effects, implicating opioid receptor activation in the NTS as the underlying mechanism. Clinical relevance: ST-36 acupuncture demonstrates dual therapeutic action addressing both pain and associated sleep disturbances through endogenous opioid pathways, supporting its application as a non-pharmacological intervention for chronic pain patients presenting with insomnia. Sample size and effect size were not specified in the abstract.

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