Acupuncture insomnia (poor sleep) therapy
Acupuncture insomnia treatment has moderate level evidence supporting the use of acupuncture insomnia therapy to help correct poor sleep patterns.
What is the history behind acupuncture insomnia therapy?
Acupuncture insomnia therapy is well covered in the texts which underpin Chinese medicine.
In Chinese medicine, sleep quality is considered to be an aspect of the shen. The shen is the expression of the mind.
At night, it is said the shen anchors which engenders sleep and during the day the shen rises which allows for being awake.
In acupuncture insomnia therapy the object is to help the shen anchor at night and rise through the day.
When someone is experiencing poor sleep it is called insomnia. Insomnia is the ‘western’/biomedical diagnosis.
From a ‘western’/biomedical perspective, what is insomnia?
Broadly speaking, you may have insomnia if you:
- have trouble falling asleep
- have trouble staying asleep
- wake early and cannot return to sleep
- wake unrefreshed
Insomnia is also classified as either acute insomnia or chronic insomnia:
- acute insomnia is episodic and might be attributable to recently occurring events
- chronic insomnia affects you at least three times/week over a three month period
What causes insomnia?
The causes of insomnia are many and varied and may include:
- difficulty breathing
- reflux or indigestion
- asthma or difficulty breathing
- body pain which disrupts sleep
- emotional unrest
- restless legs syndrome
- sleep apnoea
Diagnosing sleeping disorders includes taking a detailed case history, blood work and sleep studies. The National Sleep Foundation is an excellent, external resource about sleep.
How does the acupuncture and Chinese medicine practitioner approach acupuncture insomnia therapy?
The holistic and inclusive nature of the Chinese medicine diagnostic model makes it a perfect system for examining sleep quality.
Initial questioning will focus on the main complaint, insomnia:
- nature of sleep disturbance: do you have trouble falling asleep or do you have trouble staying asleep (or both)?; do you fall asleep alright but then routinely wake in the early hours of the morning (and not be able to return to sleep)?; do you think you sleep alright but wake up feeling unrefreshed? Do you dream vividly or have nightmares?
- timing of sleep disturbance: how frequently are you experiencing your symptoms? Are they associated with any other activities in your life?
- trigger of sleep disturbance: is there something which you can pinpoint which affects your sleep? This may be work stress or certain foods or it may be reflux throughout the night?
- history of sleep disturbance: these questions seek to build a timeline to establish whether your insomnia is acute or chronic in nature.
Will the acupuncture and Chinese herbal medicine practitioner only ask questions about my insomnia?
Because acupuncture and Chinese medicine is an holistic model of medicine, it is rare that a single symptom associated with a single condition would be all that is examined.
Once the nature, timing, triggers and history of your insomnia are established, a broader examination of other health dynamics will be explored. These might include:
- diet: especially where reflux, nausea and indigestion are waking you up
- exercise: especially where snoring or difficulty falling asleep is part of your insomnia
- propensity for experiencing headache
- whether symptoms worsen at either menstruation or ovulation
- whether there is anxiety or depression associated with your insomnia
Chinese medicine diagnosis relies on careful identification and classification of signs and symptoms of your insomnia or poor sleep.
What happens once all the necessary information has been gathered (the Chinese medicine diagnosis)?
Once a detailed case history has been taken, the practitioner will then carefully analyse the signs and symptoms according to the diagnostic principles of Chinese medicine.
The object of this analysis is to categorise signs and symptoms – not just signs and symptoms immediately related to sleep – into a diagnostic pattern.
This diagnostic pattern is called the Chinese medicine diagnosis.
The Chinese medicine diagnosis is unique to the practice of Chinese medicine and forms the first step in constructing a principle of treatment.
The principle of treatment form the backbone of the acupuncture insomnia treatment.
Because insomnia is complex and diverse in nature, very few people have exactly the same Chinese medicine diagnosis which is why no two treatments are every exactly the same.
The Chinese medicine diagnosis does not replace you biomedical diagnosis. In fact, while of interest to the practitioner, the biomedical diagnosis is not necessary because treatment is delivered to address the Chinese medicine diagnosis.
The Chinese medicine diagnosis sits nicely alongside your biomedical diagnosis.
What evidence is there to support acupuncture pain relief therapy?
Contained within this evidence review are evidence summaries of systematic reviews and other ‘level I’ forms of evidence.
A systematic review of thirty randomised controlled trials in 2016 3 concluded from twenty-seven of those trials that acupuncture was superior to medication for the treatment of insomnia (although the quality of evidence was generally low). A further three studies demonstrated acupuncture’s superiority against ‘fake (or sham) acupuncture’.
There has also been promising evidence emerge for the use of acupuncture to help improve sleep in women experiencing perimenopausal and post menopausal insomnia.
One systematic review (2016) 4 demonstrated improved sleep associated with changes in serum oestradiol ,follicle stimulating hormone (FSH) and luteinising hormone (LH). This review recommended acupuncture as an adjunct therapy for insomnia associated for the peri and post menopausal woman.
Another study 5 also recorded improved sleep quality (while the evidence was of moderate-high quality, there isn’t a lot of it).
I feel as though I need to know a little more about understanding evidence.
For those not familiar with it, interpreting evidence can be daunting and confusing.
There is an extensive discussion around the use of evidence in supporting acupuncture over on this FAQ page.
What if my condition isn’t listed on this page?
All that means is that there hasn’t been enough research to officially say, “yep it helps”. Before deciding whether acupuncture insomnia therapy is for you, feel free to give Peter a call to chat about your individual circumstances and his experience or knowledge of your problem.
Ready to book your first consultation?
Peter offers a range of days and appointment times for first and follow-up consultations. Contact Peter here and he or an associate will call you back, have a quick chat about your needs and find a mutually convenient time for your first appointment.
- MacDonald J, Janz S. The Acupuncture Evidence Project: A Comparative Literature Review (revised evition). Brisbane: Australian Acupuncture and Chinese Medicine Association Ltd; 2017. [accessed 21 February, 2018.
- Hempel S, Taylor SL, Solloway MR, Miake-Lye IM, Beroes JM, Shanman R, et al. VA Evidence-based Synthesis Program Reports. Evidence Map of Acupuncture. Washington (DC): Department of Veterans Affairs; 2014.
- Shergis JL, Ni X, Jackson ML, Zhang AL, Guo X, Li Y, et al. A systematic review of acupuncture for sleep quality in people with insomnia. Complement Ther Med. 2016 Jun;26:11-20
- Chiu HY, Hsieh YJ, Tsai PS. Acupuncture to Reduce Sleep Disturbances in Perimenopausal and Postmenopausal Women: A Systematic Review and Meta-analysis. Obstet Gynecol. 2016 Mar;127(3):507-15.
- Bezerra AG, Pires GN, Andersen ML, Tufik S, Hachul H. Acupuncture to Treat Sleep Disorders in Postmenopausal Women: A Systematic Review. Evid Based Complement Alternat Med. 2015;2015:563236.