Insomnia and Acupuncture
What you may not know is that acupuncture theory strongly links the quality of our sleep, to the state of our Shen – which can roughly be translated as Mind or Spirit. Shen is rooted in the Heart so many (but not all…) of the classic differentiation of insomnia are related to this vital organ.
This is a situation where the concept of the organ in Eastern and Western thought is very different. Insomnia is a result of emotional, spiritual or energetic disturbances of the Heart – not usually physical ones. This reflects the fact that acupuncture views all of our organs in a holistic why, that incorporates the multifaceted aspects of our existence.
There are actually a wide range of different types of insomnia in acupuncture theory, and this list can vary according to different schools of thought. I will explain the ones I most often see in clinic. These include excess and deficient conditions.
- Heart Fire Blazing
In this case the problem is not so much falling asleep, but staying asleep. Fire tends to lead to waking in the night feeling hot, especially early on, before 1am. It is also associated with mental restlessness, palpitations and anxiety. There will probably also be other signs of Heat such as bitter taste, dark urine, dry stools, thirst and tongue ulcers.
- Liver Fire Blazing
Our old friend the Liver again! In this case there is likely to be restless sleep and a feeling of heat in the night. The distinctive thing is the involvement of the Hun, which is the aspect of the Spirit that is associated with the Liver. The Hun is linked to the dreaming mind, so with this type of insomnia, when the Hun is disturbed, there will be unpleasant dreams or nightmares. Often people describe waking in the night and being far too alert to drop off again. At this point there is a tendency either to start planning or to get frustrated about being awake. There may also be headaches, irritability and dizziness and other signs of Heat including bitter taste, dark urine, dry stools and thirst. Liver time is between 1am and 3am, so this is the most common time to find yourself awake with this syndrome. This is probably the most common excess form of insomnia.
- Phlegm Heat harassing the Mind
In this case we have the Heat associated with the last two conditions and the additional problem of Phlegm. The Heat leads to restless sleep, dizziness, mental agitation palpitations, feeling hot and thirsty, and nightmares. The Phlegm leads to a general feeling of heaviness, a sticky taste, nausea, lack of appetite, mental confusion and a feeling of oppression of the chest. This condition is quite extreme and fairly uncommon.
- Heart Yin Deficiency
Like the Heat conditions, Yin deficiency insomnia is associated with waking up in the night, often frequently. The night is Yin time and so when there is abundant Yin it is strong enough to hold down the Yang at night. Where Yin is weak, it fails to do this and the Yang surges up and wakes us. Yang is hot, so another symptom in this case is night sweats. When the Heart is involved these will usually just affect the upper portion of the body. There may also be dry mouth, difficulty relaxing, palpitations, poor memory and hot hands, feet and face. This is a common condition in clinic.
- Heart and Kidneys not harmonized
This syndrome is really an extension of the one above and therefore has many of the same characteristics. These include waking frequently in the night, dry mouth, poor memory, palpitations, difficulty relaxing, hot hands, feet and face and night sweats. The addition of the Kidney aspects means that there may also be difficulty getting off to sleep, backache, dizziness, tinnitus and a tendency for night sweats to be all over the body not just the upper half.
- Heart and Spleen Blood deficiency
This is the type of insomnia where you can’t get off to sleep. It is often associated with tiredness – where you feel exhausted but when you lie down, your mind just won’t let up. There may also be poor appetite, slight anxiety, pale complexion, blurred vision or floaters, poor memory and mild palpitations. This is another extremely common form of insomnia, particularly for women due to menstrual blood loss or for anyone who has suffered excessive blood loss thought accident, injury or operations.
- Kidney Yin deficiency
This type of insomnia is slightly different as it is often associated with waking early in the morning and not being able to get back to sleep, often after getting up to go to the toilet. 3am to 7am are Bladder and Kidney time and the emotions associated with these organs are fear. Therefore, waking at this time is also often accompanied by a feeling of fearfulness or anxiety, particularly during stressful times in life. The person may actually wake with a start and a racing mind. Sleep from then on is generally light and disturbed. Due to the Yin deficiency there may also be full-body night sweats, dry mouth and backache.
- Liver Yin Deficiency
As another Yin deficiency syndrome in this case we again see frequent waking in the night with over heating symptoms such as dry mouth and night sweats. Due to the Liver’s involvement they are also symptoms such as irritability, blurred vision, sore and dry eyes, dry skin and hair. The involvement of the Hun often also results in disturbing dreams, talking in the sleep, and possibly even sleep walking. Once awake there is also a tendency to ‘plan’ or become frustrated.
So what to do?
Acupuncture can be very helpful in dealing with insomnia, but it is also very important to look at the root cause of the problem.
Starting with the excess conditions, Fire or Heat can have multiple causes and usually has more than one. It can be exacerbated by very hot external climatic condition, but generally it starts internally. Most commonly this begins with unresolved emotional problems – heart break and rejection in the case of the Heart Fire and anger and frustration in the case of the Liver. Alcohol, smoking, prolonged stress, lack of exercise and poor diet are also all Heat forming and so will add to internal Fire.
In order to help resolve these problems – start with what ever is easiest for you. You will find that as you tackle one, you will gradually feel more in control and the other things you need to change will become more manageable. Maybe start with your diet or by upping your exercise and then move to deeper levels with meditation, CBT or counselling.
Phlegm is largely associated with poor diet, especially overconsumption of heavy greasy foods, processed foods and sugar. Smoking can also lead to phlegm, especially marijuana.
The other conditions of Blood and Yin deficiency are also fairly long-standing. The lesser of these two is Blood deficiency as Blood is part of the Yin. This means that Blood deficiency can lead into Yin deficiency and also that as Yin deficiency improves you may find that your insomnia starts to morph into the Blood deficiency type. It doesn’t necessarily feel like it, but this is progress!
Deficiencies in general come from imbalance – from over doing something at the expense of something else. In this case we are overdoing the ‘Yang’ stuff – usually work, or worry or exercise or studying – over long periods of time. Unfortunately, what we really need more of is rest, which can feel a bit ironic when it results in insomnia!
Try and meet the problem halfway by slowing down a bit when you are awake. You know that feeling when you are super busy, and you can feel yourself getting faster and faster – that’s Yin deficiency and that is the moment you really need to stop and slow down. It is the hardest thing to do, but it is that adrenalised, over excitement that is keeping you awake at night. Learning to notice it as it is happening and making the effort to stop is the single biggest change you can make.
Blood and Yin building foods can also be helpful (see below), as can making sure you are getting adequate water through the day – Yin is also fluid, so the chances are you don’t get enough, and the Heat associated with the condition means that what we do get dries up fast.
Blood building foods include:
Beetroot, dark green leafy veg, grapes, watercress, aduki beans, apricot, dandelion, dates, spinach, parsley, nettles, liver, molasses and red meat.
Yin building foods include:
Apples, avocado, eggs, honey, pineapple, asparagus. kidney beans, pea, mango, pomegranate, watermelon, lemon, pear, tofu.
Don’t forget we are aiming at balance. Add more of these foods to your diet – don’t eat them exclusively…