Commercial Chinese polyherbal preparation Zao Ren An Shen prescription for primary insomnia: a systematic review with meta-analysis and trial sequential analysis.

Background: Natural products are widely used for primary insomnia (PI). This systematic review with trial sequential analysis (TSA) aimed to summarize evidence pertaining to the effectiveness and safety of Zao Ren An Shen (ZRAS) prescription, a commercial Chinese polyherbal preparation, for treating PI. Methods: Controlled clinical trials appraising ZRAS compared to controls or as an add-on treatment were systematically searched across seven databases until January 2024. Cochrane ROB 2.0 and ROBINS-I tools were adopted to determine risk of bias. Quality of evidence was assessed using the GRADE framework. Results: We analyzed 22 studies, involving 2,142 participants. The effect of ZRAS in reducing Pittsburgh Sleep Quality Index scores was found to be comparable to benzodiazepines [MD = 0.39, 95%CI (-0.12, 0.91), p = 0.13] and superior to Z-drugs [MD = -1.31, 95%CI (-2.37, -0.24), p = 0.02]. The addition of ZRAS to hypnotics more significantly reduced polysomnographically-recorded sleep onset latency [MD = -4.44 min, 95%CI (-7.98, -0.91), p = 0.01] and number of awakenings [MD = -0.89 times, 95%CI (-1.67, -0.10), p = 0.03], and increased total sleep time [MD = 40.72 min, 95%CI (25.14, 56.30), p < 0.01], with fewer adverse events than hypnotics alone. TSA validated the robustness of these quantitative synthesis results. However, the quality of evidence ranged from very low to low. The limited data available for follow-up did not support meta-synthesis. Conclusion: While ZRAS prescription shows promising effectiveness in treating PI, the overall quality of evidence is limited. Rigorously-designed randomized control trials are warranted to confirm the short-term efficacy of ZRAS and explore its medium-to-long-term efficacy. Systematic Review Registration: (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=471497), identifier (CRD42023471497).

Career Considerations in Nurse-Led Traditional Chinese Medicine Clinics: a Two-Center Qualitative Study.

Background: Growing demand exists for high-quality Traditional Chinese Medicine (TCM) care, particularly through Nurse-led TCM clinics (TCM-NLCs). Nurses with extensive experience in TCM departments represent a potential workforce for this healthcare model. This qualitative study aims to investigate the willingness of these candidates to engage in TCM-NLCs, with a specific focus on their main concerns and apprehensions when facing new challenges. Methods: Individual semi-structured face to face interviews were conducted with senior nurses from two TCM hospitals in Shanghai. Each participant had a minimum of three years of work experience in a TCM related department. Conventional qualitative content analysis was utilized. Results: Fourteen participants were interviewed and data saturation was achieved. Nurses exhibited strong interest in practicing in TCM-NLCs. They believed that such innovative TCM nursing service model not only extends nursing role, provides greater empowerment and opportunities for professional development but also meets patients' diverse healthcare needs, reduces reliance on other healthcare providers such as doctors, and increases hospital revenue. However, challenges such as deficiencies in evidence-based TCM nursing education, the absence of standardized practice guidelines, and limited prescriptive privileges were identified as primary obstacles to engaging in TCM-NLCs practice, potentially undermining the specialization of this advanced nursing practice model. Conclusion: Although the nurses interviewed were highly motivated, they generally lacked confidence to practice independently in TCM-NLCs. A pressing priority is to address their concerns by providing appropriate resources as well as education and policy support to enhance their competency and ensure their practice autonomy, therefore building a more qualified pool of professionals for advanced TCM nursing practice.

Study and Application on the Electromagnetic Stainless Steel: Microstructure, Tensile Mechanical Behavior, and Magnetic Properties.

