According to the National Heart, Lung and Blood Institute, approximately 50 million to 70 million Americans suffer from sleep or wakefulness disorders that result in more than 5,000 car crashes and a loss of productivity totaling nearly $50 billion annually. A related disorder – sleep apnea (temporary cessation of breathing while asleep) – affects 12 million to 18 million Americans.
In my practice, I see firsthand the effects of poor sleep on patients who come to me for help resolving the problem. Common side effects of poor sleep include fatigue, depression and irritability.
A person may have difficulty falling asleep, staying asleep or both. Insomnia may result from pain, neurological disorders, hormonal changes, restless legs syndrome (RLS), cortisol imbalances or emotional factors including stress.
Restless legs syndrome
RLS is not well understood. It is primarily characterized by an inability to control the legs while awake or asleep. It often presents during sleep hours and can cause a person to sleep restlessly or not at all. It is a relatively uncomfortable though not life-threatening condition.
Several medications are available to treat RLS, including Mirapex (a dopaminergic agent used for Parkinson’s Disease that increases dopamine). Several other classes of drugs are also used to help control the condition. Oftentimes, hip, knee or lower-leg surgery can exacerbate RLS symptoms.
Acupuncture can be helpful in treating RLS because of its ability to regulate the sympathetic nervous system (“fight or flight”) and stimulate the parasympathetic nervous system (“rest and digest”). Specifically, acupuncture points on the head and points that affect the limbs can have a regulatory effect (calming) on the peripheral nerves of the legs and increase blood flow to the periphery, thereby improving circulation.
Insomnia is one of the most common symptoms of menopause and can be determined if the waking is caused by night sweats. Commonly, waking occurs between 1 and 3 a.m. and is characterized by a difficulty to fall back asleep.
In this case, the underlying causes of menopause should be addressed. Acupuncture may be helpful in regulating hormonal imbalances, and usually some form of herbal intervention is required to regulate sleep cycles.
Stress-related sleeplessness is usually acute and the stressor easily identifiable. Oftentimes, stress is associated with the workplace or family. When the stress is too acute, the mind becomes restless and attempts to mentally process the situation to resolve it.
Chinese medicine perspective
Chinese medicine looks at insomnia primarily as a heart or kidney disorder. It’s important to understand that this doesn’t mean that there is an actual problem with the heart or kidneys.
Following are a few traditional Chinese medicine patterns associated with insomnia.
• Kidney yin deficiency: Yin deficiency refers primarily to a depletion of one aspect of the kidneys (yin) and is associated with dehydration on a deeper level than just the amount of water in the system. It results from many years of menstruating (in the case of women) and overwork (in both men and women) and from the normal aging process. Kidney yin deficiency also may be a primary diagnosis for menopause symptoms. Because yin has a cooling effect on the body, a depletion may be associated with overheating (hot flashes and night sweats), which will manifest especially at night.
• Heart qi deficiency: This refers to a primary weakness in the heart energy and is often associated with a lack of restful sleep. A person with this pattern will also awaken fatigued, even after a good night’s sleep.
• Heart blood deficiency: This type of insomnia is characterized by a difficulty in falling asleep where the body does not have sufficient resources to keep the mind settled in the heart. The mind wanders, and a person will have difficulty falling asleep. While this metaphor is foreign to most Westerners, a common example of this pattern is an overtired child who can’t sleep because he or she missed a midday nap.
Cortisol is released in a specific pattern during a 24-hour period to unlock sugar stores in the body to feed the brain. Because sleeping is a fasting state, cortisol is at its highest in the morning as the body depletes its sources of sugar (glucose) during the night. Over the day, the cortisol level naturally dips, and in the evening melatonin kicks in, causing one to feel sleepy.
This is a relatively complicated process, but to simplify, look at an imbalance in two ways: Usually patients exhibiting a stress response (elevated cortisol) will experience spikes in the late evening, when cortisol should be low, and those who have adrenal exhaustion will have depressed cortisol in the morning, when it should be high. In both cases, the right dietary supplements should be able to rectify the imbalance. Lifestyle, diet and counseling can help significantly as well.
Address underlying causes
Chronic sleep issues can have significant consequences for your health. They have been associated with a growing number of health conditions, including obesity, heart disease, diabetes, cancer and high blood pressure. While temporary use of medications to help sleep may be warranted, it’s critical to identify and address the underlying cause of your sleeplessness.
Ted Ray is a licensed acupuncturist and herbalist in private practice in Mountain View. For more information, call 564-9002 or visit peninsulaacupuncture.com.