BACKGROUND: Parkinson's disease (PD) patients commonly suffer from sleep disorders, significantly impacting their quality of life. Western treatments often entail adverse effects, while acupuncture (ACU) presents a safe, nonaddictive alternative. METHODS: A thorough literature search was performed across PubMed, Cochrane Library, and Embase databases. Eligible studies underwent statistical analysis via RevMan 5.4 software. RESULTS: This study synthesized data from 19 randomized controlled trials involving 1300 patients. The ACU cohort showed notable improvement in Parkinson's disease sleep scale (PDSS) scores (mean difference (MD) 10.81, 95% confidence interval (CI) 5.64 to 15.98) relative to controls. Subgroup analysis revealed significance for ACU treatments beyond 6 weeks (MD 15.39, 95% CI 11.70 to 19.09) but not for those 6 weeks or shorter (MD 3.51, 95% CI -1.20 to 8.23). Notably, electroacupuncture resulted in significant PDSS score enhancements (MD 12.39, 95% CI 6.06 to 18.71), with sensitivity analysis verifying result stability. However, without electroacupuncture, PDSS score differences were insignificant (MD 7.83, 95% CI -2.33 to 17.99) and had lower result stability. Additionally, increased ACU session frequency may yield better improvements in PDSS scores. The ACU group also observed Improved Pittsburgh Sleep Quality Index scores (MD -4.52, 95% CI -6.36 to -2.67). However, no significant variation was identified in Epworth Sleepiness Scale score improvement between groups (MD -0.90, 95% CI -3.67 to 1.88). CONCLUSION: ACU therapy effectively improves nighttime sleep quality in PD patients. A treatment duration extending beyond 6 weeks is highly recommended. Additionally, increasing the frequency of ACU sessions and incorporating electroacupuncture in the treatment regimen may be essential for optimal results.

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