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Ask an expert - neuro and psycho logical - insomnia

9 questions

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

 

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.   
 
 

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