Retrospective analysis of the clinical effect of acupuncture on insomnia after ischemic stroke by using a wireless sleep monitor as an innovative evaluation method. From March 1, 2018, to September 30, 2019, 105 cases of insomnia after ischemic stroke were extracted from the inpatient medical record system of Shenzhen Longhua District Central Hospital. According to differences in the treatment plan, the cases were divided into an acupuncture group (57 cases) and a drug group (48 cases). The acupuncture group was given acupuncture treatment on the basis of usual care, while the drug group was given estazolam oral treatment on the basis of usual care. Under the ICF framework, the related items of sleep function and emotion function were selected for evaluation. As outcome parameters, the alterations of the Pittsburgh sleep quality index (PSQI), the self-rating anxiety scale (SAS), and the self-rating depression scale (SDS) were used before the treatment, after treatment, and in a follow-up; meanwhile, the ActiSleep-BT wireless sleep monitor was used to measure total sleep time (TST), sleep efficiency (SE), and sleep arousal (SA) of the two groups before and after treatment and at follow-up. Within-group comparison showed significant differences in the acupuncture group before treatment and after treatment on the ActiSleep-BT wireless dynamic sleep monitor data as well as in PSQI and ICF. Comparing the acupuncture group with the control group also showed significant differences in the ActiSleep-BT wireless dynamic sleep monitor data, PSQI, and ICF. By evaluation using ActiSleep-BT wireless sleep monitor, acupuncture treated insomnia after ischemic stroke; the effect is better than usual care. Copyright © 2021 Yujuan Song et al.