The results showed that acupuncture was superior to the control group in improving the effective rate (OR: 3.30; 95% CI: 2.18–4.98; p < 0.00001), PSQI score (MD: −3.26; 95% CI: −4.62– −1.90; p < 0.00001), FSH (MD: −11.01; 95% CI: −15.39– −6.63; p < 0.00001), KMI score (p < 0.05), 5-HT (p < 0.05), NE (p < 0.05), MENQOL score (p < 0.05), early-wake score (p < 0.05), sleep actigraphy monitoring (p < 0.05), and Traditional Chinese Medicine symptom scores (p < 0.05) in patients with menopausal insomnia. Here, BRD2 is linked to menopause.