Objective To investigate the underlying rules and combination patterns of acupoint selection in the treatment of senile sleep disorders using data mining techniques. Methods A comprehensive literature search was conducted across five major databases-CNKI, Wanfang, VIP, PubMed, and Web of Science-from their inception to December 31, 2024. Clinical studies investigating acupuncture for sleep disorders in the elderly were systematically retrieved. Data regarding acupuncture prescriptions and TCM syndrome differentiation types were extracted. Descriptive statistical analysis was performed using Excel 2019. Furthermore, SPSS Modeler 18.0 was utilized to analyze association rules among acupoint combinations, while Lantern 5.0 was employed to conduct latent structure analysis and comprehensive clustering. Results ①A total of 175 articles were included, comprising 280 acupuncture prescriptions and 120 unique acupoints, with a cumulative usage frequency of 1 913 times; ②The five most frequently utilized acupoints were Shenmen(HT7), Baihui (DU20), Sanyinjiao (SP6), Neiguan (PC6), and Sishencong (EX-HN1); ③The Bladder Meridian of Foot-Taiyang was the most frequently involved meridian. Anatomically, acupoints located on the lower extremities and the head and face regions were the most commonly selected; ④The analysis revealed that the combination of Baihui(GV20) and Sishencong(EX-HN1) exhibited the highest degree of support at 38.21%;⑤Hidden structure analysis of high-frequency acupoints resulted in six comprehensive synthesis clustering models, matching the following syndromes: dual insufficiency of the heart and spleen, stagnation of liver Qi turning into fire, mutual inhibition between the heart and kidney, disharmony of stomach Qi, insufficiency of heart and gallbladder Qi, and insufficiency of Yin leading to fire. Conclusion The acupuncture treatment strategy for senile sleep disorders primarily focuses on balancing Yin and Yang, nourishing the Heart, and calming the mind, with a fundamental emphasis on promoting sleep and regulating the Middle Jiao. The core therapeutic prescription consists of Shenmen (HT7), Baihui (DU20), Sanyinjiao (SP6), Neiguan (PC6), and Sishencong (EX-HN1). In clinical practice, precise acupoint selection and combination should be strictly tailored to the specific TCM syndrome differentiation of the individual patient.