The Alphabet of Sleep

In today’s society we forget just how to unplug from a constant “plugged in” nature. With regularity, a top complaint from my patients is difficulty sleeping. Parents are fully aware of the necessity of forming a constant night time ritual for their children in order to develop proper and healthy sleeping lifestyles, but are common offenders to these rituals themselves.

There are so many ways to begin to turn around these feelings of perpetual fatigue and get more sleep. Start with asking yourself some of the most basic questions. How comfortable is your mattress and pillow? Is your sleeping room uncluttered and is your bed sacred sleep space only? People with any allergies should be using special mattress pads and pillow cases and remove rugs and objects under and around the bed to reduce those sensitivities.

There are many night time rituals commonly suggested that may assist in preparing for sleep. Turning off all electronics thirty minutes before bedtime, taking a bath, having warm caffeine-free drinks, practicing a meditation or breathing ritual, reading poetry or knitting are some suggestions to slow down the brain and body before sleep.

Many people have no idea how critical the down time is to their overall health and well being. Furthermore, how essential sleep time is to regulating their hormone balance and recharging their energy.

Insomnia is characterized as the acute or chronic inability to initiate or maintain adequate nighttime sleep (1).There are many reasons that insomnia may occur and a careful history of the severity, duration and consistency of the reported sleepless nights are important to ascertain. Generally insomnia is classified according to disruption and duration of the complaint such as difficulty falling asleep, frequent or sustained awakenings during the night, early morning awakenings, or persistent sleepiness despite adequate sleep. Some biomedical differential diagnoses of insomnia include:
• Acute causes due to: emotional stress, physical discomfort, jet lag• Alcohol use• Circadian rhythm disorder• CNS disease: e.g.: brain tumor, complex partial seizures, neurosyphilis• Depression• Mania or bipolar disorder• Menopause• Medications: e.g.: corticosteroids, benzodiazepine withdrawal, selective serotonin reuptake inhibitors• Medical illnesses: e.g.: chronic obstructive pulmonary disease, hyperthyroidism, hepatic encephalopathy, gastro esophageal reflux disease• Nocturia: e.g.: use of diuretics, benign prostatic hyperplasia, urinary incontinence, congestive heart failure• Poor sleep hygiene: e.g.: too many daytime naps, watching TV in bed• Restless leg syndrome• Stimulants: e.g.: caffeine, nicotine

The treatment of insomnia and sleeplessness with acupuncture and herbal formulas is quite common and successful. However treatment of insomnia is complex and requires the practitioner to focus on the root of the imbalance of the condition causing the sleep disruption.

Currently there are a number of clinical studies that have looked at acupuncture for the treatment of insomnia. The Cochrane review in 2007 assessed 7 trials of 590 participants and a variety of causes of insomnia and treatment strategies. Many of the patients in this trial reported a co-existing medical conditions possibly related to insomnia included stroke, and end-stage renal disease. Thus, the 2007 review was unable to draw any strong conclusion statistically supporting the use of acupuncture as treatment for insomnia. However, since then a number of studies have been published.

Practitioners of acupuncture have successfully treated a variety of sleep disorders using a number of classical acupuncture points for function of quieting the mind and improving sleep. Acupuncture treatment may be utilized alone or in combination with a variety of potential agents including pharmacotherapy, behavioral therapy and attention to improving sleep hygiene. The use of acupuncture plus other Traditional Oriental Medical modalities (including moxibustion and/or herbal medicine) together provide a supportive and powerful approach to treating a patient suffering from this often chronic and debilitating condition.