According to Health Direct, 30% of Australians experience insomnia at some point in their lives, although only 5% require professional treatment. Insomnia can last for a short time, or months, even years. Women and elderly people are more likely to suffer from it.
In clinic, we do see and hear about bad sleeping habits more often these days. The challenges of life and existence are not always easy to manage. Often problems with sleeping comes up in the conversation in combination with something else.
Professor Matthew Walker, a Neuroscientist with a special interest in the science of sleep says: “Two-thirds of adults throughout all developed nations fail to obtain the recommended the recommended eight hours of nightly sleep”. Eight hours of sleep for adults are recommended by both the WHO (World Health Organisation) as well as the National Sleep Foundation.
An article in Psychology Today debates if sleep deprivation is considered torture or not and further states: “The first signs of sleep deprivation are unpleasant feelings of fatigue, irritability, and difficulties concentrating. Then come problems with reading and speaking clearly, poor judgment, lower body temperature, and a considerable increase in appetite. If the deprivation continues, the worsening effects include disorientation, visual mis-perceptions, apathy, severe lethargy, and social withdrawal.” Individuals will die if sleep continues to be deprived.
In Chinese medicine, we believe that the importance of sleep is under rated simply based on the balance of Yin and Yang. Yin being the inactive, quiet part. The phase where we internalise and consciousness withdraws into the ‘centre of the blood’, the most Yin part of our body. Our sensory organs are ‘shut’ to avoid stimulation and the blood replenishes.
The foundation of sleep
Our biology bases our entire health and wellbeing on sleep. And yes, based on eight hours of sleep per night, we will sleep away 30% of our existence. But if we don’t, we may experience impaired healthiness. Thousands of studies have established the importance of sleep for any organism on this planet that lives past several days. It’s essential to our existence (and survival), no matter how foolish it seems.
Nature helps us in establishing a good rhythm which is called the circadian circle. It responds to the changes of light in our environment. Important to know is, that we all form our own rhythm and hence some people prefer to rise early, and others stay up late. The cycle also controls our preferred times for eating, the fluctuation of body temperature, moods and emotions, the amount of urine that we produce, the metabolic rate and the release of hormones. Once we have discovered and established our cycle, it’s best to honour it.
The structure of sleep
NREM (Non Rapid Eye Movement) sleep
It includes all of the stages of sleep other than REM (Rapid Eye Movement). These stages of sleep vary in depth from stage 1 (lightest) to stage 4 (deepest). Stages 3 and 4 are considered deep sleep and this is where most of the physical restoration occurs. At this stage, growth hormone is produced, and cellular repair begins in NREM.
REM (Rapid Eye Movement) sleep
It’s the deepest of all the stages of sleep. It usually takes up about 25 percent of our sleep time. REM comes in short bursts at first and lasts for only a few minutes but then it gradually stretches into longer time segments. REM is great for building memory as during this phase, the brain moves information from short term to long term memory.
As the body seems to be in a paralyzed stage and doesn’t move, the eyes move quickly from side to side. They remain closed whilst doing so. Heavy dreaming accompanies the REM phase of our sleep. As we age, the sleep architecture changes and we spend less time in deep sleep and tend to wake easier after the REM (Rapid Eye Movement) phase.
What’s detrimental to good sleep
According to Professor Matthew Walker there are five key factors that have powerfully changed the quality of our sleep:
Constant electric and LED lights
At dusk, when natural light fades, the part of our brain that is in charge of our internal clock (the suprachiasmatic nucleus) floods our system with melatonin that signals our body that darkness is near and it’s time to prepare for bed and sleep.
With constant lights around us (especially when we live in the city), this natural process is inhibited and the prepared of the body for sleep is delayed or impaired. The invention of LED (Light Emitting Diodes) made the situation worse, as the light receptors in our eyes that communicate with the brain are sensitive to the short-wavelengths light that LED’s emit and thus the release of melatonin is suppressed more strongly.
We might not look at LED powered light sources all night, but we might stare at LED-powered screens: smart phones, tablets, laptops, TV’s. Those devices emanate a blue light that has harmful effects on our bodies preparing for sleep.
Body temperature has to drop by about one-degree Celsius to be conducive to sleep. Our body temperature is regulated by the hypothalamus Those cells in that particular endocrine gland live close to the suprachiasmatic nucleus, the part of the brain that regulates the release of melatonin.
Core temperature can drop if we cool parts of the body’s surface like the hands, feet and the face. If you are feeling hot, give your extremities and your face some cooling down with a cold compress and your core temperature is able to drop that one degree to prepare our bodies for sleep.
Now living in air-conditioned homes, we have severed the natural relationship with our environment that signals the body the onset of night with cooler temperatures hanging around. This is one more reason why air conditioners seem appealing but are not really support of our health, except in some circumstances.
