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Archive for the ‘insomnia’ Category

Treating Insomnia with Acupuncture by Peter Lee

Posted on: June 13th, 2016 by Mariano

While acupuncture is used to treat a wide range of conditions, each acupuncturist tends to have an individual style and an area of particular focus. I am most interested in alleviating psychoemotional conditions such as depression and insomnia.

woman not being able to sleep

Psychological and emotional conditions are difficult to treat, and western medicine does not offer many options. Most are medication-based, and attempt only to address symptoms while ignoring root causes – and, inevitably, medications have side effects, which are sometimes severe. Also, discovering the best medication and the exact right dose for any given patient is a process of trial and error that can be prolonged and is not always successful, if indeed it is undertaken at all. More commonly, cookie-cutter solutions are imposed without regard to individual fit or efficacy.

 

How acupuncture works with psychoemotional conditions

Acupuncture, on the other hand, seeks to address both root and branches of psychoemotional conditions, and can do so effectively and with minimal risk of side effects. One of the most basic tenets of acupuncture and traditional East Asian medicine is that everyone is different, so treatment begins with a recognition of the uniqueness of the individual. Proceeding through gathering relevant diagnostic information to correct diagnosis and correctly targeted treatment, acupuncture can relieve depression and insomnia without risk of side-effects.

 

The importance of sleep

Most people acknowledge the importance of sleep, but few truly understand its profound impact on overall health. Insufficient sleep increases the risk of – or directly leads to – irritability, headaches, heart disease, weight gain, poor vision, infection, gastrointestinal conditions such as inflammatory bowel disease (IBD), depression, diabetes, and cancer. Both the amount and quality of sleep is directly related to all aspects of physical and mental health.

In traditional East Asian medicine, insomnia is defined as a condition in which quantity and quality of sleep are decreased consistently for more than a month. Insomnia may be present in the form of one or more of the following: difficulty falling asleep, waking up easily throughout the night (except from pain or full bladder), early awakening with difficulty going back to sleep, and dream-disturbed sleep. Insomnia may be due to multiple factors including pathogenic heat, overthinking, emotional frustration, and depression.

 

Research in the effectiveness  of acupuncture in treating insomnia

receiving acupuncture treatmentScientific research verifies the effectiveness of acupuncture in this area. In an article recently published in the Shanghai Journal of Acupuncture and Moxibustion, for example, acupuncture was shown to be 90% effective in improving total sleep duration and sleep quality for patients with depression, with similar clinical results as an antidepressant, but lower relapse rates and no side effects.

There were two groups, the acupuncture group and the antidepressant medication (Mirtazapine) group. Total effectiveness rate for acupuncture treatment was 90% with no side effects of any kind. Total effectiveness of mirtazapine treatment was 92.5%, but with dizziness, drowsiness, vision changes, weight gain, increased appetite, and constipation listed as common side effects.

In the research, Hamilton Depression Rating Scale (HAM-D) was used to measure improvement. Within one month of treatment, the acupuncture group showed 9.7% improvement in HAM-D score while the medication group showed 15.9% improvement in the HAM-D score. Within three months of treatment, the acupuncture group showed 36.2% improvement while the medication group showed 32.5% improvement.

For three months, the acupuncture group received treatments every other day while the medication group were given 20 mg of mirtazapine tablets orally once a day. The point prescription for the acupuncture group consisted of primary acupuncture points which addressed the depression and insomnia, and of secondary acupuncture points which addressed the differential diagnosis of each individual. The primary points included a point on the wrist (Shenmen – HT-7), a point on the leg (Sanyinjiao – SP-6), and a point between the eyebrows (Yintang). The secondary acupuncture points, which were added to address the different needs of each individual, included a point on the foot (Taichong – LR-3) and a point on the leg (Yanglingquan – GB-34) if the other symptoms they had were liver related symptoms such as headache, irritability, and rib pain, or a point on the arm (Jianshi – PC-5), and a point on the leg (Zusanli – ST-36) if the other symptoms they had were spleen symptoms such as poor appetite, indigestion, vomiting, nausea, and epigastric or abdominal pain. The needles were stimulated every 10 minutes and were retained for 30 minutes.

It was concluded that acupuncture improves total sleep duration and sleep quality significantly, which in return reduced the relapse rate for depression and insomnia and improved overall health, both physically and mentally, without any side effects.

