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Acupuncture Outperforms Drug For Insomnia Relief

Acupuncture is effective for insomnia relief. Research published by  Zhejiang Chinese Medical University finds acupuncture more effective  than a powerful sleep drug for improving sleep duration, quality,  latency, efficiency, and daytime functioning. Acupuncture achieved a  92.9% total effective rate and the drug zopiclone achieved a 67.9% total  effective rate. [1] 

Zopiclone is a central nervous system depressant used for helping  patients fall asleep and maintaining sleep throughout the night. The  Zhejiang Chinese Medical University research indicates that acupuncture  is more effective than zopiclone for improving these sleep parameters.  Zopiclone is limited to short-term use because patients develop  tolerance or dependence, risking the possibility of addiction. Although a  nonbenzodiazepine hypnotic agent used as a sedative, zopiclone enhances  GABA (gamma-aminobutyric acid) via benzodiazepine receptors.  Consequently, withdrawal symptoms are similar to those of  benzodiazepines. The research indicates that acupuncture is an effective  alternative without the adverse effects associated with drug intake.

Acupuncture improved sleep latency for patients in the study. This is  the time to transition from wakefulness to sleep. Acupuncture also  improves sleep efficiency. This is the percentage of total time spent  sleeping at night while in bed. In Traditional Chinese Medicine (TCM),  these parameters are paramount to an accurate differential diagnosis.  Imbalances preventing falling asleep and imbalances causing patients to  wake have differing causes within TCM. As a result, acupuncture and  herbal medicine modifications are based on how easily patients fall  asleep, how often they wake, and what times of day they wake.

A total of 112 patients with primary insomnia were randomized into an  acupuncture group and a zopiclone group. For the drug group, zopiclone  was administered in 7.5 mg doses, once per day, for 30 days. All  patients receiving acupuncture had the following acupoints inserted with  0.25 mm diameter, 40 mm length filiform acupuncture needles:

  • Baihui (GV20)
  • Sishencong (EX-HN 1)
  • Anmian (extra, midpoint of Fengchi (GB20) and Yiming)

Secondary acupuncture points were added based on diagnostic  considerations. For patients with heart and sleep deficiency, the  following acupoints were added:

  • Shenmen (HT7)
  • Taibai (SP3)
  • Zhizheng (SI7)
  • Fenglong (ST40)

For heart deficiency related timidity, the following acupoints were added:

  • Shenmen (HT7)
  • Zhizheng (SI7)
  • Qiuxu (GB40)
  • Guangming (GB37)

For liver qi depression transforming into fire, the following acupoints were added:

  • Taichong (LV3)
  • Yangfu (GB 38)

For phlegm heat, the following acupoints were added:

  • Fenglong (ST 40)
  • Neiting (ST 44)
  • Quchi (LI 11)

For patients with blood stasis, the following acupoints were added:

  • Xuehai (SP10)
  • Geshu (BL17)

Standards of manual acupuncture needle manipulation were maintained  according to accepted TCM principles. An even reinforcing and reducing  technique (ping bu ping xie) was applied to the three primary  acupuncture points administered to all patients. Reinforcing or reducing  techniques were applied to the secondary acupoints based on  differential diagnostic considerations. One course of treatment was  comprised of one acupuncture treatment per day for 10 days. A one day  break between each course was observed. Patients received three courses  of care. Needles were retained during each acupuncture session for 30  minutes.

Acupuncture, achieving a 92.9% total effective rate, significantly  outperformed the medication, which achieved a 67.9% total effective  rate. A closer look at the numbers reveals important findings. In the  acupuncture group, 10 patients completely recovered, whereas there were  only 3 complete recoveries in the drug group. On the other end of the  spectrum, only 4 acupuncture patients did not improve, whereas 18 drug  patients did not improve.

In the middle range of improvements, patients receiving acupuncture  had more significant improvements across a wider array of parameters.  Patients receiving drug therapy had improvements limited to sleep  quality, latency, and duration. Acupuncture caused improvements across  these parameters plus daytime functioning, sleep efficiency, and  reduction of sleep disturbances.

The research presents historical insight into TCM theoretical  principles. Insomnia is classified as Bu Mei or Bu De Wo  (sleeplessness). The research indicates that “Scholars in history made  rich discussion on physiology and pathogenesis of insomnia, mostly based  on the theory of imbalance between yin and yang, in which it holds that  change of yin and yang within human body determines the sleep and awake  cycle, and it is an inevitable phenomenon of yin yang alternation.”  [2,3] They add that the “brain is the house of the original spirit,”  which is linked to mental states. As a result, regulation of yin, yang,  and spirit (shen) is indicated for patients with insomnia.

In a detailed analysis of each acupoint, the research presents the  reasons for each point selection. GV20 was chosen because yang gathers  at this point; it is a crossing point of the hand and foot yang channels  with the Governing Vessel. GV20 is designated as the sea of yang  channels; it regulates the qi and blood of all yang channels. As a  results, the research notes that the “pathological state of yang failing  to enter yin can be corrected.” The research also notes that GV20 is  effective for “relieving fright and calming spirit.” [4]

Sishencong shares similar therapeutic properties on the two acupoints  of the four point combination that are located on the Governing Vessel.  In addition, the lateral points are within 0.5 cun of the Bladder  Channel, which connects with the kidneys and also enters the brain. As a  result, the research indicates that the lateral points of the  Sishencong combination refresh the brain and tonify essence. The  acupoint Anmian, translated as peaceful sleep, was noted for its ability  to improve sleep by regulating excitatory responses in the brain and  for improving micro-circulation.

The research was conducted at the Hospital of Integrated Traditional  Chinese and Western Medicine (Zhejiang Chinese Medical University).  Based on the data, acupuncture is more effective than zopiclone for the  treatment of insomnia. An additional benefit is that acupuncture is  non-addictive whereas the drug presents tolerance and dependence risks.  To learn more, visit the acupuncture continuing education course on the  treatment of insomnia at HealthCMi:

Insomnia Online Course >

1. Shao, Yue. “Clinical study on acupuncture  for primary insomnia.” Journal of Acupuncture and Tuina Science 15, no. 6  (2017): 410-414.

2. Xu F, Feng ZT, Wang ZN. Heart-spleen deficiency insomnia  treated by five notes syndrome differentiation cooperate Guipi Anmei  decoction. Jilin Zhongyiyao, 2014, 34(6): 582-585.

3. Xue DX, Zhang ZJ. Discussion of the syndromes and treatment of  insomnia in Shang Han Lun (Treatise on Cold Damage Diseases). Xin  Zhongyi, 2014, 46(8): 232-234.

4. Shao, Yue. “Clinical study on acupuncture for primary  insomnia.” Journal of Acupuncture and Tuina Science 15, no. 6 (2017):  410-414.

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