Thursday, May 31, 2012

Put Insomnia to Rest with Chinese Medicine

In this article:

  • Chinese Medicine and Insomnia
  • Acupuncture for Insomnia
  • Herbal Medicine for Insomnia

Insomnia, or sleeplessness, can describe anyone who has trouble falling asleep or staying asleep. Insomnia can be acute and circumstantially-related, or it can be a long-term, chronic pattern.

If you suffer from insomnia, you are not alone:

Insomnia may affect 10%-40% percent of the population according to a 2009 analysis of international research. In the U.S., insomnia is more prevalent than ever with higher stress levels and ever more demands on our time.

More and more studies show the negative effects of poor sleep, or lack of sleep:

  • loss of memory & focus
  • impaired cognition, judgement & ability to learn
  • slower metabolism (weight gain)
  • higher stress & anxiety
  • impaired immunity
  • increased inflammation & joint pain
  • tendency toward depression
  • increased likelihood of accidents (automobile, work place)
  • difficult social functioning.

Poor sleep or lack of sleep can exacerbate a range of serious health conditions. Studies have shown that people who sleep less than 6 1/2 hours per night are three times as likely to develop diabetes in the following year. Risk of hypertension, heart disease, and stroke are similarly increased by sleeplessness.

Nightly restorative sleep is as important to health as diet and exercise. And not getting enough sleep is no fun at all.

Fortunately, insomnia is easily and effectively treated with acupuncture and Chinese herbal medicine. Together with a few lifestyle adjustments (see my article Eight Lifestyle Adjustments for Better Sleep), Chinese medicine can help put insomnia to rest, and help YOU get that restorative sleep you need to stay healthy and happy.

Chinese Medicine and Insomnia

There are many reasons that cause us to have difficulty sleeping.

Keep in mind that Chinese medical treatment for insomnia is not simply a sleeping pill. It does not simply target a part of the brain to put you to sleep. And it does not have side-effects like drowsiness or addictive qualities.

Instead of simply addressing the symptom of insomnia, Chinese medicine holistically addresses the underlying physiological imbalance or root cause of sleeplessness. Your Chinese medicine practitioner will take a holistic account of your symptoms and constitutional tendencies to figure out the exact patterns of physiological imbalance that are keeping you from getting a good night's sleep. Often these are a deficiency of Yin or Blood or an excess of Yang or heat. The imbalances may be rooted in a particular organ system or systems, or in a meridian system. I describe some common insomnia patterns in more detail below.

In any case, by addressing root physiological imbalances, Chinese medicine treatment for insomnia will likely make you feel healthier & more vibrant in general, in addition to helping you sleep better at night.

Yin & Yang Imbalance:
Insomnia (or sleeplessness) is fundamentally an imbalance of Yin and Yang. The Yang aspect of our lives is activity and function -- it is the part of ourselves that fights traffic, meets work deadlines, reads the news, finishes projects, cooks dinner, drives the kids' carpools, etc. The Yin aspect is the quiet, restful, reflective parts of our lives -- particularly sleep.

Most of our lives tend to be imbalanced in the Yang direction. We keep pushing forward, producing, and achieving. Our nervous systems are continually stimulated. Comparatively little time is devoted to relaxation and rest. Needless to say, our cultural and social environment promote this imbalance.

An excess of Yang, i.e. overworking, constant productivity, excessive mental and emotional stimulation can, over time, erode our Yin on a physiological level. We lose our ability to ramp down our nervous energy and go to sleep.

Nighttime is the Yin aspect of our 24-hour cycle. It is the time when we should be sleeping. If we have trouble sleeping at night, this is seen as a weakness or insufficiency of Yin. An acupuncturist might address this by using acupuncture and herbal medicine to nourish and consolidate a patient's Yin, and possibly by regulating or sedating the Yang aspects of that patient's physiology.

The concept of Yin-Yang imbalance is reflected in the biomedical understanding of insomnia. Biomedically, insomnia as a symptom of cognitive and/or neurological hyperarousal. People who worry and ruminate a lot tend to have trouble sleeping. The sympathetic (fight-or-flight) aspect of the autonomic nervous system predominates over the parasympathetic (rest and repose) in people with insomnia. People with poor sleep tend to have higher levels of stimulatory hormones like cortisol and adrenocorticotropic hormone (ACTH) relative to hormones associated with rest and relaxation.

The Heart:
From a Chinese medicine perspective, the Heart is where the Shen or Spirit rests at night. The Heart (and the Blood of the Heart system) is said to anchor the Spirit, enabling us to go to sleep. If the Heart system is weak or disturbed (by physical or emotional factors), the Spirit is not anchored and is said to wander at night. The result is a feeling of anxiety, general restlessness of the body, vivid dreaming and inability to sleep.

The Heart also houses the Mind. When the Heart is agitated, the mind can not calm down.

Treating the Heart with acupuncture and herbal medicine is therefore often an important component of treating insomnia in Chinese medicine.

Other Organs:
The Heart's relation to Mind and Spirit is paramount, but each of the other organs of the body play a specific role in sleep and sleeplessness as well. Your acupuncturist's job is to discern each patient's unique pattern of organ imbalance and to use acupuncture and herbal therapy to correct it.

The organs, the dense material foundation of the body, are the most Yin aspect of the body. Excess Yang weakens and damages the organs. Weak organs are less able to anchor the mind and emotions. They fail to produce adequate Yin substance (Blood, body fluids) needed to nourish the body, anchor Yang energy and support relaxation. The result is more restlessness, anxiety and sleeplessness.

