You, your patients, and people all over the world are sleeping less. In 1979 a team led by American psychiatrist Daniel Kripke did a large-scale study of over a million people, which indicated that most people slept between 7-8 hours.
A more recent large-scale study in 2004 by the furniture chain IKEA showed that worldwide the length of sleep during the past decade had dropped to an average of 7 hours.
If you slept 1 hour less per night for a year it would result in:
- The loss of 44 8-hour nights of sleep
- 90,000 more breathes occurring in that year
- 210, 000 additional beats of your heart in that year
No matter what you do for a patient, if they aren't sleeping enough (or well) your best efforts will be met with mediocre results. This is because their bodies are forced to put more energy into producing wakefulness and less into healing. Here is a brief synopsis on the Western and Eastern views of sleep.
The Western Perspective
"The function of sleep has mystified scientists for thousands of years," says John Peever director of the Systems Neurobiology Lab at the University of Toronto. Brian J. Murray director of the sleep lab at Sunnybrook Health Sciences Center, says "It is incredibly complex."1
But new research shows that "Sleep serves to re-energize the body's cells, clear waste from the brain, and support learning and memory. It plays vital roles in regulating mood, appetite and libido."1 Sleep affects almost every type of tissue and system in the body – from the brain, heart, and lungs to metabolism, immune function, mood, and disease resistance.
"One of the most pervasive misconceptions about sleep is that it's just a matter of our bodies "turning off" for several hours, followed by our bodies "turning back on" when we awaken. In short most of us think of sleep as a passive and relatively constant and unchanging process. In fact, sleep is a very active state. Our bodies move frequently, as we roll about during the night, and, more importantly to the psychologist, our brain activity is even more varied than it is during the normal waking.2
The Eastern Perspective
Sleep is a natural and regularly recurring condition of rest for the body and mind. It is distinguished from quiet wakefulness by a decreased ability to react to stimuli and it is more easily reversible than hibernation or coma. It is common to all mammals and birds, and is seen in many reptiles, amphibians and fish. Regular sleep is essential for survival says, Hamid Montakab in his book, "Acupuncture For Insomnia: Sleep and Dreams in Chinese Medicine."3
Normal sleep patterns are the result of the healthy functioning of the cerebral cortex and autonomic nervous system. In Chinese medicine this normal functioning is referred to as "spirit," says Sun Zhong –ren and Sun Yuan-zheng in their book, "Acupuncture and Moxabustion for Insomnia."4
Sleep is a natural component of Yin Yang theory. Wakefulness happens when yin goes from stillness to movement. Sleep happens when yang chi goes from movement to stillness" says Lei Zheng Zhi Cai in his 18th century text, "Categorized Patterns With Clear Cut Treatments."
The Yin Qiao and Yang Qiao mai are the meridians most connected with sleep—chi flows through Yang Qiao Mai during the day and Yin Qiao Mai at night, says Bosch and van den Noort in their book, "Schizophrenia, Sleep & Acupuncture."5
Sleep Problems
There are many sleep problems, but the most prevalent is insomnia. According to the Merck Manual insomnia is "Difficulty in sleeping, disturbed sleep patterns leaving the perception of insufficient sleep."6
The Cerebral cortex and CNS are referred to as "spirit" in TCM. When they are agitated or disturbed there is insomnia. Chemically speaking, there is too much dopamine in the cerebrum say Sun Zhong –ren and Sun Yuan-zheng in "Acupuncture and Moxabustion for Insomnia."
Primary patterns causing insomnia all of which lead to a deficiency of yin and blood and the inability for yang, which is pre-eminent during the day, to be controlled by yin, thus yang spreads upward and outward when the body needs to be quiet and inward.
Scanning many major texts on the subject, I found that there are generally 4-6 primary patterns listed as causative for insomnia. "Schizophrenia, Sleep & Acupuncture" listed these, as did several others.
- Heart and Spleen deficiency
- Yin deficiency with effulgent fire
- Liver congestion weakening the spleen and blood production, which can lead to heart blood deficiency, allowing for irritation of the spirit
- Liver congestion turning into fire
- Heart deficiency with gall bladder timidity
- Phlegm heat causing turmoil of the spirit
Not surprisingly, there are many overlaps in the way insomnia is treated by both medical systems. Here is a list of combined approaches for the addressing of insomnia by a patient.
- Soaking one's feet in hot water before bed to open blood vessels in the area, and relax the entire body because of the channels that end in the feet.
- Baths between 93 and 97 degrees that last 30-40 minutes
- Exercising for 20 minutes in the sunlight in the morning to support biological clock.
- Music - Annals of music (Yu Ji) music can create harmony in life soothing music can induce sleep, alter breath, making it more rhythmic and deep and slow heart rate by regulating the autonomic nervous system whereas uplifting music can stimulate the cerebral cortex.
- Hair combing or head massage increases cerebral cortex inhibition by stimulating the local points which connect to the "100 vessels"
- Aromatherapy - calms the CNS through the olfactory nerves and is easy to get compliance from patients as it is pleasant.
- Controlling the amount of light in the room. Light can enter through the eyelids stimulating the retina of the eye, which informs the brain that the yang portion of the day is approaching, even if the light is artificial.
- Temperature in the sleep environment must be regulated so as to compensate for body temperature dropping during the night.
- Controlling the mind with calming activities and thoughts (visualizations).
- Sleep hygiene involves practices such as going to sleep at the same time every night and waking at the same time every morning. It includes habits expressed throughout the day that facilitate the body preparing for a good night's rest.
- Go to bed early! One hour of sleep before midnight is equivalent to three hours after midnight because the yin period of the day starts at noon when the sun begins to set. It extends until midnight when the sun begins to rise again. Sleeping during the yin period of the day optimizes sleep as yin supports yin.
To insure that your work is optimally utilized by your patients' bodies, have them use smartphone apps, bedside monitors, and wearable items (including bracelets, smart watches, and headbands) to informally collect and analyze data about their sleep. This can give you the information you need to determine if a referral to a sleep specialist or other physician for diagnostic or treatment purposes is of value.
Also, consider if sleep is something you want to know more about for yourself. You know, as you read this piece, if you are guilty of not valuing your own sleep sufficiently. As Reed Hastings, CEO of Netflix, has said "Our biggest competitor is sleep." Don't let this corporate giant or anyone else inhibit you from getting the rest you need.
References
- Scientific American. "What Happens in the Brain During Sleep?" SA Mind, Sept 2015; 26(5):70.
- Pinel J PJ. Biopsychology, 9th edition. Needham Heights, MA: Allyn & Bacon, 1992.
- Montakab H. "Acupuncture for Insomnia, Sleep and Dreams in Chinese Medicine." Scribd.com, 2015.
- Zhong –ren S, Yuan-zheng S. Acupuncture and Moxibustion for Insomnia. Beijing, China: People's Medical Publishing House, 2010.
- Bosch P, and van den Noort M. Schizophrenia, Sleep, and Acupuncture. Cambridge: Hogrefe, 2008.
- Doghramji K, et al. "Insomnia and Excessive Daytime Sleepiness." Merck Manuals, 2018.
Click here for more information about Felice Dunas, PhD.