Stainless steel grade 430 is a type of soft magnetic electromagnetic material with rapid magnetization and demagnetization properties. Considering the delay phenomenon during operation, this study selected 430 stainless steel as the material and explored various metallurgical methods such as magnetic annealing and the addition of Mo as well as increasing the Si content to investigate the microstructure, mechanical behavior, and magnetic properties of each material, aiming to improve the magnetic properties of 430 stainless steel. Experimental results showed that the four electromagnetic steel materials (430F, 430F-MA, 434, and KM31) had equiaxed grain matrix structures, and excellent tensile and elongation properties were observed for each specimen. Additionally, the magnetic properties of the 430F specimen were similar under the DC and AC-10 Hz conditions. According to the hysteresis curves under different AC frequencies (10, 100, 1000 Hz), both magnetic annealing and the addition of Mo could reduce the Bm, Br, and Hc values of the raw 430F material. Increasing the Si content resulted in a decrease in Hc values and an increase in Bm and Br values.

[Application of process analysis technology in traditional Chinese medicine manufacturing industry].

In the traditional Chinese medicine(TCM) manufacturing industry, quality control determines the safety, effectiveness, and quality stability of the final product. The traditional quality control method generally carries out sampling off-line testing of drugs after the end of the batch production, which is incomprehensive, and it fails to find the problems in the production process in time. Process analysis technology(PAT) uses process testing, mathematical modeling, data analysis, and other technologies to collect, analyze, feedback, control, and continuously improve the critical quality attributes(CQA) in all aspects of the production of TCM preparations in real time. The application of PAT in the TCM manufacturing industry is one of the research hotspots in recent years, which has the advantages of real-time, systematic, non-destructive, green, and rapid detection for the production quality control of TCM preparations. It can effectively ensure the stability of the quality of TCM preparations, improve production efficiency, and play a key role in the study of the quantity and quality transfer law of TCM. Commonly used PAT includes near-infrared spectroscopy, Raman spectroscopy, online microwave, etc. In addition, the establishment of an online detection model by PAT is the key basic work to realize intelligent manufacturing in TCM production. Obtaining real-time online detection data through PAT and establishing a closed-loop control model on this basis are a key common technical difficulty in the industry. This paper adopted systematic literature analysis to summarize the relevant Chinese and foreign literature, policies and regulations, and production applications, and it introduced the development trend and practical application of PAT, so as to provide references for accelerating the application of PAT in the TCM manufacturing industry, the intelligent transformation and upgrading, and high-quality development of the TCM industry.

Correction: Tumor Immunotherapy-Related Information on Internet-Based Videos Commonly Used by the Chinese Population: Content Quality Analysis.

[This corrects the article DOI: 10.2196/50561.].

Successful Treatment Strategy for Duplicate Inferior Vena Cava and Deep Venous Thrombosis: Filter Placement and Thrombolysis Approach.

BACKGROUND Duplicate inferior vena cava (IVC) accompanied by deep venous thrombosis is rare. The optimal treatment plan is determined according to the results of imaging, including venography. In this report, we present a case of successful treatment of a patient with duplicate IVC and deep venous thrombosis (DVT). CASE REPORT An 84-year-old man with history of hypertension was admitted to the hospital because of 4 days of moderate left lower-limb edema. A thorough examination led to the diagnosis of the DVT. The duplicate IVC was discovered during venography. As the blood from the left common iliac vein mainly flowed to the left IVC, and there were no other communicating branches before the convergence of the left and right IVCs, which was located above the 1st lumbar vertebrae body near the junction of the hepatic vein and the IVC, the strategy of placing only 1 filter in the left inferior vena cava were chosen, rather than placing 1 filter above the confluence of bilateral IVC, or placing a filter in each IVC below the level of renal veins on each side. Following that, the DVT was safely treated with thrombolysis and aspiration without the risk of pulmonary embolism. CONCLUSIONS This case report presented the complete evaluation and management of a patient with lower-limb DVT accompanied by the malformation of duplicate IVC. The filter placement strategy with duplicate IVC in the literature was summarized. We concluded that even in emergency situations, with comprehensive consideration, it is possible to perform endovascular intervention successfully and achieve satisfactory treatment results.