Another study, a single-blind, randomized, placebo-controlled research, concluded that acupuncture improves sleep and reduces insomnia when compared to sham acupuncture (random needling) and to a medication, estazolam. Acupuncture showed significantly superior results improving total sleep duration and sleep quality, like the previously mentioned study. The point prescription in this study included a few points on the head (Shenting – GV-24, Sishencong, and Baihui – GV-20), a point on the wrist (Shenmen – HT-7), and a point on the leg (Sanyinjiao – SP-6). The estazolam medication group experienced side effects such as daytime drowsiness.

In a further study, acupuncture was shown to increase the bodily serotonin levels and the concentration of gama-aminobutyric acid (GABA) in cerebrospinal fluid. Serotonin is one of the neurotransmitters which regulate cognitive function, mood, sleep, and appetite, while GABA is another neurotransmitter which reduces the excitability of the neurons. In this study, acupuncture was shown to have 93.3% total effectiveness rate in the treatment of insomnia. The point prescription included a point on the head (Shenting – GV-24), a point on the wrist (Shenmen – HT-7), points on the leg (Sanyinjiao – SP-6 and Zusanli – ST-36), a point between the eyebrows (Yintang), and a point behind the ears (Anmian). The needles were retained for 45 minutes each session. Additionally, acupuncture points in the ear (Subcortex and Shenmen) were used with ear seeds (Vaccaria seeds covered with zinc oxide tape) rather than needles and patients were asked to stimulate them for few minutes each day.

 

In conclusion

Research is confirming the effectiveness of the ancient arts of healing. In studies examining the effectiveness of acupuncture in treating insomnia and depression, acupuncture successfully increased total sleep duration and quality while decreasing daytime dysfunction and sleepiness, with no side effects. It’s important to understand that acupuncture does not alleviate symptoms as quickly as medications because it does not add synthetic hormones into the system or chemically modify the body, and that the absence of side effects is a significant compensation for the longer duration of treatment. Unless a condition developed overnight, it will not disappear overnight, and the additional time it takes to remediate a condition of long standing allows a more natural and lasting course of healing and restoring balance.

Read more about the author Peter Lee R.Ac. or book an appointment with him.

 

References

Kelman L, Rains JC (2005). Headache and Sleep: Examination of Sleep Patterns and Complaints in a Large Clinical Sample of Migraineurs.

Meier-Ewert HK, Ridker PM, Rifai N, Regan MM, Price NJ (2004). Effects of Sleep Loss on C-reactive protein, an Inflammatory Marker of Cardiovascular Risk.

Benedict C, Brooks SJ, O’Daly OG, Almen MS, Morell A (2012). Acute Sleep Deprivation enhances the Brain’s Reponse to Hedonic Food Stimuli: an fMRI Study.

Orzel-Gryglewska J (2010). Consequences of Sleep Deprivation.

C. A. Everson. (1993). Sustained Sleep Deprivation impairs Host Defense. American Journal of Physiology.

Tauseef Ali. James Choe, Ahmed Awab, Theodore L Wagener (2013). Sleep, Immunity, and Inflammation in Gastrointestinal Disorder. World Journal of Gastroenterology.

Baglioni C, Battagliese G, Feige B, Spiegelhaldar K (2011). Insomnia as a Predictor of Depression: A Meta-Analytic Evaluation of Longitudinal Epidemiological Studies.

Ye GC & Yan H. (2014). Therapeutic Observation of Acupuncture for Depressive Insomnia. Shanghai Journal of Acupuncture and Moxibustion. 55(6)

Lin-Peng Wang, Guo, Jing, Cun-Zhi Liu, Jie Zhang, Gui-Ling Wang, Jing-Hong, Yi, Jin- Lian cheng, and R. Musil. Efficacy of Acupuncture for Primary Insomnia: a Randomized Controlled Clinical Trial. Deutsche Zeitschrift fur Akupunktur 57, No. 4 (2014): 31-32

Wang H, Meng X.H, Zou W. (2014). Curative Effect of Acupuncture Therapy of Regulating Mentality combined with Auricular Point in the Treatment of Insomnia. Journal of Clinical Acupuncture and Moxibustion. 30(7).