Here is a summary of the major organs in relation to sleeplessness:

Related Emotion:  Anxiety, restlessness
Insomnia Characteristics:  Waking up easily; difficulty falling asleep; excess dreaming
Accompanying Symptoms:  Palpitations; sores in mouth; thirst

Related Emotion:  Anger; stress; frustration; irritability
Insomnia Characteristics:  Difficulty falling asleep; restless sleep; disturbing dreams; waking between 1:00 a.m. and 3:00 a.m.
Accompanying Symptoms:  Blurry vision; dry, red eyes; dizziness

Emotion:  Grief
Insomnia Characteristics:  Waking between 3:00 a.m. and 5:00 a.m.
Accompanying Symptoms:  Low energy; shortness of breath; frequent colds

Emotion:  Worry; rumination; obsessiveness
Insomnia Characteristics:  Difficulty falling asleep; waking at the same time every night; dream-distrurbed sleep
Accompanying Symptoms:  Tiredness, poor appetite, weak disgestion, poor memory, pale face (typical pattern in students)

Emotion:  Fear
Insomnia Characteristics:  Difficulty falling asleep; frequent waking
Accompanying symptoms:  Dry throat, night sweats, palpitations, dizziness, tinnitus, backache

Heat Regulation:
So far, I've discussed weakness and imbalance of the internal organs in relation to insomnia. Excess heat in the body is another cause.

When it's hot outside, it can be difficult to settle down and fall asleep. This is also true when your body is hot on the inside.

Even though you may feel cold when you go to bed, if your body is having trouble regulating internal heat, you will eventually heat up inside and get uncomfortable. This is one of the major causes of waking frequently during the night.

Problems of heat regulation in the body generally stem from either an excess of heat in the body or from a weakness of the cooling element in the body, the Yin. 

One cause of heat in the body can be poor dietary habits or excessive alcohol consumption. Perhaps we eat too much before we go to bed, drink too much, eat on an irregular schedule or indulge in too many rich foods. Any of these habits cause the body to have difficulty processing and moving energy. Stagnant energy in the body causes a buildup of heat in the body and a general state of irritability and discomfort.

Emotional stress can also cause internal heat. Anger, resentment, irritability, worry and rumination, in particular, weaken the Liver, hindering its ability to circulate energy through the body. Again, stagnant energy causes excess heat.

Finally, if our body's Yin becomes weak (for a variety of reasons including overwork, overstimulation and emotional stress), the Yin/Yang balance becomes compromised. The heat/fire energy generated by the body is no longer grounded by Yin/water. This leads to a buildup of heat at night. This type of heat is sometimes released by the body via sweating at night.

Acupuncture for Insomnia

Acupuncture for insomnia works much the same way as it does for other conditions. The insertion of acupuncture needles will immediately remove areas of energy stagnation in the body. Regulating and moving energy will generate a feeling of ease and relief so that the body can rest properly.

Specific acupuncture points used are chosen according to the patient's specific diagnosis. There are many points on the body indicated for releasing heat. Acupuncture can also help restore balance to the Heart and other organ systems so that the body can provide a peaceful home for the Mind and the Shen to rest at night.

Acupuncture can influence hormone production. One study showed that five weeks of acupuncture treatment was associated with a significant increase in melatonin, an important hormone for sleep regulation and typically deficient in sleepless Americans.

Acupuncture causes measurable increases in vagus nerve activity, helping the body's autonomic nervous system to shift into a parasympathetic state, exactly what is needed for a good night's sleep.

For more on acupuncture in the treatment of insomnia, check out this article this 2011 Wall Street Journal article, Can Needles Sooth Wounded Warriors? Military Doctors in Afghanistan are Using Acupuncture to Treat Brain Injuries, with Promising Results. Journalist Michael Phillips documents stories of soldiers suffering from insomnia and nightmares due to PTSD who find dramatic relief through acupuncture. Phillips writes, "The newest Defense Department and Department of Veterans Affairs clinical guidelines recommend acupuncture as a supplementary therapy for post-traumatic stress disorder, pain, anxiety and sleeplessness.

Herbal Medicine For Insomnia

Chinese herbal formulas are prescribed according to the particular insomnia diagnosis. In general these herbal formulas will help to tranquilize the mind, clear heat, support weak or imbalanced organs and nourish Yin.

All aspects that may cause insomnia will be addressed and you will fall asleep faster, stay asleep longer and have a deeper, more restful sleep.

Herbal medicine is not a sleeping pill. Instead of simply targeting particular brain chemistry, herbs work in a holistic way to support function in your body that is weak, while reducing the buildup of excess energy. There are no side effects from herbal medicine. In addition to helping you sleep, they will address the root of your condition, enhancing your health and vitality in general.

Much of the structure & content for this insomnia series came from an article, "Say Goodnight to Insomnia," by brilliant San Francisco Acupuncturist Jeremy Rothe, M.S., L.Ac., at

Sarah Halverstadt, M.S., L.Ac.

Lectures by John Nieters, L.Ac., DAOM

Consultation with Robert Zeiger, L.Ac., OMD, Pharm.D.

Alyssa Giacobbe. "Acupuncture for Insomnia Relief."

Giovanni Maciocia. The Practice of Chinese Medicine. The Treatment of Diseases with Acupuncture and Chinese Herbs.