Jet-Printable, Low-Melting-Temperature Ga-xSn Eutectic Composites: Application in All-Solid-State Batteries.

Low-melting-point Ga-xSn eutectic composites and natural silicate mineral powders were used as the electrode and solid-state electrolyte, respectively, in all-solid-state batteries for green energy storage systems. The influences of the Sn content in the Ga-xSn composite electrode on the electrochemical performance of the batteries were evaluated, and liquid composites with a Sn concentration of up to 30 wt.% demonstrated suitability for electrode fabrication through dip coating. Sodium-enriched silicate was synthesized to serve as the solid-state electrolyte membrane because of the abundance of water molecules in its interlayer structure, enabling ion exchange. The battery capacity increased with the Sn content of the Ga-xSn anode. The formation of intermetallic compounds and oxides (CuGa2, Ga2O3, Cu6Sn5, and SnO2) resulted in a high charge-discharge capacity and stability. The Ga-Sn composite electrode for all-solid-state batteries exhibits a satisfiable capacity and stability and shows potential for jet-printed electrode applications.

Tumor Immunotherapy-Related Information on Internet-Based Videos Commonly Used by the Chinese Population: Content Quality Analysis.

BACKGROUND: Tumor immunotherapy is an innovative treatment today, but there are limited data on the quality of immunotherapy information on social networks. Dissemination of misinformation through the internet is a major social issue. OBJECTIVE: Our objective was to characterize the quality of information and presence of misinformation about tumor immunotherapy on internet-based videos commonly used by the Chinese population. METHODS: Using the keyword "tumor immunotherapy" in Chinese, we searched TikTok, Tencent, iQIYI, and BiliBili on March 5, 2022. We reviewed the 118 screened videos using the Patient Education Materials Assessment Tool-a validated instrument to collect consumer health information. DISCERN quality criteria and the JAMA (Journal of the American Medical Association) Benchmark Criteria were used for assessing the quality and reliability of the health information. The videos' content was also evaluated. RESULTS: The 118 videos about tumor immunotherapy were mostly uploaded by channels dedicated to lectures, health-related animations, and interviews; their median length was 5 minutes, and 79% of them were published in and after 2018. The median understandability and actionability of the videos were 71% and 71%, respectively. However, the quality of information was moderate to poor on the validated DISCERN and JAMA assessments. Only 12 videos contained misinformation (score of >1 out of 5). Videos with a doctor (lectures and interviews) not only were significantly less likely to contain misinformation but also had better quality and a greater forwarding number. Moreover, the results showed that more than half of the videos contain little or no content on the risk factors and management of tumor immunotherapy. Overall, over half of the videos had some or more information on the definition, symptoms, evaluation, and outcomes of tumor immunotherapy. CONCLUSIONS: Although the quality of immunotherapy information on internet-based videos commonly used by Chinese people is moderate, these videos have less misinformation and better content. Caution must be exercised when using these videos as a source of tumor immunotherapy-related information.

Effects of Heat-Treatment and Cold-Rolling on Mechanical Properties and Impact Failure Resistance of New Al 6082 Aluminum Alloy by Continuous Casting Direct Rolling Process.

Al 6082 aluminum alloy has excellent corrosion resistance, strength, and formability. However, owing to the recrystallization effect of a hot working process, coarse grains form easily in this material, which reduces its strength and service life. The novel continuous casting direct rolling (CCDR) method can prevent the deterioration of this material. Thus, we used CCDR Al 6082 aluminum alloy as the research material in this study. By subjecting a CCDR Al 6082 aluminum alloy to heat treatment (T4 and T6) and cold rolling, the influence of recrystallization effect on its mechanical properties and on impact failure resistance were explored. The results demonstrated that the specimen subjected to T4 heat treatment had a higher elongation and that the specimen subjected to T6 heat treatment had a higher strength. After cold rolling, the hardness and strength of the specimens subjected to different heat treatments (coded T4R4 and T6R4) increased because of the work's hardening effect. Moreover, the elongations of both specimens decreased, but they were higher than the industrial standard (>10%). The strength of specimen T6R4 was higher (up to 400 MPa) than specimen T4R4. Moreover, relative to specimen T4R4, specimen T6R4 had greater tensile and Charpy impact failure toughness.

