Objective To investigate the efficacy of acupuncture combined with moxibustion based on "Yuan?Luo Point Pairing" in treating insomnia related to cerebral infarction， and its effects on serum hypothalamic secretin-1 （Hcrt-1）， 5-hydroxytryptamine （5-HT）， and slow wave EEG. Methods 120 patients with cerebral infarction related insomnia admitted to our hospital from July 2022 to July 2024 were selected as the research subjects. They were randomly divided into an observation group and a control group， with 60 cases in each group， using a random number table method. The control group was treated with routine western medicine， and the observation group was treated with acupuncture combined with moxibustion based on "Yuan?Luo Point Pairing" on the basis of the control group. Compared the clinical efficacy， TCM syndrome score， sleep quality， serum Hcrt-1 and 5-HT， EEG slow wave indicators， and treatment safety of two groups. Results The effective rate of observation group was higher than control group （P < 0.05）. After treatment， the traditional Chinese medicine syndrome scores of observation group were lower than control group（P < 0.05）， including timidity， palpitations， shortness of breath， lazy speech， and no complexion. After treatment， the sleep quality indicators of the observation group， including sleep latency and rapid eye movement sleep were lower than those of the control group， while the total sleep time and sleep efficiency were higher than group control （P < 0.05）. After treatment， the serum Hcrt-1 and 5-HT levels of observation group were lower than group control （P < 0.05）. the slow waves in EEG， including θ and δ waves of observation group had lower frequencies than the control group and higher amplitudes than control group（P < 0.05）. Conclusions Acupuncture combined with moxibustion based on "Yuan?Luo Point Pairing" has significant therapeutic effects on insomnia related to cerebral infarction. It can reduce traditional Chinese medicine syndromes， improve sleep quality， lower serum Hcrt-1 and 5-HT levels， improve slow wave state of EEG in patients， and has good treatment safety.