Insomnia is defined as the inability to fall asleep or stay asleep, waking up early, or a disturbance in sleep quality that makes sleep seem inadequate or un-refreshing. Sometimes, insomnia may be due to the common condition of sleep apnea, and most other times, the cause is unknown or considered to be psychologically based.1
Insomnia may lead to mood swings, irritability, and anxiety. More devastating effects of long-term insomnia leave the sufferer at a higher risk of developing chronic diseases including: breast cancer, diabetes, cardiovascular disease, and all-cause mortality.2 The most commonly used treatment for insomnia are pharmaceutical drugs such as: sedatives, minor tranquilizers, and anti-anxiety drugs.1 All of these drugs work to calm the central nervous system (CNS) so as to induce sleepiness. However, they are not without side effects and do not always work well with a patient's lifestyle or constitution.
According to Medical News Today, an estimated 30-40 percent of Americans report experiencing insomnia each year.3 With the fast-paced modern world full of caffeinated beverages and other stimulants and increasing stress levels, it is no wonder insomnia is so prevalent. The need for a viable and lasting solution is important now more than ever.
The Eastern View of Insomnia
Chinese medicine offers treatment for insomnia with little-to-no side effects. According to Chinese medicine, the definition of insomnia also includes dream-disturbed sleep and nightmares.4 Chinese medicine does not consider all cases of insomnia to fall under one umbrella, which allows the individual patient to be treated more effectively based on their particular presentation.
The reasons insomnia may develop include: emotional stress (especially anger, worry, and excessive thinking), prolonged illness that weakens the body, a constitutional weakness of the person (which manifests as cowardice, timidity, fearfulness, and indecisiveness), and an improper diet (overeating or excessive consumption of greasy, spicy food). Insomnia may occur periodically (termed 'primary insomnia') if one takes in too much caffeine or has a common cold for instance.4 What a medical provider is more concerned with is chronic, intractable insomnia. In Chinese medicine, the effects of this are similar to conventional medicine: long term illness and degeneration of the body and quality of life.
Human & Nature Are One
In Chinese medicine, it is said that the human and nature are one. This statement can be translated in many ways – one of which is that nature has weather and seasons. It has daily, monthly, and yearly cycles. Humans do as well. For insomnia, it is best to consider the daily cycle as explained in Chinese medicine terms. In health, the sun rises in the morning, reaches its peak at mid-day, and sets in the evening. It brings warmth, activity, and energy during the daytime when we are most active naturally. At night, the sun does not shine and the darkness and coolness is a time of quiescence, rest, and rejuvenation. This is the yang (activity, warmth, sunlight) and yin (darkness, quiescence, rejuvenation) of life observed outside of the human and inside the human. In Chinese Medicine yin and yang are in a constant dance with one another, always entwined. They rely on each other for sustenance and balance. When they separate there is death.
The human being has the same cycle as nature: activity happens during the day, quiescence happens at night. When there is insomnia, the quiescent nature of night is not being followed by the human, and often the active nature of day is disturbed due to the lack of rejuvenation at night. It is the task of the Chinese medicine practitioner to restore this natural cycle as represented in nature in the human being who has gone off-course – resulting in insomnia.
Treating the root (original cause) of insomnia is of primary importance in Chinese medicine. Pharmaceuticals, herbal cures, or supplements are often only treating the branch (manifesting symptoms) of insomnia. By simply treating the manifestation, results are often not long-lasting or truly effective. In addition to acupuncture and other modalities of Chinese medicine, the practitioner will likely recommend lifestyle changes as part of treatment. This aims at treating the root cause of the insomnia.
As mentioned previously, emotional factors play a key role in the development of insomnia. These are not often shifted dramatically overnight and are the sum total of habitual reactions in one's past. The body has sensations that lead to thoughts and feelings about these sensations. Inside, we tell ourselves stories about the moment, the past, and the future based on these habitual patterns of sensations, thoughts, and feelings. This inner dialogue is often reflected in outer speech and they compound each other. The Chinese paint a lovely picture of emotions. They say that emotions are like weather – they are not good or bad. The human is like a tree. The tree is affected by the weather – blown to and fro. But the weather passes.
The Emotional State of Insomnia
When a human becomes addicted to emotional states (for example they are always angry or worried) they are like a wind-blown tree - cramped and stuck in one direction. They do not have the fluidity to come back to an upright and centered tree once the storm has passed. This is what leads to diseased states according to Chinese medicine. In insomnia, the emotions plague the body-mind. A practitioner will often find an insomnia patient who reports being unable to fall asleep thinking about the worries of the day, wake at night worried or fearful about their life circumstances, or act out these emotional states in their dreams and nightmares. It is quite uncommon to find an insomnia patient without these emotional factors at play.
Can the patient with insomnia be cured? Chinese medicine has within it an innate understanding that all diseased states can be brought back to healthy states. However, the practitioner and patient must work together in identifying the true root cause. One simply way to go about the task is to work on regulating the emotional state. This can be done with acupuncture and other Chinese medicine modalities, but the ultimate responsibility lies with the patient.
In the Hands of the Patient
First, the patient must recognize that there is an internal dialogue, an internal storyline that is playing out. Second, the patient must recognize that they are not that story – that they do not need to be identified with it. Indeed, there is a force that lives inside of them that is much greater than the story and is worth living for. The story is a manifestation of the past, which is gone and dead. Third, the patient must take responsibility for changing that story – which often starts by changing the language they are using internally and externally. This takes vigilance and resolve on the part of the patient. Soon, they realize that they can tell themselves any story they would like to, it does not have to be a story gathered from the dead past. As semantic beings, humans will always tell stories. What story will we tell and live today? Is the story we are telling ourselves worth our life energy, when today could be our last? Every day is a gift full of available life force – how will we spend it?5
When we attune to what is actually happening in the living moment, there is no worry (worry relies on the past and the future), there is no anger (there are no expectations that have to be railed against), and there is no excessive thinking (because we are experiencing the living moment, not thinking about the past or future). When alignment happens with life, we return to the natural life cycles, and diseases that are contrary to those, such as insomnia, can be resolved.
Pinheiro SP, et al. A Prospective Study on Habitual Duration of Sleep and Incidence of Breast Cancer in a Large Cohort of Women. Epidemiology and Prevention, 15 May 2006;66(10):5521-5.
Crosta P. Insomnia: Everything you need to know. Medical News Today, 7 Dec 2007.
As modern medical standardization continues, the field of traditional Chinese medicine has the advantage of comprehensive personalization. For rare or complex cases, deeper consideration of constitution is invaluable. Proper constitutional assessment, especially with first-time clients, can guide desirable and predictable outcomes. This leads to a higher rate of return, and greater trust between you and your patient.
Though the creation of a financially sustainable, health-promoting model feels far away today, we are casting a vision for a full return on health, believing that this compels us to keep one foot firmly rooted in caring for the sick and the other foot firmly founded in maintaining health. Shifting from a fee-for-service model to value-based care using a phased approach is paramount.
Laser therapy has emerged as a powerful tool in the realm of traditional Chinese medicine (TCM). This new modality fits beautifully into the toolbox of the modern acupuncturist, as it can be used as a hybrid form of stimulation to acupuncture points, meridians, organs, nerves, and symptomatic areas in a new way that blends both moxa and energetic needle-like responses.
