"I just can't sleep!"

• Sleep is a delicate process that is highly susceptible to our on-the-go stressful lifestyle. Insomnia is when, despite the adequate opportunity to sleep, you either don’t get enough or whatever sleep you do get is non-restorative. It is more prevalent in women, with age, psychological discomfort and health problems.
  
• Sympathetic Nervous System vs. Parasympathetic Nervous System: Sympathetic is fight-or-flight, it is our stress response to help us run away from the large bear chasing us. Parasympathetic is where the blood and Qi go from the extremities to our organs to restore, rest and rebuild for the next day. Sleep is about your ability to switch from Sympathetic to Parasympathetic, to simply quiet down and rest, to shut off and shut out the noise of the day and in your head and to surrender to your own body. Hence the phrase “FALL asleep.”
  
• Transient/Acute Insomnia: anywhere from 1 night to a few weeks, is largely situational and can be due to recent stress, an injury, common colds, traveling, etc.
  
• Chronic Insomnia: for more than 1 month and can be due to a very long list of issues-- hormone changes in women, restless leg, sleep apnea, heart disease, acid reflux, respiratory disease, hypoglycemia, depression and anti-depressants, stimulant use, lack of exercise, appetite suppressants, heart medications like Beta-Blockers, eating late, jet lag, or any organ imbalance or dysfunction. It can also be secondary to Hypertension, cerebral arteriosclerosis, hyperthyroidism, fevers, hepatitis, anemia and menopause.
  
• In Chinese Medicine sleep quality and quantity depend on the state of your spirit or Shen, the highly refined product of your genetic inheritance, Jing, your Blood and your energy, Qi. All that you are on a daily basis-- the food you eat, the lifestyle you live, and the thoughts and feelings you have-- affects your Shen. The organs involved are:
  - The Heart: houses the Shen, governs sleep, represents the element Fire, and can be easily affected by either a deficiency in Blood &/or Yin, or conditions of excess like too much Heart Fire harassing itself disturbing your sleep;
  - The Lung: Lingering or acute infections in the lungs can cause enough heat and inflammation to wake us up or keep us from falling asleep. Check for water damage and mold exposure in your bedroom;
  - The Kidney: stores Jing, the substance which grounds the Shen, represents the element Water which serves to cool down the Fire of the Heart, and provides the fundamental material to produce Blood, Yin and Qi;
  - The Liver: stores Blood, regulates Blood flow and the smooth flow of Qi, is the first and most common organ affected by stress, and houses the Hun or Ethereal Soul, which can wander around at night when not properly housed by Blood, or can through stress create a great deal of heat which can rise up to the Heart disturbing sleep;
  - The Spleen: extracts nutrients from food to make Qi and Blood, is easily attacked by a stressed out Liver and excessive worry, and when it is not working properly produces a sludge-like substance called Dampness which can, under the influence of Heat or Fire , congeal to form Phlegm, which in turn can harass the Heart and cloud the Shen;
  - An imbalance in any of these can adversely affect your sleep.
  

"What can I do to just get some sleep?!"

• The main issues to consider are lifestyle, diet, stress-coping skills, medication or supplement use, and other health conditions you may have.



• Acute Insomnia: identify the offending agent and remove it, change your sleep habits and re-establish your optimal night-time and morning routine as sleep is all about routine.

- Acupuncture and Chinese Medicinal herbs can be tremendously helpful in dealing with acute imbalances. The key lies in identifying your pattern(s) of imbalance--Heart Fire, Lung Toxic Heat, Stomach Disharmony/Food Stagnation, Liver Qi stagnation and Heat, Phlegm-Heat Harassing the Heart, Blood Stagnation in the Chest-- and addressing it/them;
- Supplements: Valerian Root, Kava Kava, Melatonin, Tryptophan (turkey, bananas, figs, dates, yogurt, etc); avoid stimulants (caffeine, smoking, alcohol, sugar) and late-night eating;
- Prescription medications: Ambien, Trazodone, Lunesta, anti-histamines, and anti-depressants. May be useful on a short-term acute basis only.



• Chronic Insomnia: The first step is ruling out whether your insomnia is related to any other disease. The next step is to once again identify and treat your pattern of imbalance.
  - Acupuncture and Chinese Medicinal herbs: Chronic conditions tend to be of a deficient nature-- Heart Blood and Spleen Qi Deficiency, Heart & Kidney Yin Deficiency, Liver Yin & Blood Deficiency, Heart & Gall Bladder Qi Deficiency. These patterns can also combine with the more acute ones listed above as those may be an acute flare-up of your more chronic pattern.
  - Supplements: Calcium/Magnesium, Melatonin, B complex especially B5, Copper or Iron, Dehydroepisterone (DHEA), tryptophan, avoid tyramine (in bacon, cheese, chocolate, eggplant, ham, potatoes, sugar, wine);
  - Sleep Habits: be in bed only when you are sleepy, the bedroom is only for sex and sleep, same sleep and wake time, late afternoon or early evening exercise, avoid florescent lights as much possible, and take a hot bath 1-2 hours before sleep. The best position: on your right side, legs bent with a pillow in between, right arm bent in front of your pillow, left arm on thigh or hugging a pillow. Here, your Heart is in the highest position facilitating better circulation of blood, your Liver is in the lower position so blood can collect there and root the Hun, and the Stomach and duodenum are positioned to promote the downward movement of food.
  - Prescription medications: Long-term use is not advisable as they are only addressing the symptom and not correcting the root cause of your insomnia, and they become less effective with time.
  - Lifestyle: meditation and relaxation exercises, identify dysfunctional beliefs, attitudes and associations with sleep and replace them, and see a therapist to work out any emotional issues straining your heart.
  
  Take a series of classes called Sounder Sleep with Aerin Alexander. Here you will learn quiet and gentl exercises to help relax your mind and body to deepen you sleep and cope with stress.

© Jordan Hoffman, L.Ac., Dipl. OM, 2007. All Rights Reserved.

The information presented here is not medical advice, is not intended as medical advice, and is intended to provide only general, non-specific information related to Chinese Medicine and Acupuncture and is not intended to cover all the issues related to the topic discussed. You should consult a licensed health practitioner before using any of this information.

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