Insomnia

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6 03, 2012

Bed-Wetting

Bed-wetting, or involuntary nighttime urination, is a common occurrence for many children. It’s often simply a developmental stage, though an embarrassing one. It is most common for children under the age of 6 or 7, and most will outgrow it beyond this age. Between ages 8 and 11, fewer than 5% of children continue to have a problem with bed-wetting. It’s generally not a cause for concern because nighttime bladder control may not yet be established.

It’s not clear what causes bed-wetting, but there may be various factors, including a small bladder, inability to recognize a full bladder, hormonal imbalance, stress, sleep apnea,  chronic constipation, urinary tract infection, diabetes, or in rare cases an anatomical defect in the neurological or urinary system. Most children outgrow bed-wetting on their own. However, for more difficult cases, treatment may include using moisture alarms, bladder training, or if all else fails, medications.

Of course, many parents are not comfortable with the use of medications for their children. This is where Chinese medicine (TCM) can help. Children are not miniature adults, but have their own special health considerations. Their anatomy and physiology are immature, so treatments used for adults may not be appropriate for a child’s delicate system. Also, because children are generally quite healthy and quick to heal, they respond very quickly to treatment and require lighter treatment than adults. When using acupuncture, this means fewer points, gentler treatment, and fewer sessions to resolve the problem. Also, simple home remedies such as acupressure and diet or lifestyle changes may be enough to resolve the issue.

In Chinese medicine, bed-wetting is mainly due to the immaturity of the kidneys. Because the kidneys are responsible for urination and the bladder’s retention, it follows that a child’s not yet fully developed kidneys may lead to urinary problems. If bed-wetting is due to weak kidneys, it will involve nighttime enuresis of 1, 2 or more times per night, clear urination, pale complexion, lower back or knee soreness or weakness, and possibly cold limbs and an aversion to cold. Bed-wetting may also be due to a weakness in the spleen and lung organ-meridians, in which case the symptoms will involve nighttime enuresis, shortness of breath, white face, weak appetite, loose stools, spontaneous perspiration, lack of strength, and a dispirited nature.

Treatment for bed-wetting is straightforward once the correct cause is determined. Acupuncture can help to strengthen the organs and correct imbalances. But how do you know if acupuncture is appropriate for your child? I always ask parents to discuss acupuncture with their child beforehand, to find out if the child is open to trying it. With their naturally curious nature, most children find the experience to be very positive and do very well in treatment. However, if there is any fear or apprehension, it’s best to leave the idea of acupuncture alone, at least for the time being. With children or with adults, it’s no fun for either patient or practitioner if the person does not want to be there in the first place!

There are simple habits that can be performed at home to help resolve bed-wetting. Patience and understanding are essential, as fear or stress will only further damage the kidneys and aggravate the problem. Avoiding drinking too much in the evening and emptying the bladder before bed is good prevention. Also, the child should not be allowed to become too fatigued before going to bed, as overfatigue can further weaken the kidneys, spleen and lungs. Lastly, a healthy diet without too many rich, greasy, spicy or strong flavours and avoiding chilled or cold food and too much sugar and sweets can also help to strengthen these organs.

James Kaufman is a Registered Acupuncturist at Okanagan Acupuncture Centre, 1625 Ellis St, Kelowna, BC.

24 05, 2011

Shift Work

Shift work refers to both long-term night shifts and work schedules where employees change or rotate shifts between daytime and evening or night schedules. Shift work is a reality for about 25 percent of the North American working population.

Many workers prefer shift work because of the free time and flexibility it provides. However, for most workers, shift work causes at least some disruption to their family and personal life and some degree of negative health symptoms. Being constantly tired is a typical complaint of shift workers, often described as “jet lag”. Shift work can also lead to health problems including insomnia, chronic fatigue and gastrointestinal disorders. Shift work can make it difficult participate in regular social activities and family life, which can cause loneliness and isolation.

A shift worker, particularly one who works nights, must function on a schedule that is not "natural". The body is naturally attuned to a circadian rhythm- many of the body’s functions follow a daily rhythm or a 24-hour cycle. Sleeping, waking, digestion, secretion of adrenalin, body temperature, blood pressure, pulse and many other important body functions and human behaviour are regulated by this 24-hour cycle. These rhythmical processes are synchronized to allow for high activity during the day and low activity at night. However, if a person is working at night, the body rhythms get out of sync with the person's activity pattern. This disorientation can lead to feelings of fatigue and disorientation, or “jet lag”. Also, exposure to light at night can alter sleep-activity patterns and suppress melatonin production, leading to insomnia or difficulty sleeping.

