Insomnia and acupuncture, Essendon

Treatment for insomnia

To do list - sleep.jpeg

introduction

Insomnia is a common sleep disorder that can make it difficult for you to fall asleep, hard to stay asleep, or cause you to wake up earlier than what you need and not be able to get back to sleep (Mayo Clinic, 2016). It can be a persistent and distressing disorder that can impact your day today life by leaving you fatigued and irritable, leading to poor performance at work, concentration problems, and memory difficulties (Australasian Sleep Association, 2018). 

Getting inadequate sleep is a very common problem in Australia, with 33-45% of the adult population reporting that they don't get enough sleep (Adams et al., 2016). 20% of the adult population have significant insomnia, which is defined as having problems either getting to sleep or staying asleep 3 or more nights per week (Sateia, 2014). And the problems only seem to be getting worse, with rates of people affected by sleep problems increasing over the last decade (Adams et al., 2016).

Insomnia is defined as having difficulties with:

  • Sleep initiation - taking longer than 30 minutes to get to sleep

  • Sleep maintenance - being awake through the night for longer than 30-45 minutes

  • Early waking - waking up earlier than you wanted, and aren't able to get back to sleep

(Australasian Sleep Association, 2018).

Most people will experience a combination of these problems. Having sleep difficulties can lead to a number of issues in other areas of your life, such as:

  • Trouble waking at a normal time

  • Waking up too early

  • Not feeling well rested after a nights sleep

  • Daytime fatigue

  • Irritability, depression and anxiety

  • Difficulty paying attention, focussing on tasks or remembering

  • Increased anxiousness about sleep, thereby making sleep more difficult

  • Tension headaches

  • Digestive problems

(Mayo Clinic, 2016; Health Direct, 2017).

Insomnia can be characterised in a number of different ways, depending on type, length of time of having insomnia, and if there are other health concerns. In general though, there are 5 main types:

  • Acute insomnia - this is the most common type, and only lasts for a few days up to a couple of week. It is usually caused by short term stress or life events, and will resolve itself once the stress has been removed.

  • Chronic insomnia - lasts for a month or longer, where your sleep is disturbed on more than 3 nights per week.

  • Primary insomnia - this is where there is no identifiable cause for the insomnia.

  • Secondary insomnia - is where it is due to an underlying condition such as anxiety or depression, or a medical or general health condition

  • Delayed Sleep Phase Syndrome (DSPS) - refers to people who are night owls, and regularly don't get to sleep until the early hours of the morning. This is a long term problem, and usually indicates a problem with your body's internal sleep clock (circadian rhythm).

(Mayo Clinic, 2016; Health Direct, 2017). 

Insomnia can come on for a number of reasons, as mentioned earlier, which can include mental health conditions (eg. anxiety, depression, bipolar), chronic pain, work or personal stress, some medications and drugs (eg. medication for asthma, or high blood pressure, caffeine, alcohol), travel or work schedule, poor sleep habits, eating too late in the evening, medical conditions (eg. overactive thyroid, Parkinson's disease), or as you age (Mayo Clinic, 2016). 

Another cause of insomnia can be another type of sleep disorder. These can include:

  • Snoring

  • Restless legs syndrome

  • Obstructive sleep apnoea

  • Sleep hypoventilation

  • Bruxism (teeth grinding)

  • Nightmares or night terrors

(Sleep Health Foundation, 2018). 

Insomnia and Acupuncture

A number of recent studies have shown acupuncture to be an effective treatment for insomnia and sleep disorders (Yin et al., 2017; Dong et al., 2017; Fu et al., 2017; Shergis et al., 2016; Zuppa et al., 2015). In a study of people with primary insomnia, Shergis et al. (2016) found that acupuncture made a significant difference in a number of measures of sleep compared to sham acupuncture, including total time asleep, sleep efficiency, how often people were waking through the night, as well as levels of anxiety. 

Shergis et al. (2016) conducted a systematic review of 30 studies comparing acupuncture to western medication for treatment of sleep problems. It was found that acupuncture was a significant improvement over medications (both benzodiazepine type medications and antidepressants) in improving sleep quality, though it was noted that further study is needed in this area. 

