Acupuncture and Insomnia

by Mark Whalen

We get many calls to our Acupuncture clinic asking if Acupuncture can help treat insomnia.  The answer is an emphatic yes!  Insomnia is typically characterized as an inability to fall asleep, stay asleep or waking up un-refreshed in the morning.

I’m sure everyone has experienced this from time to time in his or her life.  Is there anything more frustrating than lying in bed staring at the ceiling knowing you should be asleep?

While insomnia can be temporary due to changes in schedule or new stressors in your life, hopefully it is not a persistent issue for you.  Today I want to talk about chronic insomnia.

Chronic insomnia isn’t just frustrating; it can have a major impact on your quality of life and your health.  Sleep may seem to be a period of rest for us, but for our body and brain it is a period of activity during which our bodies restore and rejuvenate.

How/why we get sleepy

In humans, sleep is dictated by a series of chemical messengers known as neurotransmitters.  In an effort to maintain homeostasis, our bodies are constantly balancing out the levels of these neurotransmitters.  The key neurotransmitters that influence sleep are Adenosine, Melatonin and Serotonin (this is not an exhaustive listing).

I’m sure you’ve heard this process of balancing our sleep-wake cycles referred to as our Circadian Rhythm or internal clock.  The Circadian Rhythm is mostly dictated by light, specifically natural light.1

Prior to the advent of electricity (damn you Edison!), our circadian rhythms were more naturally attuned to the fluctuations of day and night.  As the sun would set, our body would begin to release Melatonin to increase our desire to sleep.

In our modern world with artificial light everywhere (thanks Edison!), it is easier for our internal clocks to be thrown off.  Exposure to artificial light after dark may inhibit the release of Melatonin, confusing your body into staying awake later than you should.

Even if it’s dark outside, if you are in a well-lit room watching TV and playing on your laptop, it may be hard for you to get quality sleep2.

What happens when we sleep?

Sleep is generally divided into two states known as Rapid Eye movement or REM sleep and Non Rapid eye movement or NREM.  The NREM state of sleep is divided into four stages with each stage a progressively deeper state of sleep.

During the night, our body cycles through these different stages of sleep.   While we may think of sleep as a restful time, our brains and body are hard at work.

During NREM sleep our bodies are working hard to repair and regenerate tissues, build bone and muscle and strengthen the immune system.

REM sleep begins about ninety minutes after we fall asleep.  REM sleep is the deepest state of sleep where dreaming occurs.  This stage is often referred to as paradoxical sleep because our brains are very active but our muscles are relaxed. 3

Chronic insomnia can lead to a myriad of health problems including weight gain, depression, decreased pain tolerance, diabetes, high blood pressure and weakened immune system functioning.

Weight Gain

Insufficient sleep impacts the hormones Leptin and Grehlin which signal the brain that you’ve had enough food (Leptin) or that you are hungry (Grehlin).

Without insufficient sleep, Leptin levels drop and Grehlin levels increase, creating a double whammy for increasing our appetites.   Our brain signals that we are hungry and doesn’t shut us down when we should be full.  There are some studies showing that this effect is different for men and women.  Women feel less full overall and men feel hungrier4.

A study from the Journal of the Academy of Nutrition and Dietetics reviewed articles on the effect of poor sleep on weight regulation and found:

reduced insulin sensitivity, increases in ghrelin, and decreases in leptin among partially sleep-deprived individuals. Changes in ghrelin and leptin influenced energy intake among the study populations5.

Poor sleep may also lead to slower glucose metabolism. Patients who sleep less than four hours a night tend to have a higher risk of developing diabetes6.

Depression

I’m sure we’ve all felt moody or irritable after a poor night’s sleep.  A chronically sleep deprived person is ten times more likely to develop depression than someone who gets enough sleep7.

Pain Tolerance

A recent study illustrated the link between a lack of sleep and a decreased pain tolerance. The exact mechanism is unknown but it is theorized that a lack of sleep causes an increase in inflammation throughout the body.  The effect of painkillers may even be blunted for those who are chronically sleep deprived8.

In summary, not sleeping is not good for you.

Acupuncture and sleep

In the clinic, I see patients with sleep disorders ranging from difficulty falling asleep, frequent waking, dream disturbed sleep and nightmares.   Whichever end of the spectrum you fall on, acupuncture can help you get a better night’s sleep.

