Insomnia is a term covering a number of disturbances to our normal sleeping pattern: some people may for example, have difficulty going off to sleep in the first place, while others wake during the night and may be unable to sleep soundly thereafter. Whatever the pattern, chronically disturbed sleep means waking unrefreshed, makes it very hard to function properly during the day, and undermines our vitality and full enjoyment of life.

If you have been taking medication to help with the problem, then that is usually no barrier to receiving acupuncture. You may have been prescribed small amounts of newer drugs like zopiclone or zimovane; GPs are reluctant to supply anything more than very limited quantities because they are not licensed for long term use, and tolerance to them can in any case develop in three to fourteen days. Under such circumstances, acupuncture may effectively fill the gap left by a lack of further treatment options.

If you come to see me about insomnia, my first step is to ascertain exactly how your sleep is disturbed. You might identify with some of the patterns I commonly encounter:

- Do you find it difficult to go off to sleep at the very start of the night, and is a busy mind part of the problem? Your thoughts may be around worrying or stressful issues, or they may hop incessantly from one relatively inconsequential topic to the next.

- Conversely, is your mind reasonably peaceful, and yet it is still hard to drop off to sleep in the first place?

- Or are you someone who can go to sleep fairly easily, but who then wakes in the early hours? If you wake at broadly the same time most nights, then the time can be of significance to me.

- Do you sleep for most of the night, but restlessly, perhaps due to disturbing dreams, feeling hot etc ?

The answers to these questions provide very useful pointers, and coupled with information about your general health and well-being, I can arrive at a Chinese medical diagnosis of the causes of your insomnia. Treatment would in most cases be weekly, for a fixed period, and if your insomnia stems from stress or worry, then we can try to address that too.

It is also helpful to look at lifestyle and see whether there are any useful steps you can take for yourself. These depend on the type of insomnia you have, but may include a calming ritual before bedtime, controlling caffeine intake, and being choosy about any television or other stimulation in the evening: the ten o’clock news might not be the best choice if you wish to promote the harmony of spirit which is conducive to sound sleep!

The beneficial effects of acupuncture reported by insomniacs in relation to their sleep quality and daytime social functioning, have been backed up by the results of electronically monitoring their cyclical sleep patterns.

Forty-seven patients with chronic insomnia, received four courses of electroacupuncture treatment. Patients themselves reported on various aspects of the quality of their sleep, whilst polysomnogram measurements were used to objectively assess the cyclical stages of their sleep. Electroacupuncture was found to not only improve sleep quality and daytime social functioning, but also to exert a repairing effect on disrupted sleep continuity, prolonged slow wave sleep time, and rapid eye movement sleep time.

(Electroacupuncture Treatment of Chronic Insomniacs. Chinese Med Journal (Engl) Dec 2009.)

Researchers have found that acupuncture is able to assist with the problem of insomnia which appears after a stroke, and it does so by reducing hyperactivity in the sympathethic nervous system.

Fifty-two hospitalised stroke patients with insomnia, were randomly assigned to receive either real acupuncture for three days, or sham acupuncture as a control. There was greater improvement in the group receiving real acupuncture, but additionally, measures of autonomic nervous system functioning (blood pressure and heart rate variability) suggested that sympathetic nervous system hyperactivity was reduced in the real acupuncture group.

(Intradermal Acupuncture on Shen-men and Nei-kuan Acupoints Improves Insomnia in Stroke Patients by Reducing the Sympathetic Nervous System Activity: A Randomised Clinical Trial. American Journal of Chinese Medicine 2009.)

Researchers in Hong Kong have carried out a systematic review of twenty randomised controlled trials investigating the effects of acupuncture on insomnia. The majority of trials concluded that traditional acupuncture was significantly more effective for helping insomnia, than benzodiazepines, the mean effective rates being 91% and 75% respectively.

The authors point out methodological shortcomings in the studies reviewed and cite the need now for large scale, high-quality trials. (Traditional Needle Acupuncture Treatment for Insomnia: A Systematic Review of Randomised Controlled Trials. Sleep Med 2009 March 18. Epub ahead of print)