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Home > Newsletters > October 2005 > Ask the Doctor

Points - October 2005 - Ask the Doctor

Q: I was wondering if acupuncture can help with insomnia?

A: If the insomnia is stress induced or aggravated, acupuncture would have no problem in helping you out with this. Acupuncture loves anything that hurts, anything that is aggravated by stress, or anything that is aggravated with the menstrual cycle.

If the insomnia is due to the fact that you live above a bowling alley below an elevated train track next to a concrete quarry with a punk rock group that rehearses at night, then perhaps moving would be the quickest solution.

There are actually quite a few causes for insomnia though some of them are more effectively treated with Chinese herbal medicines. It really all depends on the cause of the insomnia, and that can be determined by a practitioner of TCM (traditional Chinese medicine).

The usual experience of insomnia is with difficulty in falling asleep. Acupuncture and TCM herbal medicines would likely approach this as a deficiency of either Yin (body fluids) and/or Blood (in this case, perhaps we could call them "neurotransmitters"). Our goal would be to stimulate the appropriate internal organs to produce more Yin or Blood to provide more restful sleep. There are a few acupoints that are specific to restful sleep such as the points named "an mian" which translates to... you guessed it, "restful sleep."

Keep in mind too, that the herbal medicines or acupuncture treatments don't have a heavy druggy sedated sort of feeling associated with them. Drugs tend to work on the body's chemistry rather than having an effect on the spirit. Acupuncture and herbal medicines really target the spirit, not the body. So there's no drugged out feeling associated with these treatments. You're just more calm and peaceful which allows you to sleep better without any draggy feeling the next day.

The treatment always begins with understanding the cause of the insomnia. For instance, we use a specific herbal formula for those who awaken in the early morning hours and can't fall asleep. Actually, in this case, acupuncture with the herbs are both indicated. This version of insomnia really is associated with stress, The mind wants to get up and going in the early morning hours, but since your brain is telling you to stay in bed, all you can do is lay there and think about your plans. There is some stress induced aspects of this in addition to a deficiency of certain blood products and neurotransmitters, to put it into biomedical terms.
Or, if the problem is that dreams are very intense and they're waking you up we might instead remove the heat from the (Chinese version of the) Heart to allow the spirit to rest more calmly. There are a variety of causes of heat in the Heart and of course we'd want to address the source of the heat as well.

Sometimes the insomnia is found in the very light sleeper who is frightened awake by the smallest of sounds. We call this a Gall Bladder Qi deficiency. Again, this is the Chinese version of the Gall Bladder, which isn't just a sac for bile. It is an organ that, when it is deficient in Qi energy can become skittish and easily frightened. When this happens at night, it leads to insomnia.

There's the insomnia associated with menopause where again, there is heat in the Heart causing the spirit to be agitated at night, but it isn't because of too much heat, its really because of a deficiency of cooling mechanisms in the body. This syndrome called "Yin deficiency" also gives rise to night sweats and hot flashes. Menopausal women know Yin deficiency very well, but of course you needn't be menopausal or female to experience this kind of insomnia.

Another type of insomnia can be linked to diet or food intake too close to the sleeping period. In "A Christmas Carol" by Charles Dickens, Scrooge, upon seeing the ghost of Jacob Marley for the first time suggests to the ghost that he is nothing more than an undigested bit of cheese. TCM would agree. Dairy products can be difficult to digest and when the stomach and intestines are working hard while you're trying to sleep the gastro-intestinal activity can give rise to internal heat which agitates the Heart giving rise to nightmares and insomnia. As for as being a "Scrooge", I think we'll leave that pathology to the ghosts of Christmas past, present and future. : )

Many kinds of insomnia, many different treatment principles, one result. It works. I've found that TCM treatments for insomnia are very beneficial. TCM doesn't work for everything, but this is definitely one of those things where great benefits can be realized.

Be well.


Q: How exactly does moxibustion work? Can one benefit from burning it in a bedroom while sleeping or is direct heat needed to allow the aromatic properties of the herb to penetrate the skin?

A: There are a number of syndromes in Chinese medicine that are considered either cold in nature i.e. a Yang deficiency, or are a direct result of an invasion of cold. Hypothermia is one example of this. The moxibustion is burned over the acupoint that is closest to the organ affected, or the location of the cold as is the case in arthritis that is aggravated by cold weather.

There are a few different paradigms at work in regards to how to apply the heat. Some people will take some dried, shredded moxa wool and roll it up, apply it directly to the skin and let it burn. That is the old school traditional way of doing it. It can leave little scars and so we avoid that technique usually in the West, which is kind of odd really, considering the number of patients I see with tattoos and body piercings. I'll bet moxa scars could become a fashionable trend if the right people are doing it.

Anyway, another method is to use a rolled up cigar made of the same material as the wool and burn it above the acupuncture point in question. This works well, and it doesn't scar. Moxa sticks, as they are called, come in both the smoky traditional form and the so-called smokeless moxa. The smokeless moxa puts out good heat, but there is little, or should I say less smoke involved.

The moxa itself is made out of an herb called "Ai Ye" which is Mugwort leaves. It is also used internally as a medicinal herb mostly for gynecological problems that results in a stagnation of blood due to cold. You wouldn't just drop a moxa cigar into hot water, its really a different form of the herb that we use as a raw herb for teas.

The form that I like to use is a little tiny incense size cone that has a hole in the middle. That allows me to place it on the needle that I've inserted into an acupuncture point. I like this because it doesn't burn the skin, but it heats up the needle which transfers that heat deep down inside to take the heat where it needs to go via the needle.

Another paradigm says that you can roll up some of that moxa wool and instead of applying it directly to the skin, you can place it on top of a slice of raw ginger which is placed into the naval. This therapy is said to warm up the digestion. Cold in the body, especially in the digestion, or the tummy, can give rise to all sort of digestive problems including a great deal of stomach pain. But its not for any stomach pain. It can aggravate the symptoms if the pain is not due to an invasion of cold. Diagnosis is very important in this case.

Finally, some people pour some salt into the naval and burn the moxa wool on top of that. This is used for the so-called Kidney Yang deficiency. There are a variety of signs and symptoms that go along with that. Western medicine might call that a hypothyroid condition. Kidney Yang is the heat in the body that generates cellular activity and so there is a certain amount of overlap with the Western concept of the thyroid gland as well as the adrenal glands.

More recently, we've been using heat lamps which aren't so different from the lamps you'll find in a restaurant to keep the food warm. These are most often used for arthritic conditions since they can warm up the superficial levels of the body very well, though their efficacy for the more internal issues isn't very clear to me.

The only other form of moxa that I've seen is a spray on substance that has a warming property much like Tiger Balm or Ben Gay. I've used that a bit and wasn't ever too impressed with it, but there may be practitioners out there who do use it and like it for their own reasons.

Part of the therapeutic use of moxa in the herbal form is said to be the actual aromatic qualities of the smoke and so some people avoid the heat lamps for that reason. On the other hand, the moxa smells a lot lie burning marijuana and some avoid it because it fills the room with smoke. That can be a problem for some practitioners because of ventilation or other issues.

To answer your question, I wouldn't go to sleep with any of these tools being used. If you have a cold problem, try a heating pad that is designed for you to sleep with.

This Month's Articles

October, 2005
Volume 3, Number 10

Getting Our Money's Worth?

Kick the Sugar Habit and Save Yourself from Diabetes with Chinese Medicine

Health Preservation & Rehabilitation after Childbirth

Recent Research

Ask The Doctor

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