Restlessness, exhaustion, and difficulty falling asleep, staying asleep, or both are all symptoms of insomnia. We all know about the importance of sleep and unfortunately, 70 million Americans suffer from a sleep disorder with insomnia as the most common.
Acupuncture to Help You Sleep Better
In 2012 a systemic review of 33 studies with a total of 2,293 participants assessed acupuncture for insomnia relief. Compared to either no treatment or placebo acupuncture, acupuncture improved participants’ sleep quality. Additionally, participants who were participating in other forms of treatment still saw an improvement in the sleep with acupuncture compared to those participants who only continued with their conventional treatments.
This analysis suggests that not only could acupuncture support insomnia relief as a single treatment but could provide benefit as an adjunctive care.
To look specifically at individual studies, a randomized controlled trial in 2017 looked at the efficacy and safety of acupuncture treatment for primary insomnia. Primary insomnia is sleeplessness not due to an existing medical condition, while secondary insomnia is when the sleeplessness is symptoms manifesting from another condition.
The participants either received acupuncture three times a week for four weeks or sham acupuncture treatment. To record sleep and assess sleep quality, participants wore sleep monitors and completed questionnaires every two weeks. The participants who received acupuncture had significant improvements in the Insomnia Severity Index at two weeks post-treatment, four weeks post-treatment, two weeks follow-up, and four weeks follow-up.
That is to say that at every time the study collected data, the acupuncture treated group’s sleep was superior to the sham treatment group’s sleep.
Additional significant improvements in the acupuncture-treated group were seen in sleep efficiency, total sleep time, and the self-rating depression scale.
A randomized controlled trial in 2020 similarly assessed acupuncture treatment for primary insomnia. This study additionally measured sleep quality for 6 weeks post-treatment to determine if the acupuncture would remain clinically effective for that long duration. Ninety-six participants either received acupuncture or sham acupuncture for two weeks.
The study measured quality of sleep from the Pittsburg Sleep Quality Index. Throughout the study period, the PSQI ratings in the acupuncture treated group were superior to that of the sham acupuncture treated group and the clinical efficacy of those improvements were maintained for 6 weeks.
This study supports the idea that acupuncture treatment provides benefits for longer than the period of treatment.
While the previous studies included sham acupuncture as controls, a meta-analysis in 2020 focused on whether the effectiveness of acupuncture was due to a placebo effect. The analysis included studies that provided insomnia patients with either acupuncture therapies or sham acupuncture therapies in similar clinical settings.
A significant difference in the Insomnia Severity Index occurred, revealing clinical improvements in sleep in the acupuncture group in comparison to the sham group. The meta-analysis concluded that insomnia improvements from acupuncture were due to true acupuncture, not a placebo.
A systematic review in 2017 looked at acupuncture as an adjunct to conventional medical care. The review assessed 18 randomized-controlled clinical trials where participants either received conventional medical care or conventional medical care with the addition of acupuncture.
Compared to conventional treatments alone, acupuncture produced better sleep quality and improvements in depression ratings. The improvements in depression are especially notable because the acupuncture therapies affected both insomnia and the root cause of insomnia/depression.
This study highlights acupunctures’ ability for multiple targets and its potential as an efficacious therapy option.
As mentioned earlier, insomnia can be related or unrelated to pre-existing conditions. These existing medical conditions commonly include depression and menopause.
Insomnia is one of the most common complaints of those entering menopause. A randomized controlled trial in 2017 explored the short-term efficacy of acupuncture for peri-menopausal insomnia. 76 participants were randomized to either receive 10 sessions of acupuncture or placebo acupuncture over 3 weeks.
After the therapies, the sleep quality in the acupuncture-treated group, as reported by the Pittsburgh Sleep Quality Index, was higher than the placebo-acupuncture group. Data from overnight polysomnography exams additionally showed that the acupuncture-treated group experienced less wake time after sleep onset, higher efficiency of sleep, and longer total sleep time in comparison to participants who did not receive the acupuncture.
This study notably shows that even just three weeks of treatment can lead to clinical improvements in sleep. It is powerful to see that after just three weeks, acupuncture treatment could help an individual sleep better!
Herbal Support for Poor Sleep
Individual experiencing insomnia
Many practitioners have utilized Kampo formulas and Chinese herbs to address insomnia. According to a review in 2017, these sedative herbs’ pharmacological action mechanisms include acting through gamma-aminobutyric acid (GABA) and/or this neurotransmitter’s receptor.
Additional mechanisms include the inhibition of the 5-hydroxytryptamine 1A receptor or upregulating the expression of other signals such as orexin-A, leptin, orexin receptor-1, and leptin receptor in the brain.
The common Chinese herbal medicines include Suanzaoren (Ziziphus spinose), Fuling (Poria cocos), and Gancao (Glycyrrhiza uralensis).
A meta-analysis published this year included 14 randomized controlled trials with 910 participants. The analysis found the Banxia (Pinellia Tuber) formula to have higher efficacy for improvements in the Pittsburgh Sleep Quality index than conventional treatments.
The groups who received the Banxia formulas additionally reported fewer adverse events than the groups who received conventional medications. The study listed heterogeneity in the type of conventional medication utilized and further studies should compare one specific therapy to another to strengthen the data and support for one therapy versus another.
A retrospective analysis in 2010 looked at 1,523 peri- and postmenopausal women who reported moderate to severe sleep disturbances. These women either received only health education or a Kampo formula. The Kampo formula was designed to support sleep. These formulas included Tokishakuyakusan (TJ-23), Kamishoyosan (TJ-24), or Keishibukuryogan (TJ-25).
After a 5-month follow-up, participants in each of the groups that received a Kampo formula reported improvements in sleep.
All the groups that received a Kampo formula reported reductions in sleep disturbances. The TJ-24 group additionally experienced improvements in difficulties falling asleep. The study did not report similar improvements in the group that only received health education.
One night of poor sleep can lead to disruptive fatigue and exhaustion. When someone is experiencing so much sleeplessness that their lack of sleep is classified as insomnia, it is essential that their health be supported.
Acupuncture, traditional Chinese herbs, and Kampo formulas can provide that support. Just as the above data states, there are multiple types of therapies available to assist an individual’s care both as stand-alone therapies or as adjuncts to conventional care.