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Ask an expert - neuro and psycho logical - insomnia

13 questions

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

 

Q: Where on the body are the acupuncture points for someone suffering from insomnia please?

 

A:  There are no fixed points on the body for specific named conditions. There are, of course, a number of points which are frequently used for treating commonly seen complaints, so you could say with about 75% certainty that treating headaches would probably involve a specific point on the upper surface of the foot, but the correspondence is not a simple one between the complaint and the point. Many headaches arise because of disturbances in the Liver energy, as understood in the language of Chinese medicine. The question which the practitioner will always address, however, is whether that is the primary cause of the problem, or whether something else is disturbing the system, and causing a knock-on effect on the Liver energy which in turn generates the symptom of headaches.
 
This may all sound like hair-splitting, but is actually the essence of how Chinese medicine can be so powerful. If the symptom is simply an alarm bell that shows that the system as a whole is out of kilter, then treating the symptom alone as though it were the problem will do very little, perhaps bring short term relief before the same, or other, symptoms develop again. This is why the BAcC is so committed to proper degree level of equivalent training for acupuncturists. If someone simply uses a point prescription book and sticks needles in according to dircet correspondences, the treatment may work, but it is equally likely that it won't, and the consequence will be that someone will conclude that 'acupuncture doesn't work' instead of the more accurate 'acupuncture done in this way by this person doesn't work.'
 
Traditional acupuncture treats the person, not simply the complaint, and the well-qualified practitioner will want to know why this particular person cannot sleep, and want to be able to help to deal with the problem in a way which brings sustained change. In our experience formula acupuncture for named conditions is neither as powerful nor as enduring as properly crafted diagnosis and treatment according to Chinese medicine principles. 
 
 

As our two factsheets show

 
Please click here

 

Please click here

 
 
there is a growing body of evidence to suggest that acupuncture may be of value in treating both of these conditions. The research is still a little methodologically weak and not quite plentiful enough for us to give an unqualified recommendation, but both of these disorders have existed for thousands of years, and Chinese medicine, exactly as conventional does today, has developed a number of established protocols for the more frequent clinical presentations.
 
However, the real strength of Chinese medicine is that is sees all of the symptoms which a patient experiences as a part of an overall pattern rather than single and separate problems to be picked off one at a time. If someone is suffering from insomnia and depression it is highly likely that these are just a part of a much wider picture which probably contains a number of physical symptoms or dysfunctions, as well as mental and emotional components. A practitioner will want to spend time looking at all aspects of the way someone is functioning to make the most accurate assessment of what is happening in the individual patient, and to gain a better understanding of how the problems have arisen.

 

We would advise you to seek out a BAcC member local to you and arrange a short visit to discuss with them whether they think acupuncture might be a suitable option.   
 
 

Q:I have insomnia caused by an over active mind. I have no trouble at all going to sleep, but I often wake in the night, usually to go to the toilet, and my mind starts racing and I can't go back to sleep. Please could you let me know if acupuncture can help with this sort of insomnia?

 

A: As far as insomnia itself is concerned, there have been many trials which seem to show that acupuncture may be of benefit to you. A systematic review at
 
http://www.ncbi.nlm.nih.gov/pubmed/19922248
 
which is effectively a review of all trials in order to aggregate their findings, makes the same positive noises with which we are familiar - 'signs that there is an effect but need larger trials to confirm'.
 
However, the great strength of Chinese medicine is that each person is unique and different, and no single disease label will ever capture that. Your experience of insomnia, while similar to others, will not be exactly the same, and it is the small details even in the brief note which you send which would excite the practitioner's interest. Getting to sleep originally but waking later, needing to go to the toilet, the description of the mind racing, your sense of having an over active mind - all of these suggest possible changes in the body's functions as understood in Chinese medicine which, together with signs which a practitioner uses like the reading the tongue and taking the pulse at the wrist, would lead them to a diagnosis unique to you. Treatment would then be aimed at correcting the specific imbalances which manifest in order encourage proper function again.
 
The practitioner would routinely ask a great many questions about lifestyle and daily habits, and there may well be some additional clues and keys in what they find. We're sure that you have eliminated the obvious culprits, like strong caffeine drinks towards the evening, and also too much liquid before sleeping, but there may be nonetheless things that you are eating, drinking or doing which, given your own specific patterns of energy, may be causing the cycle to continue. Of course, the worst problem is dealing with the expectation that once you wake you're awake, and that's that. For people who have never suffered insomnia this is difficult to understand, but rather like the film Groundhog Day, the dreadful feeling that it's 3.00am and you're awake exactly the same again is a hard one to describe to someone who has never experienced it.
 
Our best advice is to contact a BACC member local to you for a bried face to face chat about whether they think they can help your specific case, and if so, what their expectation might be. We trust that they will give you an honest assessment.
 

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