November 2014

Acupuncture: Insomnia and Sleep Problems

by Patricia Kowal, Licensed Acupuncturist in Noosa

Insomnia is the ongoing inability to get asleep and/or stay asleep, and is becoming a common issue in our busy lives. The demands of working and family can create tension and stress to where we cannot calm our body and mind. We may then have difficulty relaxing enough to get sufficient rest to face the next day. This affects our quality of living, efficiency at work, energy levels, and emotions. Western conventional medicine offers pharmacological treatments that may prove to help in the short term, however they don't always come without the addition of side effects. Often lifestyle changes are needed in order to see your sleep pattern shifted.

What type of insomnia do you have? Chinese medicine, generally speaking, talks about two types of insomnia: hard to fall asleep and hard to stay asleep.

What is the reason you are having trouble sleeping? There are various reasons for insomnia. Once you can identify possible reasons you may start to work on them. For example: periods of heightened stress, medical illnesses, medication side effects, pain, too much stimulation from technology, caffeine and stimulants, menopause, urinary frequency, restless legs, alcohol, and eating after hours.

What time of the night are you waking up? If you are waking during the night, is it always around the same general time frame? According the to the Chinese body clock, you can reference the time of night you are waking and possibly gain some insight into what acupuncture meridian needs balancing.

What emotion do you experience most often? Chinese medicine links emotions to the organ and meridian systems. By referencing what type of emotions you tend towards the most, this may indicate the need to support that organ and meridian. For example, if you are an over-worrier you may resonate more with the spleen and anger resonates more with the liver.

(This is a diagram of the Chinese body clock. Each number refers to the time of day or night, and it's associated organ and element. The numbers refer to the time that your circulation is navigating through that particular organ. Find which time you are waking up and this could mean an weakness or an excess condition in that organ. See below for the characteristics of organ times in relation to sleeping)

Sleep problems affect everyone differently. The patterns of stress you have accumulated in you body may manifest differently in you than in another person's body. Some have trouble falling asleep, others have difficulty staying asleep, and some have restlessness through the night and wake up not feeling rejuvenated or rested. Traditional Chinese Medicine (TCM) views insomnia as agitation of the "shen" (spirit/mind). TCM differentiates various patterns in the body that are causing agitation of the shen and looks for imbalances in circulation and temperature.

Looking at the Chinese body clock above you will notice that certain times are involved with different organs and meridians. This may help you sort out which organ/meridian system can be addressed to help with rebalancing the body's sleep pattern. Each meridian is linked with a certain emotion, which one resonates the most with you based on these characteristics? Do you have more than one that resonates with you?

SPLEEN CHARACTERISTICS
Paired emotion: excessive worry, obsessiveness
Insomnia type: waking at the same time every night; dream-disturbed sleep

LIVER CHARACTERISTICS
Paired emotion: anger, frustration
Insomnia type: hard to fall asleep; waking between 1 - 3 am

HEART CHARACTERISTICS
Paired emotion: anxiety
Insomnia type: waking easily; hard to fall asleep

LUNG CHARACTERISTICS
Paired emotion: grief
Insomnia type: waking between 3 - 5 am

KIDNEY CHARACTERISTICS
Paired emotion: fear
Insomnia type: frequent waking through the night

Insomnia and difficulty falling asleep

If you have a harder time falling sleep than you do staying sleep, there can be various reasons why. One of them is having an over-active mind: ruminating thoughts linked together, numerous conversations going on in your mind at once, and the inability to slow thoughts. We might be planning our day tomorrow or running through a to-do list while we are supposed to be settling into the idea of a peaceful slumber. Whatever it is that you're thinking of, it's not allowing the calmness of mind needed to fall asleep. Lifestyle changes are often necessary to address the reasons for excessive stressors like family, work and relationships.

The heart in Chinese medicine is known to "house the shen". When it is disrupted this will commonly cause difficulty falling asleep. The heart can become disrupted for various reasons: heat or inflammation can rise to the upper part of our body and cause irritation and restlessness. Stress may cause a sluggish circulation through the blood vessels, therefore not smoothly reaching and nourishing the heart as adequately as it should. Long term food choices that are high in dairy content, fat and processed chemicals may cause a 'stickiness' to accumulate in our digestion (called dampness or phlegm), which may also impede our circulation to the heart.

Every person is different, and based on your body type, your history, your current medical condition and medication you taking, a customized plan is developed for you.

Tips if your type of insomnia is difficulty falling asleep:

1) Avoid spiking your sugar levels in the evening hours: this can cause stimulation in your body and make it harder to calm down.

2) Avoid caffeine, especially after lunchtime: caffeine is a strong stimulant and it may be affecting your ability to sleep more than you think it is. Experiment with cutting back your coffee times to see if that makes a difference. Consider finding an alternative to coffee all together!

3) Avoid stimulants: alcohol and nicotine are both stimulants. As we start to realize what is stimulating our systems we are able to make better choices.

