Anyone with anxiety and/or insomnia, which often go hand in hand, can tell you how a lack of sleep can seriously hamper daily activity. One inevitably leads to the other and a vicious cycle ensues. Since the COVID pandemic there has been an increase in the number of people affected by insomnia and anxiety. The Centre for Population Change (CPC) compared data collected in 2018/19 to that collected in April 2020 and found 25% of people surveyed experienced problems with sleep or anxiety, with women being twice as likely to experience these symptoms.
When it comes to treating insomnia & anxiety, there are currenlty two groups of Western medicine prescribed to treat these complaints; Benzodiazepines and Selective Serotonin Re-uptake Inhibitors (SSRIs). Interestingly, each of these drugs acts in a different way. Benzodiazepines act by slowing down bodily and brain functions. Since the body can get used to the dose, this may need to be increased. The main drawbacks for this category of drugs are the side-effects and the limitations for prescription. Benzodiazepines cannot be prescribed to patients with lung disease/lung problems, sleep apnea, severe liver disease or a neuromuscular condition such as uncontrolled myasthenia. The side effects, which do not affect everyone, include drowsiness, light-headedness, confusion, unsteadiness (especially in older people, who may fall and experience injuries), dizziness, slurred speech, muscle weakness, memory problems, constipation, nausea (feeling sick), dry mouth and blurred vision [1].
In contrast, SSRIs are a type of antidepressant. A major drawback of SSRIs is that these take several weeks to take effect. As with Benzodiazepines, SSRIs also have side-effects which may appear[2]; these include feeling agitated, shaky or anxious, feeling or being sick, indigestion, diarrhoea or constipation, loss of appetite, dizziness, blurred vision and a dry mouth.
Whilst being generally effective for acute conditions, chronic conditions (longer than six weeks) are harder to treat as these drugs can only be used for a few weeks and for some patients the side effects can lead to a host of other issues.
Can acupuncture help with insomnia?
In 2009 one study [3] reviewed and analysed the findings of 46 previous studies (a total of 3811 patients) which had focused on the use of acupuncture for insomnia. The study concluded that acupuncture had a beneficial effect when compared with no treatment and that acupuncture plus medications showed better effect than medications alone on total sleep duration. Similarly, acupuncture plus herbs was significantly better than herbs alone on increase of sleep rates.
Interestingly, the study found NO difference between acupuncture and medications in average sleep duration. When side effects were factored in, the study found NO serious adverse effects related to acupuncture treatment in the included trials.
Furthermore, a more recent study by Zhang et al., (2020) [4] found that Acupuncture used for 6 weeks, when compared to placebo acupuncture, is effective in treating insomnia.
These studies indicate that acupuncture can offer an effective alternative to medication to help patients with insomnia.
Is an acupuncture treatment the same for everyone?
An acupuncturist looks at finding the cause of insomnia and also considers how your symptoms. For some people, getting to sleep is an issue whilst for others waking in the night followed by an inability to return to sleep is the problem. Treatment is dependent on the diagnosis. In some cases, advice to add Blood building foods is given as the root cause can be a poor diet.
Tips to help you get a good night’s sleep
Room temperature
Keep the temperature in your bedroom on the slightly cool side. We tend to warm up under our cosy duvets. Being too warm can lead to nightmares or restless sleep which can in turn wake us up. So, switch the heating off at night.
Read a book
If you wake and cannot fall back to sleep read a book or listen to a podcast which doesn’t require much thinking! Avoid reading on a phone, tablet or laptop as the glare from the screen has been shown to affect serotonin production, which is required to go to sleep.
Listen to a guided meditation
Find a guided mediation you like. This can be based on the content or whether you like the narrators voice- a soothing or melodic voice is best. Use the meditation when you go to bed if you struggle to sleep, or when you wake during the night. By listening to the same mediation when struggling to sleep, the brain starts to associate the meditation with sleep. Meditation is proven to reduce blood pressure and stress levels in the body (5) and change our brain waves (6). This, in turn, lets our mind know that there is nothing to worried about.