Acupuncture has also been found to be effective in more specific populations with sleep quality issues. Fu et al. (2017) studied the effect of acupuncture on insomnia in perimenopausal women. They found that both the quality of sleep improved, and the severity of insomnia decreased, when compared to sham acupuncture. And in a study of sleep quality in an elderly population, Zuppa et al. (2015) found acupuncture to be highly effective in improving the quality of sleep.

And in a meta-analysis of patients with insomnia related to their depression, Dong et al. (2017) compared acupuncture to western medicine. Their findings showed that acupuncture made a significant improvement to sleep quality when compared with western medical treatments, and that adding acupuncture to the treatment protocol improved the outcome for people who were receiving western medications only. 

what to expect

Your acupuncture session will last for about an hour, with the needles being left in for 25-30 minutes. In your initial appointment, I will ask about all aspects of how your sleep problems affect you in your daily life. We will go through what a typical night is like for you, and when you have difficulties with getting to, or staying, asleep. I will also ask about other aspects of your health and lifestyle, as in Chinese medicine we see you as a whole person, and where your sleep can be affected by other areas of your life. I will also have a look at your tongue and feel your pulse, which will help to give me a more complete picture of not only how your sleep issues are affecting you at the moment, but the underlying condition that has brought these difficulties about.

I will then get you to lie on the massage table to begin the acupuncture treatment. For most people acupuncture is a very relaxing experience, with a lot of people falling asleep on the table. I use very fine acupuncture needles that are about as thick as a human hair. You may feel a small pinch as the needle is inserted, and afterwards you might feel the area getting warm, or feel a slight heaviness in the area. I'll then leave you alone to relax for about half an hour, leaving the needles to do their work.

After the session I'll check in with you to see how you're feeling, and I might give you some dietary or lifestyle advice. I may also prescribe either Chinese or Western herbal medicine for you to take in-between appointments.

To book your acupuncture appointment today, please call the clinic on 9337 8572. If you have any questions or queries, please don't hesitate to get in touch at lachlan@essendonnaturalhealth.com.au.

Stones.jpg

References

Adams, R., Appleton, S., Taylor, A., McEvoy, D. & Antic, N. (2016). Report to the Sleep Health Foundation: 2016 Sleep Health Survey of Australian Adults. The Adelaide Institute for Sleep Health: University of Adelaide.

Australasian Sleep Association (2018). Insomnia. [Online] Available at: https://www.sleep.org.au/documents/item/355 [Accessed 10 June 2018]

Dong, B., Chen, Z., Yin, X., Li, D., Ma, J., Yin, P., Cao, Y., Lao, L. & Xu, S. (2017). The efficacy of acupuncture for treating depression-related insomnia compared with a control group: A systematic review and meat-analysis. BioMed Research International. Vol. 2017. DOI:10.1155/2017/9614810.

Fu, C., Zhao, N., Yuan, L., Xie, C., Yang, W., Yu, X., Yu, H. & Chen, Y. (2017). Acupuncture improves peri-menopausal insomnia: A randomised controlled trial. Sleep, 40 (11), 1-8.

Health Direct (2017). Insomnia: types, symptoms and causes. [Online] Available at: https://www.healthdirect.gov.au/types-of-insomnia [Accessed 10 June 2018]

Mayo Clinic (2016). Insomnia - symptoms and causes. [Online] Available at: https://www.mayoclinic.org/diseases-conditions/insomnia/symptoms-causes [Accessed 10 June 2018]

Saetia, M. (2014). International Classification of Sleep Disorders - Third Edition: Highlights and modifications. Chest, 146 (5), 1387-1394.

Shergis, J., Ni, X., Jackson, M., Zhang, A., Guo, X., Li, Y., Lu, C. & Xue, C. (2016). A systematic review of acupuncture for sleep quality in people with insomnia. Complementary Therapies in Medicine, Vol. 26, 2016, 11-20. 

Yin, X., Gou, M., Xu, J., Dong, B., Yin, P., Masquelin, F., Wu, J., Lao, L. & Xu, S. (2017). Efficacy and safety of acupuncture treatment on primary insomnia: a randomised controlled trial. Sleep Medicine, Vol. 37, 193-200.

Zuppa, C., Prado, C., Wieck, A., Zaparte, A., Barbosa, A. & Bauer, E. (2015). Acupuncture for sleep quality, BDNF levels and immunosenescence: A randomised controlled study. Neuroscience Letters, 587, 35-40