Just about everyone has experienced a sleepless night at one time or another. Usually it’s because of nervousness or excitement over an upcoming event, or emotional upset due to some recent stressor. For most of us it is an isolated incident and we return to our usual, restful sleep pattern pretty quickly. There are those however, who suffer from lack of or poor quality sleep more often; sometimes for extended periods of time. The National Sleep Foundation estimates approximately 40 million Americans experience some sort of insomnia every year. It seems to be increased in prevalence among women and older adults.
Insomnia is defined by the medical community as the state of reduced or poor sleep at least 3 times a week that lasts for 3 or more months consecutively. This constitutes what is known as chronic insomnia. Repeated bouts of insomnia lasting 1-3 months each with at least 2 episodes in a year is called “Recurrent insomnia”. “Acute insomnia” would be a bout of sleeplessness that is fairly new in occurrence and that resolves itself in a short period of time.
“Onset insomnia” is the term used to define patterns where a patient has trouble falling asleep. “Maintenance insomnia” is the term for patients who fall sleep easily but cannot stay asleep all night or who regularly wake up too early.
“Primary insomnia” occurs by itself, without any other disease or health process involved. “Secondary insomnia” is sleep loss as a result of some other health issue or disease (like pain or a viral infection) or behavior (caffeine consumption or excessive napping/poor sleep scheduling).
Different age groups require differing amounts of sleep to be well rested. Basically, babies and small children need the most, with times required declining as you age.
The causes of insomnia
Short-term, insomnia can be triggered by life stressors, both positive and negative. “Nerves” over financial, personal or community issues and traumas can create a temporary situation where sleep becomes affected. Acute illness, such as a cold or flu or flared allergies can also adversely affect sleep.
It can be difficult to discover the cause of long-term sleep disturbance. Certainly there are many cases where poor sleep quality is a result of chronic pain, indigestion or other obvious physical ailments. Sometimes, and all too often, it is caused by chronic emotional states, immune system weakness or other long-term, difficult sources. Sometimes it is hard for a person to nail down just what is causing their sleep loss which can make it very difficult to address the problem.
Treatment for insomnia
In Western Medicine there are several treatment strategies used, depending on the presentation of the insomnia. Cognitive Behavioral Therapy (talk therapy) is a first line strategy to help people deal with stressors or lifestyle that is interfering with their sleep. Sometimes training in “sleep hygiene” is employed, such as reducing/discontinuing late day caffeine consumption, late eating, light in the sleeping area, sleep or bedtime inconsistency, “blue light” exposure (from tv, computer or phone usage” close to bed time.
For those who’s sleep issues seem tied to Seasonal Affect Disorder, occurring more frequently in dark winter months, using a blue light box daily to increase UV light exposure can help regulate not only moods, but sleep cycles.
Sometime medications are prescribed. Two of the most common are Lunesta and Ambien. While these help many fall asleep, they have some side effects that are important to understand. The same goes for the common use of the antihistamine Benadryl to cause drowsiness and sleep. Long-term use of medication always has side effects and can also become habit forming (not necessarily addicting) if a person finds themselves unable to sleep at all without the medication.
How does Chinese medicine view and treat insomnia?
In Chinese medical theory insomnia occurs when the conscious mind (Shen) is unable to interact with the spirit (Hun) allowing the mind to go into a rest state. This can have several causes: pathogens such as internal “heat” or toxins can disturb the mind. Deficiency of blood/vitality does not allow the smooth transition from active to quiet in the body/mind. Deficiency of Yin (the quiet, calm, nutritive quality of human physiology) where the body/mind is unable to switch out of active mode and rest.
We understand these issues to arise from stress, poor diet, extended illness or a genetically frail constitution. All of these can predispose one sleep problems.
There is also a distinction made between which internal organs may be imbalanced and contributing to insomnia based on how the sleep problems manifest. Someone who has a hard time falling asleep will be treated differently from the person who wakes many time at night. Different treatments will address the person who has dreams disturbing sleep quality verses the person who has restless sleep with a few dreams. Of course, other occurring health issues like allergies, aches and pains or indigestion must be addressed as well, as all of these things can strongly affect the quality of sleep.
Strategies can be suggested for self care, including lowering the temp of your bedroom, having melatonin-containing foods like tart cherry, banana or pineapple, or an herbal tea before bed. Previously mentioned sleep hygiene is excellent. Avoid exercising too late or eating a big meal or having alcohol before bed. Essential oils such as lavender or sandlewood can help the mind relax. Some people have a meditation they like to do before bed to quiet the mind from the day’s concerns. All of these, in addition to a comprehensive treatment plan from a qualified Chinese Medical Professional can help address insomnia in a natural and balanced way.
Upon seeing an Acupuncturist for insomnia, an in-depth and complete health history is taken, along with pulse diagnosis and observation in order to determine the underlying cause of your sleep issue. Only then can an effective, comprehensive and personalized strategy of Acupuncture, lifestyle adjustment, or herbal medicine be created to return your body to balance. Once the body is balanced, sleep will return.