Association of glycaemic index and glycaemic load with type 2 diabetes, cardiovascular disease, cancer, and all-cause mortality: a meta-analysis of mega cohorts of more than 100 000 participants.

BACKGROUND: There is debate over whether the glycaemic index of foods relates to chronic disease. We aimed to assess the associations between glycaemic index (GI) and glycaemic load (GL) and type 2 diabetes, cardiovascular disease, diabetes-related cancers, and all-cause mortality. METHODS: We did a meta-analysis of large cohorts (≥100 000 participants) identified from the Richard Doll Consortium. We searched the Cochrane Library, MEDLINE, PubMed, Embase, Web of Science, and Scopus for cohorts that prospectively examined associations between GI or GL and chronic disease outcomes published from database inception to Aug 4, 2023. Full-article review and extraction of summary estimates data were conducted by three independent reviewers. Primary outcomes were incident type 2 diabetes, total cardiovascular disease (including mortality), diabetes-related cancers (ie, bladder, breast, colorectal, endometrial, hepatic, pancreatic, and non-Hodgkin lymphoma), and all-cause mortality. We assessed comparisons between the lowest and highest quantiles of GI and GL, adjusting for dietary factors, and pooling their most adjusted relative risk (RR) estimates using a fixed-effects model. We also assessed associations between diets high in fibre and whole grains and the four main outcomes. The study protocol is registered with PROSPERO, CRD42023394689. FINDINGS: From ten prospective large cohorts (six from the USA, one from Europe, two from Asia, and one international), we identified a total of 48 studies reporting associations between GI or GL and the outcomes of interest: 34 (71%) on various cancers, nine (19%) on cardiovascular disease, five (10%) on type 2 diabetes, and three (6%) on all-cause mortality. Consumption of high GI foods was associated with an increased incidence of type 2 diabetes (RR 1·27 [95% CI 1·21-1·34]; p<0·0001), total cardiovascular disease (1·15 [1·11-1·19]; p<0·0001), diabetes-related cancer (1·05 [1·02-1·08]; p=0·0010), and all-cause mortality (1·08 [1·05-1·12]; p<0·0001). Similar associations were seen between high GL and diabetes (RR 1·15 [95% CI 1·09-1·21]; p<0·0001) and total cardiovascular disease (1·15 [1·10-1·20]; p<0·0001). Associations between diets high in fibre and whole grains and the four main outcomes were similar to those for low GI diets. INTERPRETATION: Dietary recommendations to reduce GI and GL could have effects on health outcomes that are similar to outcomes of recommendations to increase intake of fibre and whole grain. FUNDING: Banting and Best and the Karuna Foundation.

Acupuncture for primary insomnia: Effectiveness, safety, mechanisms and recommendations for clinical practice.

Primary insomnia (PI) is an increasing concern in modern society. Cognitive-behavioral therapy for insomnia is the first-line recommendation, yet limited availability and cost impede its widespread use. While hypnotics are frequently used, balancing their benefits against the risk of adverse events poses challenges. This review summarizes the clinical and preclinical evidence of acupuncture as a treatment for PI, discussing its potential mechanisms and role in reliving insomnia. Clinical trials show that acupuncture improves subjective sleep quality, fatigue, cognitive impairments, and emotional symptoms with minimal adverse events. It also positively impacts objective sleep processes, including prolonging total sleep time, improving sleep efficiency, reducing sleep onset latency and wake after sleep onset, and enhancing sleep architecture/structure, including increasing N3% and REM%, and decreasing N1%. However, methodological shortcomings in some trials diminish the overall quality of evidence. Animal studies suggest that acupuncture restores circadian rhythms in sleep-deprived rodents and improves their performance in behavioral tests, possibly mediated by various clinical variables and pathways. These may involve neurotransmitters, brain-derived neurotrophic factors, inflammatory cytokines, the hypothalamic-pituitary-adrenal axis, gut microbiota, and other cellular events. While the existing findings support acupuncture as a promising therapeutic strategy for PI, additional high-quality trials are required to validate its benefits.

