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Ask an expert - neuro and psycho logical - insomnia

15 questions

Q:  I can't sleep I am not falling asleep till about four in the morning.   I don't feel tired.  I have tried everything it's getting me down.  I can't go on like this.  I wonder if you can help me please.

A:  There is no doubt that acupuncture has a good track record for helping with insomnia. While the studies are not really sufficient in quantity to make substantive claims such as there have been, as you can see from our factsheet

 are very encouraging.

 The real strength of traditional acupuncture, however, is not in treating conditions as much as it is in treating the people with the conditions. Although a dozen people with insomnia may present for treatment with exactly the same kind of insomnia, it would be not unusual if each was treated differently. The failure to get to sleep is a sign that the system is out of balance, but the causes can be quite different. The art and skill of the practitioner lies in finding out exactly why this distressing symptom occurs in you.

 Of course, as you well know, the problem becomes a spiral of descent into despair. Less sleep means that people become more anxious, less able to concentrate, and this can all make the problem far worse. The treatment can also help with these sorts of aspects. Invariable we find that there are often life conditions or emotional states which precede the onset of the problem, and these too form a part of the diagnostic process.

 The best advice, especially for someone suffering as you are, is to visit a BAcC member local to you for a brief face to face assessment of what is going on. The advice will be much more precise than we can give here, and most members are happy to see someone without a small amount of time without charge to establish whether acupuncture is the best option. This also gives you a chance to meet them and see where they work before committing to treatment.

Q:  Over 7 weeks I had acupuncture treatment for chronic insomnia (one session per week). The insomnia has slightly worsened, not improved, and I am awake from 3 am most mornings. I used to get some relief from Valerian, but since the acupuncture Valerian does not work. How long is it before the effects of the acupuncture wear off?

A:  We are sorry to hear that you are experiencing increased problems with the insomnia, but we would be very surprised if the change was down to the acupuncture treatment. Traditional acupuncture, when delivered properly, is all about balancing energies and unblocking areas of stuck energy. The most that usually happens after a session is that there can be a 24-72 window during which the energetic changes can cause mild and transient reactions like a slight headache or lightheadness, and in the case of musculo-skeletal problems a slight worsening of the symptoms. After this the body tends to stay in its adjusted state unless someone is doing something which causes it to revert, like working far too hard or eating erratically.

In this very limited case, where the treatment is given against a backdrop of poor lifestyle (not that we are suggesting that you have) it might be possible for a treatment to 'wear off' but if this were to be the case then the practitioner would be particularly concerned to adjust the treatment to avoid a kind of boom-slump cycle. The practitioner might also be interested in the fact that you are awake from 3.00am. Odd as it might sound, there are a number of diagnostic patterns where this would be a significant and which might just have been made more apparent by an overall boost in the body's energies. Over the longer term, however, the pattern would revert, so it would be surprising to find that a course of treatment had caused long term adverse effects.

We are interested to read from your supplementary question that it was a drop-in session at which you had the treatment. We are not quite sure what this means. We have a number of members who operate in multi-bed settings which offer treatment at reduced rates for people who could not otherwise afford it, but we are aware that there are other settings where people offer acupuncture, often ear acupuncture, on a walk-in basis. If it is the former this would still be traditional acupuncture. If it was the latter then it might be slightly more formulaic, and there is no doubt that for some people the repeated use of a formula which was not suited to the patient might exacerbate a problem. The best person to ask would be the practitioner who offered the treatment. If it has been done in a traditional way and crafted to your individual needs, the feedback will make sense and perhaps point to ways forward. If it is/was a formula treatment, then it might simply be better to avoid further sessions, as you have.

There is no doubt that acupuncture can benefit in treating insomnia, as our factsheet shows

and you may still find that seeking advice from one of our members working locally to you is a good option if the treatment that you had was offered by someone who did not belong to our body. Most members are happy to offer a brief chat without charge to assess whether someone may be able to benefit from traditional acupuncture.

Q:I have suffered from insomnia for 25 years. I had acupuncture 20 years ago which did help me sleep eventually for a year. Since then I have tried hypnotherapy, counselling and I am on and off sleeping tablets which make me feel groggy. I am now re looking at acupuncture but I am not sure who to see? The previous acupuncture clinic of 20 years ago is no longer there. I live in Chandlers Ford Hampshire. Any suggestions would be greatly received as I feel so exhausted all the time.

A:  We are sorry to hear that your sleeping problems have returned but pleased to hear that they responded well to acupuncture before. This usually means that there is good reason to expect that they will do so again.

Finding a practitioner local to you could not be easier. On our website home page there is a postcode search facility which will offer you a number of suggestions who are geographically nearest to you. All of our members are trained and qualified to the same very high standards, so it is really a matter of finding someone who you can do business with. Most practitioners are more than happy to invite you for a brief face to face assessment before you commit to treatment and this will offer you a chance to meet them in their work surroundings.

We hope that acupuncture treatment offers the same results again and helps you to regain your joie de vivre.


Q:  Does acupuncture help to cure insomnia? I have been suffering from insomnia for many years. may be over 20 years. I have been taking over the counter remedies, such as Valerian,  hop and magnesium. 

A:  There is no doubt that acupuncture has been used with some success in treating imsomnia. As we wrote in a reply two years ago:

As our BAcC factsheet shows

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:

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. Indeed, the one thing which would concern us is that your sleeplessness has now been going on for over twenty years. As we said in the earlier reply, people get used to certain habits and patterns, and it can be very difficult to unpick these when they have existed fa long time. This can have some extraordinary consequences. Sometimes volunteers are employed by sleep clinics to keep people awake until 4.00am in an attempt to make the three hour sleep pattern end at a normal waking time, and then start trying to move the start time back while keeping the waking time. Insomniacs begging to be allowed to sleep - very strange!

It is always best never to prejudge the situation, though. From our perspective everyone is unique and different, and it could well be that a practitioner can trace patterns in your energy which, when corrected, make your sleeping easier and more refreshing. Let's hope so!


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 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.

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