Sleep peacefully with Oriental Medicine

How did you sleep last night? Could have been better? If you are rubbing your eyes while reading this and trying to counteract the effects of insomnia with coffee, you are not alone. Almost one in four of us has trouble sleeping on a regular basis.

Much has been said about modern life eating into our sleep. In Victorian times, before the electric light bulb, adults generally slept 9-10 hours per night. Ancient Chinese texts describe the idea of the body being governed by a 24-hour clock, with each of the 12 main meridians responsible for a 2-hour segment of the clock. For the body to function at its best, with all meridian pathways and associated organs working smoothly, it is advised to be in deep sleep by 11pm, so to go to bed between 9 and 10pm, and to rise between 5 and 7am. But with today’s long and irregular working hours and access to electronic devices that stimulate the brain instead of winding us down, many of us would struggle to follow these guidelines.

We now know that chronic (long-term) sleep deprivation has a host of health consequences. It plays havoc with your hormonal and metabolic regulation, contributing to weight gain, elevated stress hormones, and raised blood pressure. If you aren’t sleeping well, you are also more likely to struggle to concentrate, have accidents at work or while driving, and to suffer from depression.

If insomnia has been a long-term issue for you, you will probably have tried a lot of the self-help strategies recommended. Even so, it’s worth reading through the list at the end of this article to see if there are ways you could tweak your lifestyle to help promote sleep.

Various medications are available for insomnia, but most have side-effects you’d probably rather be without, like feeling groggy in the day. And for some classes of these drugs, long-term dependence is a real issue. So the ideal approach (in combination with lifestyle changes, of course) is one that’s natural and doesn’t have troublesome side effects.

That’s where Oriental medicine (the combination of acupuncture and Chinese herbal medicine) come in. This has a long history of use for insomnia. There are several Oriental medicine patterns associated with insomnia, and we work out which is responsible by taking a detailed history of your sleep issues and other aspects of your health, examining your pulse, tongue and abdomen and putting all the information together.

Treatments focus on calming the mind, using a combination of points throughout the body. I use the gentle Japanese style of needling, which inserts very fine needles very shallowly, so is suitable for even the most needle-phobic. Generally, 4-6 weekly sessions will give us a good idea of your response to treatment. After a few sessions, herbal support is often introduced as the frequency of acupuncture treatments is dropped.

There has been quite a bit of research done on acupuncture and sleep, although the quality of the research could be better.

One recent research trial looked at the effect of acupuncture on insomnia, focussing on quality of sleep. This trial was small (180 patients) but had a great design, comparing true acupuncture (points selected to treat insomnia) with sham acupuncture (points that don’t actually treat insomnia) and a commonly used sedative as control measures. This was done to make sure that any effect of the acupuncture treatment was not just due to being paid attention by the practitioner, or relaxing in the treatment room, or some other aspect of the treatment not actually related to needling specific acupuncture points.

After 6 weeks of treatment, those in the true acupuncture group rated their sleep quality as better than those in the sham acupuncture or sedative groups. They also reported less drowsiness and more energy in the daytime (in contrast to those on the sedative, who felt worse during the day even though their sleep improved). These improvements were maintained 2 months after the end of the treatment period.

Another couple of small trials looked at how acupuncture (or in one case, acupressure) works to help you sleep. They found that acupuncture or acupressure tended to normalise the levels of melatonin, a hormone produced by the pineal gland in the brain that regulates the sleep-wake cycle. This is very intriguing; and hopefully larger studies will explore this area in the future to verify the results.

The bottom line? Acupuncture can be a long-lasting remedy for insomnia, giving you better sleep quality without that hung-over feeling from sedatives.

Some tips to help you sleep.

• Avoid caffeine after 4pm, or noon if you are sensitive to it. Remember that chocolate and green tea also contain small amounts of caffeine that can be too stimulating for some people. Many “energy drinks” contain a lot of caffeine too.
• Try to get up at around the same time each day and go to bed at the same time each night. This gets your body into a regular pattern, so that the sleep hormone, melatonin, is being produced right when it’s needed.
• Aim for a short walk in sunlight (about 20 mins without sunglasses if you can tolerate it) first thing in the morning. A surge in melatonin (which promotes sleepiness) happens about 12 hours after this first exposure to sunlight, so this is another measure that can help reset your sleep clock.
• For at least an hour before bed, limit your use of TV, internet, mobile phones and other electronic devices, which tend to stimulate the brain. For some people who are sensitive, 2 hours may be better.
• If you can’t sleep after 30 mins, go and do something that’s not very interesting for 10-20 mins in low light, then try again. Avoid TV etc, for the reasons given above.
• Acupressure (applying pressure to acupuncture points) can help. Run your fingers outwards from the back of the neck at the base of the skull, till you reach a sore point behind the ear (but still under the skull). This is the An Mian (peaceful sleep point). Massage this area with firm pressure. The other point to apply pressure to is Kidney 1, which is on the sole of the foot, about 1/3 of the way down from where the toes join the sole of the foot. When you bend your foot downwards, you can feel a depression here, which may also feel quite tender.