Classical Chinese Medicine conceptualizes the human organism as a dynamic system of relationships in which structure, function, environment, and transformation are inseparable. Although derived from a fundamentally different epistemological framework, contemporary systems biology increasingly describes health and disease through interacting networks involving the nervous system, extracellular matrix and connective tissues, immune and endocrine signaling, metabolism, and the gut microbiome. This conceptual convergence provides an opportunity for dialogue, but not for direct equivalence between traditional constructs and modern biological structures. Acupuncture offers a particularly relevant model through which to examine this interface. Experimental studies have demonstrated that needle insertion and manipulation can generate measurable biomechanical effects within connective tissue, including tissue winding, fibroblast cytoskeletal remodeling, and mechanotransduction. Acupuncture and electroacupuncture can also activate somatosensory pathways and, under defined experimental conditions, engage somato-autonomic reflexes and central neural networks. Evidence for acupuncture-related neuroplasticity has been reported predominantly in preclinical studies and neuroimaging investigations, although its causal relationship with clinical outcomes remains incompletely established. The microbiota–gut–brain axis provides an additional level of biological integration through neural, immune, endocrine, metabolic, and barrier-mediated signaling. Emerging evidence suggests that acupuncture may modify gut microbial composition and microbiota-associated pathways in selected experimental and clinical contexts. However, this literature remains dominated by preclinical studies, substantial methodological heterogeneity, and associative rather than mediation-based evidence. This Perspective therefore proposes a multilayered framework in which connective-tissue mechanotransduction, somatosensory signaling, autonomic regulation, neuroplasticity, immune-metabolic pathways, and the microbiome are considered potentially interacting dimensions of the biological response to acupuncture. Importantly, these mechanisms should not be regarded as anatomical demonstrations of Qi, meridians, or other constructs of Classical Chinese Medicine. Scientific progress is more likely to emerge from rigorous comparison between distinct explanatory systems than from attempts to reduce one to the terminology of the other.

Background/Objectives: Fibromyalgia is a chronic, symptom-defined condition whose recognition and management depend on sustained access to care. Recorded utilization during crises may therefore reflect disrupted access, diagnostic recognition, and longitudinal engagement rather than disease burden. Since 2019, Lebanon has experienced overlapping financial deterioration, the COVID-19 pandemic, the Beirut port explosion, and armed conflict. We characterized recorded fibromyalgia utilization and continuity across these six years. Methods: This retrospective cohort study analyzed all outpatient encounters with fibromyalgia as the primary diagnosis in electronic health records of the American University of Beirut Medical Center, January 2019–December 2024. Monthly encounter volume was the primary utilization outcome. Recorded continuity was evaluated as time from each patient’s index encounter to a subsequent fibromyalgia-coded encounter, with 180-day return as the principal measure. Results: We identified 4,969 encounters from 3,237 patients (87.5% female; mean age, 46.7 years). Monthly encounter volume fell around the 2019 financial and banking disruption and remained below the preceding nine-month level (84.3 vs. 66.8 encounters/month; rate ratio, 0.76; 95% CI, 0.61–0.94), with a further exploratory reduction in mid-2024. The 180-day probability of a subsequent encounter declined from 22.8% in the 2019 cohort to 15.6% in 2024 (hazard ratio, 0.59; 95% CI, 0.45–0.76); lower return rates emerged from the 2022 cohort onward. Conclusions: Recorded fibromyalgia utilization and longitudinal engagement changed at different times during Lebanon’s compounding crises. These findings describe recorded care, not disease occurrence: recovering patient numbers may coexist with persistently impaired longitudinal engagement, so aggregate utilization alone incompletely measures recovery for continuity-dependent chronic conditions.

Background: Sleep and epilepsy are linked through a complex, bidirectional relationship in which physiological sleep processes influence cortical excitability and seizure susceptibility, while epileptic activity and its treatments profoundly affect sleep architecture and quality. Sleep disturbances (including insomnia, obstructive sleep apnea, circadian rhythm disorders, excessive daytime sleepiness, and fragmented sleep) are highly prevalent among people with epilepsy and contribute to impaired seizure control, cognitive dysfunction, psychiatric comorbidities, reduced quality of life, and increased healthcare utilization. Although substantial research has examined individual aspects of this relationship, the evidence remains fragmented across multiple disciplines, limiting its translation into comprehensive clinical practice.Objective: This scoping review aimed to systematically map the contemporary evidence regarding the role of sleep across the epilepsy care continuum, encompassing pathophysiological mechanisms, clinical assessment, diagnostic strategies, therapeutic interventions, digital health technologies, and emerging research priorities, while identifying critical knowledge gaps to guide future investigation and precision medicine approaches. Methods: This scoping review was conducted according to the methodological framework proposed by Arksey and O'Malley, refined by Levac and colleagues, and further finalized by the Joanna Briggs Institute, and was reported in accordance with the PRISMA Extension for Scoping Reviews (PRISMA-ScR). Comprehensive searches of PubMed/MEDLINE, Embase, Scopus, Web of Science, and the Cochrane Library identified English-language studies published from January 2020 onward. Eligible publications included adults and children with epilepsy or seizure disorders addressing at least one sleep-related domain. Evidence was descriptively synthesized across predefined domains, including sleep physiology and epileptogenesis; sleep disorders and epilepsy; effects of antiseizure medications on sleep; sleep deprivation and seizure risk; diagnostic modalities, including polysomnography, electroencephalography, actigraphy, and wearable technologies; digital health and artificial intelligence; therapeutic interventions; perioperative and long-term follow-up; implementation challenges; and health equity. Conclusions: By providing the first comprehensive mapping of sleep throughout the epilepsy care continuum, this review establishes an integrated conceptual framework linking mechanistic, diagnostic, therapeutic, and technological advances. The findings highlight priorities for multidisciplinary research, support the implementation of precision sleep medicine in epilepsy, and inform future evidence-based clinical strategies designed to optimize seizure control, neurological outcomes, and patient-centered care.