Effect of High-Frequency Stellate Ganglion Block on Sleep and Affective Symptoms in Insomnia Disorder: A Prospective Clinical Study

Background Insomnia disorder imposes substantial health burdens, while current pharmacotherapies risk adverse effects and cognitive behavioral therapy face implementation barriers. Stellate ganglion block (SGB) modulates autonomic function and sleep architecture but lacks evidence for optimized protocols. This study evaluates high-frequency SGB for improving sleep, anxiety, and depression in insomnia disorder. Methods A single-center, prospective single-arm trial enrolled 72 patients diagnosed with insomnia disorder according to ICSD-3 criteria Participants received daily ultrasound-guided SGB (0.8% lidocaine, 3ml) unilaterally for 10 consecutive days. Outcomes included Pittsburgh Sleep Quality Index (PSQI), Generalized Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9) scores assessed at baseline (T1), post-intervention (T2), 4 weeks (T3), and 12 weeks (T4). Statistical analysis used repeated-measures ANOVA. Results PSQI global scores significantly decreased from baseline (15.35 ± 2.39) at all follow-ups (T2–T4: P  < 0.05). Component scores revealed marked improvements in subjective sleep quality (− 40.32%), sleep duration (− 36.03%), and daytime dysfunction (− 41.21%). Anxiety (GAD-7: baseline 7.47 ± 4.57) and depression (PHQ-9: baseline 9.07 ± 5.72) scores also showed significant reductions post-treatment (GAD-7: T2–T4 P  < 0.05; PHQ-9: T2–T4 P  < 0.05). Conclusion In this observational analysis of patients with insomnia disorder, high-frequency SGB may be associated with improvements in sleep quality and reductions in affective symptoms. The observed association with beneficial sleep and psychological outcomes appeared to persist throughout the 12-week follow-up period. These preliminary findings suggest this protocol warrants further investigation as a potential neuromodulatory intervention for addressing limitations of conventional therapies. Trial registration This study was registered on the Chinese Clinical Trial Registry on March 19th, 2025 (Registration No.: ChiCTR2500099219).