Frequent changes in schedule and disruption to circadian rhythms can lead to chronic fatigue and other health problems, including higher risk for heart attack and cardiovascular conditions, digestive problems such as indigestion, heartburn, stomachache and loss of appetite, and insomnia or sleeping disorders. Shift work can also interfere with medications and the medical treatment of some diseases. Because of the way that shift work disrupts the circadian rhythm, research suggests long-term shift work may also increase the risk of cancer. Shift workers are also at risk of eating a less healthy diet because the loss of appetite at night often leads to increased snacking on "junk" food, while fatigue may encourage the consumption of caffeinated drinks to help the worker stay awake. This can further aggravate health issues particularly gastrointestinal problems and difficulty sleeping.

Where does acupuncture fit into this? Acupuncture can offer stellar results for improving the wellbeing and quality-of-life of shift workers. Acupuncture is very effective for many of the symptoms that accompany shift work: it can improve energy and mental clarity, resolve insomnia, and correct digestive disorders. It can also help shift workers adjust to changes in schedules or days off and help the body bounce back more quickly. One of the ways acupuncture may be particularly helpful for shift workers is the way in which it helps to normalize and regulate the body’s functions. Research has shown that acupuncture can influence many systems within the body, including our hormones, our neurotransmitters, our immune system, our blood pressure, and our circulation, helping to correct any functions that are out of balance or not working properly. What this means is that acupuncture may help the body to get back into its normal circadian rhythm, and help these rhythms to adjust more quickly to changes in the daily routines.

One of the biggest changes that shift workers notice with acupuncture is a boost in their energy levels. There is a huge improvement in quality of life that accompanies this change, as a person is more alert both at work and through the daytime, better able to enjoy time off and to be more involved in their family and social life. Indeed, many people find that with regular treatments, shift work no longer has to take a huge toll on their personal life.

Prevention and healthy lifestyle are also very important for shiftworkers, both for maintaining quality of life, and because shift work puts a worker at higher risk for health problems. Regular exercise and maintaining an adequate level of fitness is important, as is good dietary habits, managing stress, and making time for leisure activities. Participation in family and social life is also important for physical and mental health.

James Kaufman is a Registered Acupuncturist at Okanagan Acupuncture Centre, 1625 Ellis St, downtown Kelowna.

14 10, 2010

Night Sweats – Sleep Hyperhidrosis

Night sweats, or sleep hyperhidrosis, are episodes of excessive night time sweating even when your bedroom isn’t excessively hot. It is a fairly common problem, with many people experiencing them from time to time. Night sweating usually isn’t considered a serious medical concern, however it can be uncomfortable when it occurs regularly or interferes with sleep.

Night sweats can be a side effect of certain medications such as antidepressants, hypoglycemic agents, temperature-regulating medications, or hormone therapy. Many women also experience night sweating during menopause. In some cases, underlying medical conditions can lead to night sweats, such as infections, cancer, nervous system disorders, or problems with the body’s endocrine (hormone-producing) system. It’s always important to get symptoms checked out by your doctor to be sure that they aren’t a sign of something more serious.

For people experiencing night sweats, acupuncture can offer relief. The development of the Chinese medical system occured through astute observation. Their doctors became masters of accurately diagnosing medical conditions based on a very detailed observation of symptoms. With observation, they discovered that groups of symptoms typically occur together, and together these symptoms point towards a specific pattern of imbalance. By determining which imbalance, you can treat the problem effectively to resolve the symptoms.

For this reason, whenever Chinese medicine trained acupuncturists talk about a symptom such as night sweating, or headaches, or pain, we are never simply talking about the symptom by itself. We are talking about all of the other symptoms that may be accompanying the complaint, in order to understand which pattern of imbalance is the true cause. From a Western medical perspective these patterns may all be lumped together as the same condition (such as “headaches” or “insomnia”), whereas in Chinese medicine we may have a number of different types of one condition that are each different because they are each due to a different pattern.

With night sweating, there are a few different patterns of imbalance that can be at work. The most common pattern involved in night sweating is a yin deficiency. Night sweating is commonly seen in people with a yin deficiency combined with internal heat, but can also occur in a heart blood deficiency or a spleen qi deficiency with internal damp accumulation.

So how do these patterns translate into outward symptoms? A deficiency of heart blood would have night sweating along with symptoms of heart palpitations, insomnia, pale complexion, shortness of breath, and fatigue. With yin deficiency with internal heat, night sweats would be frequent with a tendency to feel warmer in the later afternoon, reddening of the cheeks, heat in the chest, and hot hands and feet.  Spleen qi deficiency with damp accumulation would cause night sweats with headaches with a “head full of cotton” feeling, heavy limbs, poor appetite, and slippery or slimy feeling in the mouth.

As you can see, with night sweats there are a number of different situations that can occur. By determining which type of pattern is at the root of the problem, acupuncture can help the body to correct the imbalance and resolve the symptoms- not just the night sweats but accompanying symptoms such as fatigue, insomnia, appetite, headaches, or poor sleep. It is simply a matter of redirecting the body’s energy and to encourage the body’s own natural healing processes.

