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Ask an expert - neuro and psycho logical - insomnia

11 questions

Q:  Do acupuncturists specialise in specific problems. I am looking for an acupuncturist who has experience of helping people with sleep problems in the London area.

A:  The question of specialisms is rather a vexed one inside the profession. Chinese medicine is by its very nature generalist, and in ancient times the specialist was looked upon as an inferior being because he or she could only treat one range of conditions. In essence, Chinese medicine treats the person, not the disease. This means that twenty people with the same named western condition might have twenty different treatments, each being tailored to their specific needs.

There are one or two areas, however, where we have invested a great deal of time in drawing up guidelines for what we would call expert practice. These are obstetrics, paediatrics and mental health issues. The issue is not that there is an untapped pool of Chinese medical knowledge which practitioners can tap into as much as the fact that working with a specific group of patients means that the practitioner can spend more time studying the conventional treatments of these problems and develop a skill set based on their experience. There are now several fertility and childbirth networks, and several members who run children's clinics, and we have almost reached the
point of setting standards which would enable them to advertise themselves as expert practitioners in these fields.

The treatment of insomnia, however, is not an area where we have seen a specific focus, and since nearly all of us treatment people with sleep problems on a regular basis within our generalist frameworks we can't foresee much chance that there will be an expert practitioner definition. The only likelihood of this would be if a BAcC member were attached to a sleep clinic, and this might create a basis for expert practice, but we have not heard of this yet.

You can be assured that all of our members are able to help address the problem. There is a small amount of good evidence that acupuncture treatment can help, as our factsheet shows  http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/insomnia.html but the causes of insomnia are so diverse that it really does take, in our view, an individual approach which looks at all aspects of a person's functioning to make sense of the problem and start to put it right. Chinese medicine has this focus, and is ideally suited to treating conditions which do not have a single specific cause.

The best advice that we can give is that you contact a number of BAcC members in your area and ask what experience they have had of treating insomnia. The best option would be to  see one or two in person; even a very brief face to face assessment will give them enough information to offer you an estimate of how much benefit
acupuncture treatment might offer.

Q:Can acupuncture help with insomnia.. Where can I find one in the Norwich, Norfolk area?

A: We were asked this question last year at the time of Acupuncture Awareness Week, and our response was:

Q: Can acupunture definitely help with sleep problems?

A: As our BAcC factsheet shows

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/insomnia.html

there is some encouraging evidence which suggests that acupuncture has a role to play in helping people to deal with longstanding sleep problems. Indeed, the issue is a very topical one; we are just about to launch Acupuncture Awareness Week and Toyah Wilcox has lent her support to the venture because she found acupuncture to be a very effective solution to a sleep problem which she had had for many years. Her story can be found here:

http://www.mirror.co.uk/lifestyle/health/toyah-willcox-on-her-battle-with-insomnia-1586599

From a Chinese medicine perspective there are a number of well established patterns which explain why the mind refuses to close down at night even though the person is physically exhausted. A skilled practitioner will want to know not simply about the sleeping patterns but about everything else to do with daily functioning, and it is highly probable that there will be other signs and symptoms which will show or confirm what is out of balance and needs to be corrected and harmonised.

Delightful as Toyah Wilcox's account is, though, her response to treatment was exceptional. One of the real problems with sleeplessness is that the body gets used to patterns or habits, and it can sometimes take a while for the system to realise that change is possible. We have found patients who couldn't sleep until 2.00am desperately hanging on till 2.00am even though they were now properly exhausted and ready for sleep 'because that's my bedtime'. Many people know this experience well from trying to go to bed at 9.00pm ready for a journey at 4.00am and finding it really hard to do. So, helping someone back to a good sleep routine can often be a challenge but there are success stories.

As we often remind people, though, Chinese medicine works from an entirely different paradigm. Insomnia doesn't have a single specified treatment, and each person who cannot sleep does so in a way that is unique to them. The best advice will always be that given after a brief face-to face assessment by a BAcC member local to you, who can have a quick look at the overall diagnostic picture and offer you a candid assessment of how acupuncture may be able to help you.

We think that this still remains the best advice we can give.

We don't give out individual recommendations; we take the view that all of our members are well enough trained and qualified to be able to handle the vast majority of cases which arrive at their doors. The important thing is to find someone near to where you live, and our practitioner search function on our home page www.acupuncture.org.uk

Q:  I had acupuncture and the needle was placed in my sternum for sleep problems. I felt an intense pressure and tightening and the the needle had to be removed. Is this normal?

