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Insomnia and Acupuncture Treatment

Chronic insomnia, characterized by difficulty falling asleep or staying asleep, can result from disruptions in sleep-wake rhythms. Frequently, insomnia leads to the use of sleeping pills, which can cause dependency. Acupuncture offers a simple and effective treatment for insomnia without the side effects commonly associated with medication. According to numerous reports, acupuncture has a success rate of around 90% in treating insomnia.

Treatment options include body acupuncture, auricular acupuncture, or moxibustion, either alone or in combination. The choice of acupuncture points varies with the practitioner's experience, with common points including Shenmen (HT7) and Anmian for insomnia.

The selection of acupuncture points, intensity of stimulation, and duration of treatment are closely related to the patient's mental state at the time of the visit. To suppress excessive mental excitement in patients who need immediate sleep or are struggling to fall asleep, more sensitive points, especially on the head and face, are stimulated more intensely. Strong stimulation of points like Anmian and Zanzhu (BL2) can produce a significant needle sensation, often helping patients fall asleep faster.

However, most insomnia patients visit during the daytime, not requiring immediate sleep but often appearing lethargic due to several nights of poor sleep. In such cases, mild stimulation is preferable, focusing on peripheral points of the limbs, such as Shenmen (HT7) and Shenmai (BL62). Weak stimulation during the day helps maintain alertness, facilitating easier transition to a suppressed mental state and better sleep at night.

For some intractable cases of insomnia, evening acupuncture sessions can significantly enhance therapeutic effects.

Patients with insomnia often experience hypersensitivity in the nape and back of the head, where even slight touch can be uncomfortable.

A simple folk remedy for insomnia is soaking feet in warm water before bed. This method works by redirecting blood flow downwards, reducing cerebral congestion, and is particularly beneficial for those who engage in mental labor. Soaking feet in hot water for 5-10 minutes before bed can aid relaxation and improve sleep.

Modern popular foot reflexology, especially massaging the Yongquan (KD1) area for 5-10 minutes until a warm sensation is felt, seems even more effective for insomnia, especially for those with usually cold feet.

Previously, the effectiveness of acupuncture in treating insomnia was judged subjectively, based on the patient's self-assessment of sleep quality. Nowadays, objective measurements using polysomnography are employed. A study by Montakab in Germany involved 40 patients with difficulty falling or staying asleep, randomly divided into two groups. One group received genuine acupuncture treatment, and the other received sham acupuncture at non-acupoints, with treatments once a week for 3-5 weeks. Their sleep states were objectively recorded in a specialized sleep laboratory. The results showed significant improvements only in the group receiving genuine acupuncture.

The mechanism behind acupuncture's effectiveness in treating insomnia is likely related to its role in modulating the sleep-wake cycle. This cycle is one of the most important diurnal rhythms controlled by the biological clock, where sleep and wakefulness result from the inhibitory or excitatory actions of the brainstem on the cerebral cortex. The two phases of sleep – slow-wave sleep and REM sleep – are influenced by neurotransmitters in the brainstem, such as the 5-HT system and the norepinephrine system, along with other sleep-inducing substances.

Overall, acupuncture offers a promising, non-pharmacological approach to managing insomnia, potentially regulating the intricate neurochemical and physiological processes involved in the sleep-wake cycle.


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