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Beth Conroy Compendium - Insomnia - Acupuncture Physical Medicine

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INSOMNIA

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WESTERNMEDICINEDEFINITION Insomniaincludeshavingtroublefallingorstayingasleep.It'soneofthemostcommon medicalcomplaints.Withinsomnia,youusuallyawakenfeelingunrefreshed,whichtakesatoll onyourabilitytofunctionduringtheday.Insomniacansapnotonlyyourenergyleveland mood,butalsoyourhealth,workperformanceandqualityoflife. Howmuchsleepisenoughvariesfrompersontoperson.Mostadultsneedseventoeight hoursanight.Morethanonethirdofadultshaveinsomniaatsometime,while10to15percent reportlongterm(chronic)insomnia.(Staff,2009) APMDEFINITION Insomniaandagitatedsleeppatternsinpeoplesufferingfromthisfirstpatternoffatigueand dysfunctionareoftenduetoahabitualincreaseinthepersonslevelandamountofstressful activity.Theymaybetakingalotofstresshomewiththemafterwork.Whenbusinessprojects findtheirwayintothepersonsprivatelife,thereisnolongeranyseparationbetweenbusiness andleisuretime.Returninghomeatnightshouldbeareturntoasafeplace,aplaceofpeace andrestandpleasure.Bringingworkhomecreatesaconflictbetweenwantingsometimeto oneselfandwhatoneshouldstillbedoing.Itisimpossibletogotosleeptotallycalmlyinsuch asituation,andunresolvedworkthathasinvadedthehomespacecaneasilyinvadeones sleep.(Seem,2000,p.107)

SOURCES
Maciocia,G.(1994).ThePracticeofChineseMedicine.InG.Maciocia,Insomnia(pp.281 303).Edinburgh:ChurchillLivingstone. Seem,D.M.(2000).AcupuncturePhysicalMedicine.Boulder:BluePoppyPress. Staff,M.C.(2009,January8).Insomnia.RetrievedDecember1,2009,fromMayoClinic: http://www.mayoclinic.com/health/insomnia/DS00187

CATEGORIESOFDISHARMONY
Dx:TaiYangZoneExcesswithKidneyandHeartProtectionMeridianDysfunction TheFirstPatternofFatigue:SpinalIrritation Thefirstpatternentailsthedorsal,ortaiyangacupuncturezone,andinvolvesthetai yang/shaoyincircuitfromanacupunctureperspective.Myexperienceinthesecasesisthat,in additiontoreactivityinthemusculatureofthetaiyangordorsalzone,thereisadisruptionof theChineseorganfunctionsofthekidneysandadrenalsinthelowerheaterandheartandheart protectorintheupperheater.Thekidneyandheartfunctionsconstitutetheshaoyinfunctions

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Beth Conroy Compendium - Insomnia - Acupuncture Physical Medicine

protectorintheupperheater.Thekidneyandheartfunctionsconstitutetheshaoyinfunctions whicharepairedwithtaiyangorsmallintestineandbladderfunctionsinacupunctureand constituteacompletecircuit.(Seem,2000,p.86)

CLINICALMANIFESTATION
Usuallypeoplewithsuchsleepdisturbanceshavetremendoustensioninthelowerback,inthe quadratuslumborumandparaspinalmusclesthere,similartowhatisseenincasesofadrenal exhaustion,becausetheyarerunningonempty.Theyarealsousuallyverytightintheupper trapezius,anotedstressmuscle.Bothoftheseareasneedtobereleasedwithsurface myofascialtechniques.(Seem,2000,p.107)

TREATMENTPRINCIPLE
Tx:DisperseTaiYangZoneExcessandRegulateKidneyandHeartProtectorMeridians

TREATMENTSTRATEGY&PLAN
Inadditiontothewei,surfaceenergeticreleaseofthequadratuslumborum,lumbarparaspinal musclesanduppertrapezius,ItreatthecorelevelwithSI3andBL62fordumaiandyang qiaomai,coupledwiththeiryincounterpartLu7forrenmaiandKi6foryinqiaomai.IdoSI3 ononeside,saytherighthand,andBL62ontheleftfootinthisexample.ThenIaddLu7on thelefthandandKi6ontherightfoot,creatingacrossingpattern.Thisisarenmai/dumai infinitytreatmentconnectingfronttobackanduppertolower,therebycalmingthenervous system.Thisisthesameasmakingwater(thekidneyroot)communicatewithfire(theheart andshen,orspirit),inafivephaseacupunctureapproach.IalsohadHt7tocalmthespirit. (Seem,2000,p.108) Also,althoughDr.SeemdoesnotnoteitinthisparticularsectionofAcupuncturePhysical Medicine,byusingKid6andBL62thetreatmentstrategyisalsoregulatingtheYinandYang Qiaoextraordinarymeridianswhichwillharmonizetheflowofenergytoeyesandpromote sleep.(Maciocia,1994) Exampleofafulltreatmentprotocol(Seem,2000,pp.108,133): JingLevelPoints Local: BBL10,BL40:DivergentChannelMeetingPoints Distal: RSI3:DuMaiOpeningPoint LBL62:YangQiaoMaiOpeningPoint LLu7:RenMaiOpeningPoint RKid6:YinQiaoMaiOpeningPoint YingLevelPoints Local: BBL23,BL14:HarmonizeKidneyandHeartProtector Distal: BKid3,BL58:Source/LuoforaffectedMeridians
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Beth Conroy Compendium - Insomnia - Acupuncture Physical Medicine

WeiLevelPoints Distal: BL59:ReleasestheOcciputandtheBackoftheNeck BL581/2:ReleasesQuadratusLumborum,Gluteals,andPiriformis Local: VanNghiorTriggerPointReleaseNeedlingasindicatedforthefollowingmusclesgroups: QuadratusLumborum ParaspinalsoftheLumbar UpperTrapeziusMuscles

PATIENTEDUCATION/RECOMMENDATIONS
Inadditiontonotallowingworktototallyinvadethehomespace,Irecommendtopatientsthat theydonointellectualactivityforthelasthourbeforebed,andinsteaddosomethingrelaxing, suchasahotbubbleorEpsomSaltsbath,drinkacupofcalmingteasuchasCelestial SeasoningsSleepTimeTea,orlistentocalmingmusic,toslowthemselvesdown.Ialso suggesteatingnolaterthan7pmtoallowthebodytodigestanddrinkingonlyaminimum,if any,alcoholsoasnottodevelopcounterflowheatthatoftenagitatessleep.(Seem,2000,p. 108)

PROGNOSIS
Dr.Seemdoesnotspecifyaprognosis.Inmostofhistreatmentsregardingtriggerpointswhich existasaresultofaholdingpattern,though,thereisoftentherecommendationforpatientsto betreatedthreetimesataweeklyintervalbeforetakingamonthofftoreassessifthebody hasretainedtheretrainingofthemuscleswhichshouldresultfromthetreatment.Often,the morechronicthecondition,however,thelongeritwilltakeforthedisharmonytoresolve.

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