OBJECTIVES: Cancer-related insomnia (CRI) takes a toll on many cancer survivors, causing distressing symptoms and deteriorating the quality of life. Acupuncture therapy has been used for CRI already. However, it is still uncertain which acupuncture regime is best for CRI. The primary objective of this review is to conduct a comparative evaluation and ranking of the effectiveness of different acupuncture therapies for CRI. METHODS: Randomized controlled trials (RCTs) that were published up to July 31, 2023, from 8 databases (PubMed, Embase, Cochrane library, Web of Science, China National Knowledge Infrastructure, Wanfang Database, VIP Database, and China Biology Medicine disc) were integrated in this study. Trials that met the inclusion criteria were evaluated the risk of bias. Pittsburgh sleep quality index (PSQI) was used to assess the efficacy of different acupuncture therapies as the primary outcome. Then, STATA 15, R, and OpenBUGS were applied to perform the network meta-analysis. PRISMA statements were followed in this network meta-analysis. RESULTS: A total of 37 studies were included in this review, involving 16 interventions with 3,246 CRI participants. Auriculotherapy plus moxibustion (surface under the cumulative ranking curve (SUCRA) 98.98%) and auriculotherapy (SUCRA 77.47%) came out top of the ranking, which were more effective than control, medicine, usual care and sham acupuncture. CONCLUSIONS: Auriculotherapy plus moxibustion and auriculotherapy plus acupuncture emerged as the top two acupuncture regimes for CRI and future studies should pay more attention to CRI. CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov/, identifier INPLASY202210095.

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