ABLIM1, a novel ubiquitin E3 ligase, promotes growth and metastasis of colorectal cancer through targeting IĸBα ubiquitination and activating NF-ĸB signaling.

Actin-binding LIM protein 1 (ABLIM1), a member of the LIM-domain protein family, has been reported as a suppressor in several tumors whereas its role in colorectal cancer (CRC) remains unknown. In this study, we find that ABLIM1 is up-regulated in CRC patients and high levels of ABLIM1 predict short disease-free survival time. Knock-down of ABLIM1 in CRC cell lines by lenti-virus leads to inhibited cell proliferation, migration, and invasion capabilities in vitro and impaired growth of tumor xenografts and liver metastasis lesions in vivo, while ABLIM1 overexpression accelerates tumor growth and invasion in vitro. Mechanistically, we uncover that ABLIM1 activates the NF-ĸB/CCL-20 signaling through modulating IĸBα ubiquitination and proteasomal-mediated degradation. Further co-immunoprecipitation, in vivo and in vitro ubiquitination assays reveal ABLIM1 as a novel ubiquitin E3 ligase binding to IĸBα. Interestingly, The E3 ligase catalysis activity of ABLIM1 depends on its 402-778aa rather than its LIM domains and its interaction with IĸBα relies on the HP domain. Our findings delineate the oncogenic role of ABLIM1 in CRC progression and reveal it as a novel E3 ligase targeting IĸBα, providing new insights into the regulation of NF-ĸB signaling in tumors.

Microstructural Characteristics and Material Failure Mechanism of SLM Ti-6Al-4V-Zn Alloy.

This study focuses on the additive manufacturing technique of selective laser melting (SLM) to produce Ti-6Al-4V-Zn titanium alloy. The addition of zinc at 0.3 wt.% was investigated to improve the strength and ductility of SLM Ti-6Al-4V alloys. The microstructure and mechanical properties were analyzed using different vacuum heat treatment processes, with the 800-4-FC specimen exhibiting the most favorable overall mechanical properties. Additionally, zinc serves as a stabilizing element for the ß phase, enhancing the resistance to particle erosion and corrosion impedance of Ti-6Al-4V-Zn alloy. Furthermore, the incorporation of trace amounts of Zn imparts improved impact toughness and stabilized high-temperature tensile mechanical properties to SLM Ti-6Al-4V-Zn alloy. The data obtained serve as valuable references for the application of SLM-64Ti.

Identifying complementary and alternative medicine recommendations for anxiety treatment and care: a systematic review and critical assessment of comprehensive clinical practice guidelines.