Reduce caffeine intake
Avoid caffeinated drinks at least 3 hours before bedtime. Some people are particularly sensitive to caffeine so need to avoid these drinks even earlier.
Avoid the TV or any other screen
Watching TV until just before you pop to bed or when you are lying in bed can affect your ability to fall asleep as our brains need downtime to relax. Put any screens aside, or better still leave these out of your bedroom to avoid any temptation to check your social media feed or try to find a pair of shoes online!
Start a journal
If anxiety or worries are affecting your sleep keep a journal to help you put things into perspective. The focus of a journal in this instance is to park any worries and focus on the positives in your life. Follow the steps below for every entry:
1. Write three great things that happened that day. These can be anything – even the smallest thing can be noted.
2. Write a concern or worry. The act of writing a worry can help the brain to let go of the worry. Put a huge cross through the worry (this gives your brain a message that the worry isn’t something to focus on).
3. Write one thing you are going to do tomorrow that will make you happy. This can be something as simple as 'I will enjoy my garden for ten minutes' or 'I will dance to my favourite song' (one that is attached to a good memory).
4. Write an affirmation or positive statement about your life, e.g. 'Everything in my life flows smoothly', 'My life is full of joy and happiness', 'I am healthy, happy and loved'.
Use lavender or chamomile
Lavender has soothing and calming properties. Several lavender pillow or room sprays are available to buy. Alternatively, lavender roll-ons to use on the area where you would feel for your pulse as well as just behind the ears are also very effective in helping to induce calm. Chamomile tea is reputed to have calming effects, but avoid drinking anything and hour before you go to bed as this may lead to a need to wake up in the middle of the night to go to the toilet.
Set up a routine
Because of the COVID pandemic, many people are finding they are working longer hours and our routines have changed as we often work later than we would have had we needed to travel in to the office. In terms of Traditional Chinese Medicine (TCM), the best time to go to bed is prior to 10:30 pm as shortly after this we get our second wind and find we are wide awake! It is also important to develop a bedtime routine so that you are giving your mind and body clear signals that serotonin levels need to increase to induce sleep. Have a relaxing bath, read a book or listen to a podcast and don’t forget to use your journal.
If you know any other tips pop them into the comments box :)
Acupressure Points to help you sleep:
An Mian
This point is located behind the ears. Find the bony projection which feels like a raised round bone just behind the ears. Gently massage the back and lower border of this bone.
PC6
Located on the inside of the wrist approximately 2-3 cm up the arm (away from the wrist). Gently massage this area using three fingers.
If you find that you are struggling to resolve sleep issues then a talking therapy along with acupuncture may be the solution. Get in touch to find out if acupuncture may be of benefit to you.
yasminhodgeacupuncture@gmail.com
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REFERENCES
[1] (source: https://www.mind.org.uk/information-support/drugs-and-treatments/sleeping-pills-and-minor-tranquillisers/side-effects-of-benzodiazepines/) [2] source: NHS site https://www.nhs.uk/mental-health/talking-therapies-medicine-treatments/medicines-and-psychiatry/ssri-antidepressants/side-effects/) [3] Acupuncture for Treatment of Insomnia: A Systematic Review of Randomized Controlled Trials. Cao, H., Pan, X., Li, H., and Liu J,. (2009) [4]The effects of active acupuncture and placebo acupuncture on insomnia patients: a randomized controlled trial (Zhang et al., 2020) (5) Chambers, J., Phillips, B., Burr, M., & Xiao, D. (2016). Effects of meditation on stress levels of physical therapist students. Journal of Physical Therapy Education, 30(3), 33-39.
(6) Kaushik, M., Jain, A., Agarwal, P., Joshi, S. D., & Parvez, S. (2020). Role of yoga and meditation as complimentary therapeutic regime for stress-related neuropsychiatric disorders: Utilization of brain waves activity as novel tool. Journal of Evidence-Based Integrative Medicine, 25, 2515690X20949451.