Earlier we discussed the role of Melatonin in regulating the sleep-wake cycles.  Acupuncture needle stimulation influences the central nervous system and triggers the release of Serotonin and the beta-endorphins (‘feel good’ chemicals).

Serotonin just happens to be the pre-cursor to, wait for it…. Melatonin.  Serotonin is released from the Pineal Gland and converted to Melatonin as natural light fades.

Remember that neurotransmitter Adenosine mentioned earlier?  Adenosine rises throughout the day when we are awake, increasing our bodies need for sleep.  At night, once asleep, Adenosine levels go down9.

Turns out that Acupuncture needling influences Adenosine also.  In fact, it may be one of the main mechanisms behind Acupuncture’s effect10.

Your Treatment

In Acupuncture we will search for the reason YOU are not sleeping.  Your sleep disturbance may be treated differently from another patient who has a similar sleep disturbance.

In order to help identify the root cause of your problem, there are many key questions we ask:

  • How long does it take you to fall asleep?
  • Do you wake frequently in the night-if so, is it a consistent time?
  • Do you dream?  Do you have nightmares?
  • Do your dreams wake you in a state of panic?
  • Do you get night sweats?
  • Do you talk in your sleep?
  • Are you refreshed in the morning?

These and other questions will help us identify the best approach to treating you.

Tips for better sleep

  • Establish a routine.  Go to bed and get up at the same time daily.   Aim for 7-8 hours per night.
  • Use your bed for sleep and sex only.  No reading, watching tv, texting,  Ipad-ing or whatever devices are out there.  Do not watch violent or scary images before bed.
  • Cut down on caffeine intake if you do not sleep well.  Remember, caffeine is a stimulant designed to keep you awake.  Even a cup early in the morning can affect you.  Monitor your intake and experiment with the timing of your caffeine and how you sleep.
  • Cut down on alcohol at night.  While alcohol is a mild sedative that wears off over time, it actually will cause you less restful sleep.
  • No big heavy meals before bed.   You won’t be able to sleep well and your body won’t digest the food that well either.
  • De-stress- before bed is a great time for deep breathing exercises or some light yoga stretching.  Anything that helps to calm your mind and take your thoughts away from your day is beneficial.
  • No strenuous exercise within 3 hours of bedtime.  Intense exercise activates the nervous system at a time when it should be winding down.  At night, choose more gentle forms of exercise such as walking or yoga.

 

Hopefully this blog didn’t put you to sleep.

 

-Mark

 

Sources:

  1. http://www.sleepfoundation.org/sites/default/files/SleepWakeCycle.pdf  
  2. Webmd.com. Light Exposure May Cut Production of Melatonin.   Hendrick, Bill.  January 19, 2011
  3. Webmd.http://www.webmd.com/sleep-disorders/excessive-sleepiness-10/sleep-101.  Coping with excessive sleepiness
  4. http://www.medicalnewstoday.com/articles/253462.php  
  5. http://www.medicalnewstoday.com/releases/251947.php  

    Ghrelin And Leptin Levels Affected During Sleep Deprivation Consistent With Increases In AppetiteOct 25th

  6. Ibid.
  7. http://www.sleepfoundation.org/article/sleep-topics/depression-and-sleep  
  8. Really? Losing Sleep Reduces Your Pain Tolerance ByANAHAD O'CONNOR.  December 17, 2012.  New York Times.
  9. http://www.sleepfoundation.org/sites/default/files/SleepWakeCycle.pdf  
  10. University of Rochester Medical Center (2010, May 31). Acupuncture's molecular effects pinned down: New    insights spur effort to boost treatment's impact significantly. ScienceDaily. Retrieved January 8, 2013, from http://www.sciencedaily.com­ /releases/2010/05/100530144021.htm

 

 

 

 

 

 

 

 

Mark Whalen is a Licensed Acupuncturist and Board Certified Herbalist and the founder of Five Points Acupuncture & Wellness in Reading, MA.

Mark Whalen – who has written posts on Acupuncture Reading MA - Five Points Acupuncture & Wellness.


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Five Points Acupuncture & Wellness
20 Pondmeadow Dr #107, Reading, MA 01867
Phone: (781) 944-3000
 

 

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