4) Avoid technology in bed and in the evening hours two hours before bed: most of us don't go a day without looking at a computer screen. Some of us work in jobs where we sit in front of one all day for work. The lights from the screen and the constant action in our eyes as we view the screen is stimulating the head area: our mind. It's over working this part of the body, causing more activity in the mind and a harder time to recover from so much stimulation. Make a point to put the technology aside in the evening and give our eyes and mind a rest in order to prepare for sleep.

5) Teach your body how to relax: find an activity away from technology such as yoga, meditation, hiking, or something that makes you feel at ease and peaceful. Are you taking on too much responsibility? Incorporating more peaceful activities into your life will break up the body's ability to accumulate stress and tension. The longer you work on relaxing the mind, the more cumulative effect it will have and the easier you may find it to bring yourself into a relaxed state of being in order to get to sleep.

6) Do more relaxing through the day: by making an effort to calm your mind throughout the day, you may not accumulate as much stress that can cause over active thinking. This could be as simple as taking a deep breath at your desk, walking outside briefly to clear your mind or even taking some meditative time during your lunch break (relaxed walking, breathing while laying down, changing and breaking up the demands on your brain).

7) Set up a sleep routine and regular bedtime: by setting up a routine your body will start to remember and feel that there is now a time for sleeping.

8) Keep a pen and paper by the bedside: to-do lists and other exciting thoughts of new projects and endeavours may be running around your mind. Write them down and read them in the morning!

9) Massage the bottom of your foot: bring the body's attention and energy away from the head and towards the lower body, more "grounded".

10) Exercise: having a daily exercise routine can help your body to become more tired at night and naturally want to fall into sleep due to physical tiredness. Even a vigorous walk for 30 minutes in the morning may be enough. Restorative or gentle yoga sequences in the evening before bed may calm the mind and body as well.

11) Lavender essential oil: Use a nice quality lavender oil on your pillow at night (spread a few drops on your hands first and then put on the pillow), or start burning an essential oil burner as part of your sleep routine. There has been research on the use of lavender to calm the nervous system which may help with sleep quality, relaxation and emotional support.

12) A new pillow: what is your pillow like? Is it support your head so your head isn't flexed all night (tilted back). Make sure your pillow is supportive enough so that your head is in a "slight nod" position. I personally don't recommend the use of the pillows with the dip in the middle. These pillows put your neck into a flexed state, which may cause aggravation (especially if you are a neck pain sufferer). I recommend a latex pillow, it is supportive enough and make sure you find the right one so your head is in a slight forward nod position.

13) Create a sleep friendly environment: work on creating a peaceful atmosphere in your bedroom. Have a look, is it cluttered? Is there lots of technology that is creating a low hum? Take a minute to decorate and make it feel cozy and peaceful. You'll be surprised at the difference.

Insomnia: difficulty staying asleep

Frequent waking during the night and not being able to get back to sleep is another form of insomnia. This usually presents as a chronic problem with common symptoms such as: irritability, dizziness, dry mouth, and warm hands and feet. This interrupts our body's sleeping rhythm and our ability to go through the appropriate sleep cycle. This pattern of insomnia is commonly associated with an experience of heat at night: waking from night sweats and feeling flushed in the evening. This feeling of heat may agitate the liver and interrupt proper sleeping.

Helping the body properly create a cooler environment is ideal here by addressing the underlying cause of the body's "heat". "Heat" is used in Chinese medicine to describe the internal environment of your body, and someone feeling the heat more often may fine a harder time staying asleep than others.

Tips if your type of insomnia is difficulty staying asleep:

1) Avoid stimulants and foods/beverages that are thermal in nature: alcohol, caffeine and spicy foods are seen as having a thermal nature, having a heating effect on the body. Especially avoid these in the evening hours.

2) Be mindful of your sugar intake in the evening hours: spiking your sugar levels in the evening may cause your body to wake from 'low blood sugar'. If you are feeling hungry reach for a snack with more protein than sugar or carbohydrates.

3) Liquid intake: be mindful of how many drinks you are consuming at night, especially alcohol. These will enhance your desire to wake and use the bathroom.

Utilize the tips above to begin trying to change your sleep habit. This may take some patience and time but you may find this well worth the effort seeing as though sleep is so important in many aspects of our health. This article addresses to general concepts of sleep problems and insomnia from a Traditional Chinese Medical perspective: difficulty falling or difficulty staying asleep.

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Patricia Kowal is an AHPRA Licensed Acupuncturist, Chinese Herbal Practitioner in Noosa on the Sunshine Coast.

Disclaimer: Please follow up with your practitioner if you are unsure or are having questions about the information contained in this material.

References:

http://umm.edu/health/medical/altmed/herb/lavender

Web That Has No Weaver, Kaptchuk, Ted

http://www.webmd.com/sleep-disorders/guide/insomnia-symptoms-and-causes

http://www.merckmanuals.com/home/brain_spinal_cord_and_nerve_disorders/sleep_disorders/

insomnia_and_excessive_daytime_sleepiness.html

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