Traditional Chinese Medicine for Insomnia and Sleep Disturbance
Well I’m just over two thirds of the way through the first year of my MSc in Chinese Herbal Medicine at the Northern College of Acupuncture in York. As today is World Sleep Day 2018, I thought I’d share with you some interesting findings I discovered whilst researching for a recent assignment on insomnia and sleep disturbance. I feel confident in saying that it affects every one of us at some point in life, even if it is just a few nights lost sleep during a difficult period of time in our life. It is a complex condition and the mechanisms behind it are not fully understood in science. However, what is agreed is that brain activity is altered and sleep cycles are changed.
Despite it being prevalent in a modern day society insomnia is not a new condition, and in ancient Chinese texts it can be traced back well over 2000 years.
Studies show that it now affects around one third of the adult population, and is a major health problem associated with cognitive impairment, cardiovascular disease, the development of psychological disorders, a compromised immune system and premature death. There is no formal medical definition of insomnia. The World Health Organisation describe a set of symptoms against which it can be measured. The National Institute for Health and Care Excellence (NICE) have a set of guidelines, broadly defining it as difficulty falling asleep, staying asleep, early awakening or non restorative sleep and which has an impact on daytime function. They indicate that up to 20% of cases have no identifiable medical cause. However, the remaining 80% are as a result of other medical conditions, mental health disorders, other sleep conditions, drug/substance misuse, or as a side effect of medications.
It is probably not a surprise that in recent times there has been a sharp rise in the use of prescription drugs, many of which have an array of side effects, some serious, including death, or, rather ironically, insomnia! Individuals can become increasingly tolerant, so higher doses need to be prescribed, and they are not recommended for long term use. So a vicious cycle prevails. The benefits of using these drugs needs to be balanced against the prevalence of these unwanted side effects, dependence and addiction, costs to the NHS and the wishes of those prescribed them. With this in mind the case has never been stronger for alternative approaches.
Over the counter herbal preparations are already a popular choice, which is not without its own concerns regarding the hazards of self-medication. Chinese herbal medicine, by contrast, offers a safe and effective treatment strategy when properly prescribed by a well qualified professional. The humble ‘spiny date seed’, Suan Zao Ren, (botanical name: Zizyphus jujuba), is one such herb. It is well tolerated in high doses and is reported to have low toxicity. It has been used as a herbal medicine since at least the second century, first appearing in the fabulously named Divine Husbandsman Classic of Materia Medica. Here it was indicated for pain in the limbs. It wasn’t until around 500 AD that it first appeared for its use in insomnia. It is grown in the northern provinces of China, and is harvested from the fruit of the jujube plant (a delicious variety of date). Either the fresh or dried variety can be used, both with similar therapeutic effect.
Furthermore, recent research published in Phytomedicine, demonstrates that Suan Zao Ren has active pharmacological components with proven sedative properties. These components are similar to, and act on the same pathways as benzodiazapines. Since 2010 it has formed part of research studies into its effect in sleep disturbance in menopause, anxiety, plus a Randomised Controlled Trial for methadone users. This research has demonstrated its efficacy in sleep disturbance, it often performs better than the drugs against which it is compared, and without the unpleasant side effects.
Of course many people also find that acupuncture can be effective in improving sleep and the symptoms of insomnia. In fact, even those who are fortunate not to experience sleep disturbance, find that a pleasant snooze on the couch whilst having an acupuncture is a very welcome side effect of the treatment!