Professor Matthew Walker recommends a bed room temperature of 18.3 degrees Celsius assuming that there standard bedding and clothing made from natural fibres is used as well. There are slight varieties based on gender, age and unique physiology but you will know what’s right for you.
Adenosine is the chemical that builds in our brains when our body requires sleep. With every waking minute, the build up grows and the desire to sleep increases. There is one chemical that counteracts this process and its called caffeine. Caffeine is the most used psychoactive stimulant in the world and apparently the second highest commodity traded after oil.
Caffeine fights for the adenosine receptors. In this way, caffeine blocks the sleepiness signal and that’s how we feel more awake and alert. In pharmacological terms, caffeine has a half-life (which means that build up of it in the body halves) in five to seven hours. For instance, if you have a cup of brewed coffee at 7.30am in the morning, (which contains an average of 95mg of caffeine), six hours later, at 1.30pm, there is still 44.5mg of caffeine in the system.
This amount halves again in the next five to seven hours, which means that at 7.30pm, an amount of 22.25mg of caffeine is still in the system. Most people do not realise how long it takes the body to clear caffeine out of the system. This certainly explains why drinking coffee (eating chocolate or ice-cream that may contain caffeine) is not the best idea if you find it hard to sleep at night.
By the way, de-caffeinated coffee still contains caffeine: about 15-30% of the amount of regular coffee.
In contrast to our expectation for alcohol to relax us, it actually sedates us which doesn’t mean that our sleep improves. Alcohol is a powerful sedative and suppressor of the important REM phase of sleep. Alcohol also fragments sleep, which you might not remember, because you have been sedated by its effects.
As a result, sleep is broken, and its restorative effects are lost. Over time, this will build up and lack of continuous sleep (during the night) will have harmful effects. The body will go to the extend of erupting the REM phase into waking consciousness as hallucinations, delusions and disorientation. Just to show how important the REM phase is for our health and wellbeing.
Women are more susceptible to the effects of alcohol due to delayed metabolism of alcohol in the system. Alcohol is literally flowing around the body for longer because the update is inhibited by a larger content of fatty tissue.
Waking with alarm clocks
How do you feel about living in an industrialised world, where most of us start and finish work at the same time? Nine to Five? Being rattled out of our slumber and worse, repeatedly shocking the cardiovascular system with the snooze button, over and over again?
We are actively working against our unique circadian rhythm unless, our own rhythm reflects the nine to five cycle. A study showed that participants being woken from sleep prematurely with an alarm clock, suffer a spike in blood pressure and an acceleration of the heart rate triggered by the fight and flight response of the nervous system.
What’s great for better sleep
With all the information provided, it’s easy to work out which activities promote quality sleep and why:
- Use candlelight or turn off LED lights at night, particularly leading up to bedtime
- Switch off screens such as smart phones, tablets and TV’s and read a book to avoid the harmful effects of blue light on sleep
- Turn off air conditioner so your body can naturally adjust to environmental temperatures and pick up the cool breeze at dusk, signaling the end of the day and sleep ahead
- Stop drinking alcohol if you want to catch a good night sleep, particularly if you are a woman
- Don’t drink excessive amounts of coffee particularly after midday or make coffee an exception rather than a necessity
When treating sleeplessness with Chinese medicine, we determine the pattern causing insomnia. Secondly, we treat the imbalance with acupuncture and Chinese herbal medicines and discuss sleep hygiene.
Table 1 – Source: Classification of Insomnia Using the Traditional Chinese Medicine System: A Systematic Review
Following are the 10 most common Chinese medicine patterns for insomnia:
|Chinese medicine pattern||Chinese name||Subjects with insomnia (N = 9499)|
|Number of subjects (%)|
|Deficiency of both the heart and spleen||心脾 兩虛||2378 (25.0)|
|Hyperactivity of fire due to yin deficiency||陰虛 火旺||1622 (17.1)|
|Liver-qi stagnation transforming into fire||肝鬱 化火||921 (9.7)|
|Heart-kidney noninteraction||心腎 不交||767 (8.1)|
|Qi deficiency of the heart and gallbladder||心膽 氣虛||544 (5.7)|
|Internal disturbance of phlegm-heat||痰熱 內擾||466 (4.9)|
|Liver fire flaming upward||肝火 上擾||285 (3.0)|
|Heart deficiency with timidity||心虛 膽怯||202 (2.1)|
|Stomach disharmony||胃腑 不和||120 (1.3)|
|Stomach qi disharmony||胃氣 不和||44 (0.5)|
The pattern of insomnia is most likely connected to other signs and symptoms. The application of tongue and pulse diagnosis and well as looking at your circumstances, enables us to suggest a treatment strategy.
Make an appointment today with a registered Chinese medicine practitioner today, if you suffer from insomnia and would like to tap into natural treatment modalities to help you catch a good and restful night of sleep (full of dreams).
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