Background: Clinical practice guidelines (CPGs) are used to guide decision-making, especially regarding complementary and alternative medicine (CAM) therapies that are unfamiliar to orthodox healthcare providers. This systematic review aimed to critically review and summarise CAM recommendations associated with anxiety management included in the existing CPGs. Methods: Seven databases, websites of six international guidelines developing institutions, and the National Centre for Complementary and Integrative Health website were systematically searched. Their reporting and methodological quality were evaluated using the Reporting Items for practice Guidelines in Healthcare checklist and the Appraisal of Guidelines for Research and Evaluation (2nd version) instrument, respectively. Results: Ten CPGs were included, with reporting rates between 51.4 and 88.6%. Seven of these were of moderate to high methodological quality. Seventeen CAM modalities were implicated, involving phytotherapeutics, mind-body practice, art therapy, and homeopathy. Applied relaxation was included in 70% CPGs, which varied in degree of support for its use in the treatment of generalised anxiety disorder. There were few recommendations for other therapies/products. Light therapy was not recommended for use in generalised anxiety disorder, and St John's wort and mindfulness were not recommended for use in social anxiety disorder in individual guidelines. Recommendations for the applicability of other therapies/products for treating a specific anxiety disorder were commonly graded as "unclear, unambiguous, or uncertain". No CAM recommendations were provided for separation anxiety disorder, specific phobia or selective mutism. Conclusion: Available guidelines are limited in providing logically explained graded CAM recommendations for anxiety treatment and care. A lack of high-quality evidence and multidisciplinary consultation during the guideline development are two major reasons. High quality and reliable clinical evidence and the engagement of a range of interdisciplinary stakeholders are needed for future CPG development and updating. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022373694, identifier CRD42022373694.

The appearance of new accessory pathway after the Cone procedure.

INTRODUCTION: Acquired Wolff-Parkinson-White (WPW) syndrome can occur after congenital heart disease (CHD) surgery. METHODS AND RESULTS: A 27-year-old male with Ebstein's anomaly and manifest WPW syndrome received catheter ablation twice. The first electrophysiology study (EPS) induced orthodromic atrioventricular reentrant tachycardia and successfully eliminated the posteroseptal accessory pathway (AP). Six months after the Cone procedure, the patient suffered from palpitation. The second EPS was performed and abolished the right lateral AP. CONCLUSION: The appearance of a new AP after the reconstruction of CHD is a rare finding and should raise suspicion of an acquired AP connection.

Effect of High Temperature and Thermal Cycle of 4043 Al Alloy Manufactured through Continuous Casting Direct Rolling.

CCDR 4043 Al alloys are an outstanding candidate for producing mechanical components for automotive or aircraft engines. Two experimental environments-sustained high temperature and repeated heating-cooling-were simulated in the laboratory to replicate the actual operating conditions of engine components. This research investigated the microstructural evolution, mechanical properties, and fracture characteristics of the 4043 Al alloy manufactured through the continuous casting direct rolling (CCDR) process under different post-processing conditions. The CCDR process combines continuous casting, billet heating, and subsequent continuous rolling in a single equipment of production line, enabling the mass production of Al alloy in a cost-effective and energy-efficient manner. In the present work, the 4043 alloy was subjected to two environmental conditions: a sustained high-temperature environment (control group) and a cyclic heating-cooling environment (experimental group). The maximum temperature was set to 200 °C in the experiment. The experimental results show that, in a sustained high temperature working environment, the strength and elongation of the CCDR 4043 Al alloy tend to be stable. The overall effect involves the Al matrix softening and the spheroidization of eutectic Si caused by prolonged exposure to high temperature. This can enhance its ductility while retaining a certain level of mechanical strength. Comparatively, in the working environment of cyclic heating-cooling (thermal cycle), the direction of Si diffusion was different in each cycle, thus leading to the formation of an irregular Ai-Si eutectic structure containing precipitated Si particles of different sizes. The two compositions of Al and Si with very different thermal expansion coefficients may induce defects at the sharp points of Si particles under repeated heating-cooling, thereby reducing the strength and ductility of the material. The results of this work can confirm that the fracture behavior of 4043 Al alloys is obviously controlled by the morphology of the precipitated eutectic Si. In addition, CCDR 4043 Al alloys are not suitable to be used in working environments with a thermal cycle. In practical applications, it is necessary to add traces of special elements or to employ other methods to achieve the purpose of spheroidizing the precipitated eutectic Si and Al-Fe-Si phases to avoid the deterioration of strength and ductility under cyclic heating. To date, no other literature has explored the changes in the microstructure and mechanical properties of CCDR 4043 Al alloys across various time scales under the aforementioned working environments. In summary, the findings provide valuable insights into the effect of thermal conditions on the properties and behavior of CCDR 4043 Al alloys, offering potential applications for it in various engineering fields, such as the automotive and aerospace industries.

