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Can acupuncture help sleep onset insomnia?

Acupuncture for the treatment of sleep onset insomnia is one of the modalities that is still up and coming in the US; even though the therapy itself dates back a couple of thousand of years.

I have talked about how acupuncture and other natural modalities can help heal sleep onset insomnia in a previous article

Common treatments for sleep onset insomnia

Medication is commonly used for sleep onset insomnia. In addition, melatonin supplementation is often utilized to help patients fall asleep easier (Zwart, Smits, Egberts, Rademaker, & van Geijlswijk, 2018).

In patients with hormonal imbalances, hormone replacement therapy is useful, as progesterone supplementation can often help resolve insomnia (Siebern, Suh & Nowakowski, 2012).

Sleep hygiene, sleep restriction, stimulus control, and relaxation training can each be used independently, or together as in CBT-I, which can also help with sleep onset insomnia (Siebern, Suh & Nowakowski, 2012). 

A multitude of nutritional supplements besides melatonin can also be used to help with sleep onset insomnia, such as magnesium, zinc, GABA, l-theanine and B vitamins (Rondaneli, Opizzi, Monteferario, Antonielo, Mani & Klersy, 2014; Kim, Jo, Hong, Han & Suh, 2019). 

Biomedical considerations for sleep onset insomnia 

Sleep onset insomnia may be associated with other disorders such as anxiety, perimenopause, and gut issues. Some of the biomarkers to consider getting tested for are the following:

  • hormone testing for progesterone, estrogen, testosterone and FSH; another possibility for hormones testing is the hormone mapping which looks at progesterone, estrogen and LH over an entire month 
  • urine neurotransmitter testing that looks at serotonin, GABA, dopamine, epinephrine, norepinephrine, and glutamate
  • Thyroid testing, such as TSH, free T4, free T3, reverse T3, and thyroid antibodies
  • saliva cortisol levels measured four times throughout the day to assess the hypothalamic–pituitary–adrenal axis health 
  • stool analysis to look at beneficial bacteria levels and possible harmful bacteria, parasites that create inflammation in the gut and affect neurotransmitter production; in addition food sensitivity testing can also be beneficial 
  • saliva melatonin levels 
  • B vitamin levels
  • MTHFR genetic testing; homocysteine and methylmalonic acid to assess methylation 

Community resources for insomnia

When insomnia strikes and people can’t sleep for a few nights in a row, they typically end up in the emergency room. Before the insomnia gets to such severity, looking for various practitioner to help you get to the root if this type of insomnia is highly recommended.

Here are some of the practitioners to visit and how to find them:

  • look for an accredited sleep center in your area; the sleep medicine doctor will assess your case and also order a sleep study to rule out sleep apnea, restless leg syndrome and other sleep disorders: http://sleepeducation.org/find-a-facility
  • find a licensed acupuncturist and/or herbalist to help you heal your insomnia: https://directory.nccaom.org
  • work with a certified functional medicine practitioner to help you look into hormones, neurotransmitters, gut issues, cortisol levels and more: https://www.ifm.org/find-a-practitioner/
  • find a somatic psychotherapist to help you soothe the anxiety and teach you mindfulness tools to help you fall asleep easier: https://www.psychologytoday.com/us/therapists

Can I heal from sleep onset insomnia?

Based on my clinical experience, patients with sleep onset insomnia tend to recover faster than patients with maintenance sleep insomnia.

If you choose acupuncture and Chinese medicine as a method of healing for your insomnia, know that most patients with chronic insomnia require three months of weekly acupuncture to fully recover and a smaller portion of patients take longer to fully recover.

For example, the perimenopausal women may recover in as little as three months, however they require at least monthly maintenance until they reach menopause to maintain the results. 

Sleep onset insomnia can be successfully treated with acupuncture and Chinese medicine over a period of three months, or longer in certain patients.

An integrative approach is recommended as insomnia can be complex and stubborn to treat.  Read Acupuncture and Chinese Medicine Treatments for Sleep Onset Insomnia.



References:

Kim, S., Jo, K., Hong, K. B., Han, S. H., & Suh, H. J. (2019). GABA and l-theanine mixture decreases sleep latency and improves NREM sleep. Pharmaceutical biology, 57(1), 65-73.

Rondaneli M, Opizzi A, Monteferario F, Antonielo N, Mani R, Klersy C. (2014). Efficacy of 8-weeks treatment with a food supplement (melatonin, magnesium, zinc conveyed by pear pulp) on quality of sleep and morning alertness in primary insomnia elderly: double-blind, placebo-controlled clinical trial. Giornale di gerontologia. 59(1), 46‐56 

Siebern, A. T., Suh, S., & Nowakowski, S. (2012). Non-pharmacological treatment of insomnia. Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics, 9(4), 717-27.

Wing-Fai Yeung, Chung, K., Poon, M. M., Fiona Yan-Yee Ho, Shi-Ping, Z., Zhang-Jin, Z., Vivian, W. T. (2012). Prescription of chinese herbal medicine and selection of acupoints in pattern-based traditional chinese medicine treatment for insomnia: A systematic review. Evidence – Based Complementary and Alternative Medicine, 2012 doi:http://dx.doi.org.pacificcollege.idm.oclc.org/10.1155/2012/902578

Zwart, T. C., Smits, M. G., Egberts, T., Rademaker, C., & van Geijlswijk, I. M. (2018). Long-Term Melatonin Therapy for Adolescents and Young Adults with Chronic Sleep Onset Insomnia and Late Melatonin Onset: Evaluation of Sleep Quality, Chronotype, and Lifestyle Factors Compared to Age-Related Randomly Selected Population Cohorts. Healthcare (Basel, Switzerland), 6(1), 23. doi:10.3390/ healthcare6010023

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