Purpose: This study aimed to examine the effect of acupressure on sleep initiation and maintenance disorders among nurses working rotating shift work schedule. Method: In this randomized controlled trial, 62 shift-working nurses with self-reported insomnia were randomly assigned to either an experimental group (n=31) receiving auricular acupressure or a control group (n=31) receiving sleep hygiene education. The intervention lasted two weeks. The Pittsburgh Sleep Quality Index (PSQI) was administered at baseline, Week 1, and Week 2; insomnia severity was measured using a Numeric Rating Scale; and depression was assessed with the Patient Health Questionnaire-9. Stress was identified as a covariate and controlled for in repeated-measures ANCOVA. Results: After adjusting for baseline stress, the experimental group showed a significantly greater reduction in insomnia severity compared to the control group (F=4.53, p=.013). Although there was no significant difference between groups in total PSQI scores (p>.05), the experimental group demonstrated significant improvements in sleep latency (PSQI item 5a, F=6.41, p=.002) and subjective sleep quality (PSQI item 6, F=5.84, p=.004). Minor adverse effects did not result in withdrawal from the study. Conclusion: Acupressure may be an effective adjunct intervention for reducing insomnia severity and improving certain aspects of sleep initiation and maintenance disorders in nurses working a rotating shift work schedule. Further research is recommended to investigate its long-term efficacy, optimal acupressure points, and applicability in various clinical settings.