A: We always say in these situations that what you experienced isn't normal but it isn't unknown either.
 
The usual, sensation people feel when needles are inserted are a slight tingling sensation or a dull ache. The latter is regarded more as a reaction understood in Chinese medicine terms than in orthodox physiology and is called 'deqi'. On rare occasions the reaction to a needle can be as you describe. The western trained physiologist would describe this as a neurophysiological reaction, possibly involving a spasm in the local musculature such as it is in the area, and the Chinese medicine practitioner would describe this as a kind of 'needle grab' where the needle feels like it is being pulled into place.
 
Whichever way you describe it, removing the needles immediately is the appropriate course of action if the patient feels either incomfortable or anxious. We strongly suspect that this was the only needle which produced this kind of reaction, and that the practitioner was able to insert other needles without this kind of reaction. From our perspective, the energy of the points in this area can be very powerful and induce slightly greater reactions, but as we said, this is quite an unusual reaction. We hope that it hasn't put you off further treatment.   
 

Q: I have hyperasrousal insomina.  I can't fall  asleep because of my hyperarousal nerve system.  Can accupunctre treat my insomia?

A:  As our factsheet shows

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/insomnia.html

there have been a number of studies which seem to show encouraging results for the treatment of insomnia with acupuncture, although they fall short of the standard required for us to make definite claims. Studies such as

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3041619/

make for interesting reading, and participants for a large prospective study are currently being recruited in Pittsburgh.

However, hyperarousal insomnia is not simply about not being able to sleep but usually a much more complex pattern affecting many other systems of the body. A practitioner of Chinese medicine would be looking very carefully at all aspects of someone's functioning to get an overall picture of what was happening. Although Chinese medicine has an entirely different theoretical basis, and is supported by theories about energy and its flow and balance, the symptoms which people describe and the signs they display are not new, and the kinds of discomfort and stress which hyperarousal creates would have been understood for the last 2,500 years within the Chinese medicine system. This means that there will probably be a number of treatment options based on some of the other diagnostic evidence which a practitioner might identify.

However, we have to sound a note of caution based on our practical experience of treating problems such as yours. They are oftenvery complex and with a variety of interlocking causes, an acupuncture treatment alone may not be able to deliver a result. The problems can also have a spiral effect - the sleeplessness can often generate new problems, both physical and emotional, and these can develop a life of their own.

 

We can do no better than recommend that you contact a BAcC member local to you for a chat and informal assessment of the potential value of acupuncture treatment.

Q: can acupunture definatley help with sleep problems

 

A:  As our BAcC factsheet shows
 
http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/insomnia.html
 
there is some encouraging evidence which suggests that acupuncture has a role to play in helping people to deal with longstanding sleep problems. Indeed, the issue is a very topical one; we are just about to launch Acupuncture Awareness Week and Toyah Wilcox has lent her support to the venture because she found acupuncture to be a very effective solution to a sleep problem which she had had for many years. Her story can be found here:
 
http://www.mirror.co.uk/lifestyle/health/toyah-willcox-on-her-battle-with-insomnia-1586599
 

 

From a Chinese medicine perspective there are a number of well established patterns which explain why the mind refuses to close down at night even though the person is physically exhausted. A skilled practitioner will want to know not simply about the sleeping patterns but about everything else to do with daily functioning, and it is highly probable that there will be other signs and symptoms which will show or confirm what is out of balance and needs to be corrected and harmonised.
 
Delightful as Toyah Wilcox's account is, though, her response to treatment was exceptional. One of the real problems with sleeplessness is that the body gets used to patterns or habits, and it can sometimes take a while for the system to realise that change is possible. We have found patients who couldn't sleep until 2.00am desperately hanging on till 2.00am even though they were now properly exhausted and ready for sleep 'because that's my bedtime'. Many people know this experience well from trying to go to bed at 9.00pm ready for a journey at 4.00am and finding it really hard to do.  So, helping someone back to a good sleep routine can often be a challenge but there are success stories.
 
As we often remind people, though, Chinese medicine works from an entirely different paradigm. Insomnia doesn't have a single specified treatment, and each person who cannot sleep does so in a way that is unique to them. The best advice will always be that given after a brief face-to face assessment by a BAcC member local to you, who can have a quick look at the overall diagnostic picture and offer you a candid assessment of how acupuncture may be able to help you.

 

 

 

The link to find a BAcC member close to you www.acupuncture.org.uk/find

 

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