Managing depression with complementary and alternative medicine therapies: a scientometric analysis and visualization of research activities.

Background: Complementary and Alternative Medicine (CAM) interventions may prove to be an attractive option for the treatment of depression. The aim of this scientometric analysis is to determine the global scientific output of research regarding managing depression with CAM and identify the hotspots and frontiers within this theme. Methods: Publications regarding the utilization of CAM for treating depression were collected from the Web of Science Core Collection from 1993 to 2022, and analyzed and visualized by Bibliometrix R-package, VOSviewer, and CiteSpace. Results: A total of 1,710 publications were acquired. The number of annual publications showed an overall rapid upward trend, with the figure peaking at 179 in 2021. The USA was the leading research center. Totally 2,323 distinct institutions involving 7,638 scholars contributed to the research theme. However, most of the cooperation was limited to within the same country, institution or research team. The Journal of Alternative and Complementary Medicine was the most productive periodical. The CAM therapies of most interest to researchers were acupuncture and body-mind techniques, such as yoga, meditation and mindfulness. Systematic review and meta-analysis are commonly used methods. "Inflammation," "rating scale" and "psychological stress" were identified as the most studied trend topics recently. Conclusion: Managing depression with evidence-based CAM treatment is gaining attention globally. Body-mind techniques and acupuncture are growing research hotspots or emerging trending topics. Future studies are predicted to potentially investigate the possible mechanisms of action underlying CAM treatments in reducing depression in terms of modulation of psychological stress and inflammation levels. Cross-countries/institutes/team research collaborations should be encouraged and further enhanced.

Identifying complementary and alternative medicine recommendations for insomnia treatment and care: a systematic review and critical assessment of comprehensive clinical practice guidelines.

Background: There is a need for evidence-informed guidance on the use of complementary and alternative medicine (CAM) for insomnia because of its widespread utilization and a lack of guidance on the balance of benefits and harms. This systematic review aimed to identify and summarize the CAM recommendations associated with insomnia treatment and care from existing comprehensive clinical practice guidelines (CPGs). The quality of the eligible guidelines was appraised to assess the credibility of these recommendations. Methods: Formally published CPGs incorporating CAM recommendations for insomnia management were searched for in seven databases from their inception to January 2023. The NCCIH website and six websites of international guideline developing institutions were also retrieved. The methodological and reporting quality of each included guideline was appraised using the AGREE II instrument and RIGHT statement, respectively. Results: Seventeen eligible GCPs were included, and 14 were judged to be of moderate to high methodological and reporting quality. The reporting rate of eligible CPGs ranged from 42.9 to 97.1%. Twenty-two CAM modalities were implicated, involving nutritional or natural products, physical CAM, psychological CAM, homeopathy, aromatherapy, and mindful movements. Recommendations for these modalities were mostly unclear, unambiguous, uncertain, or conflicting. Logically explained graded recommendations supporting the CAM use in the treatment and/or care of insomnia were scarce, with bibliotherapy, Tai Chi, Yoga, and auriculotherapy positively recommended based on little and weak evidence. The only consensus was that four phytotherapeutics including valerian, chamomile, kava, and aromatherapy were not recommended for insomnia management because of risk profile and/or limited benefits. Conclusions: Existing guidelines are generally limited in providing clear, evidence-informed recommendations for the use of CAM therapies for insomnia management due to a lack of high-quality evidence and multidisciplinary consultation in CPG development. More well-designed studies to provide reliable clinical evidence are therefore urgently needed. Allowing the engagement of a range of interdisciplinary stakeholders in future updates of CPGs is also warranted. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=369155, identifier: CRD42022369155.