James Kaufman is a Registered Acupuncturist at Okanagan Acupuncture Centre, 1625 Ellis St, Kelowna, BC.

8 10, 2010

Frequent Urination

Frequent urination can have wide-ranging causes, whether due to a medical condition such as diabetes or a neurological disorder, or from poor kidney function, urinary tract inflammation, bladder infection, or certain medications. In many cases, doctors are unable to exactly identify what’s causing this symptom but nonetheless it can be an uncomfortable and difficult problem to live with.

Frequent or urgent urination in Chinese Medicine (TCM) is most commonly caused by two things. One cause is considered an excess pattern, and the other a deficiency pattern. The excess pattern is that of dampness and heat accumulating in the bladder. Damp-heat can be brought on by a number of reasons, but the biggest reason is poor diet from over-intake of greasy or rich foods, dairy, or hot, spicy foods. Another reason for damp-heat is poor digestion due to a weak spleen and stomach, which can again be caused by poor dietary habits that over time weaken the digestive system.

When dampness accumulates it tends to do so in the lower abdomen where it then stagnates and creates heat or inflammation. If this damp-heat accumulates in the bladder it causes symptoms such as frequent urination with urgency, burning pain on urination, and scanty, yellow, cloudy urine. In Western medicine, this translates into a bladder infection.

The deficiency pattern is due to kidney yang deficiency. The kidneys’ yang energy is responsible for warming and transporting of fluid in the lower abdomen, as well as supplying the bladder with enough energy to contain the urine. Symptoms due to the kidney yang failing to contain urine can include copious clear urine, nighttime urination, lack of warmth in the hands and feet, dizziness, tinnitus and aching low back and knees.

Acupuncture can help strengthen the body to decrease the frequency of urination in many cases. However, in the case of damp-heat in the bladder, stronger treatment is required due to the nature of the problem being an infection, and a visit to your doctor is recommended. In this case acupuncture can be helpful in preventing future bladder infections in people who are prone to them. Acupuncture can help to strengthen a weak spleen and stomach and to clear problems of damp and heat in the bladder that typically lead to bladder infections. This is a good example of how an imbalance in the body can give rise to other health issues, the cause of which may not always be evident.

Acupuncture can be very beneficial in correcting any imbalances in the body that may be impeding optimal health, making acupuncture a very effective treatment method for a wide range of health concerns.

James Kaufman is a Registered Acupuncturist at Okanagan Acupuncture Centre, 1625 Ellis St, Kelowna, BC.

8 06, 2009

Insomnia

Insomnia is one of the most common medical complaints- more than one-third of adults have insomnia at one time or another, while 10-15% suffer from chronic insomnia. With insomnia, a person usually awakes feeling unrefreshed, over-fatigued and has a hard time concentrating during the day. This lack of sleep can sap energy levels and moods, as well as health, work performance, and quality of life. Insomnia can cause daytime fatigue or sleepiness, as well as irritability, depression or anxiety, a loss in concentration and focus on tasks, increased errors or accidents, tension headaches and gastro-intestinal problems. It is a problem that takes a huge toll on a person’s health and well-being.

From a Western medical perspective, insomnia can be caused by stress, anxiety, or depression, medications, caffeine, nicotine, or alcohol, eating too much late in the evening, work schedule, changes in your environment or routine, poor sleep habits, and a variety of underlying medical conditions. Insomnia can also be a result of aging or changes in health or lifestyle. Typical treatment may include making changes to sleeping habits, relaxation techniques, light therapy, behavioural therapy, and in difficult cases, medications.

In Traditional Chinese Medicine (TCM), insomnia covers a number of different sleep-related problems such as an inability to fall asleep easily, waking up during the night, sleeping restlessly, waking up early in the morning, and dream-disturbed sleep. As with Western medicine, the amount and quality of sleep depend on the state of the mind. Because the organ most closely related to the mind is the heart, this organ is often affected in cases of insomnia. If the heart organ is healthy, the mind will be grounded and sleep will be sound; if the heart is deficient or if it is being affected by other internal pathogenic factors in the body, the mind becomes agitated and sleep is affected.

There are seven major factors that lead to insomnia in Chinese medicine: overexertion and worry, overwork (both mental and physical and working long hours without adequate rest), anger-related emotions (including frustration, resentment, and irritation), constitutional weakness that leads to timid character, irregular diet, childbirth, and internal heat in the body. The most important differentiation for insomnia is whether it is due to an excess or deficiency in the body. Once this differentiation is made, there are a number of different patterns that lead to insomnia. Although there are many different patterns that lead to insomnia, treatment will always have the end goal of calming the mind because it is at the root of insomnia, but how this is achieved varies greatly according to the pattern presented.

It is this very specific diagnosis that makes Chinese medicine so effective for insomnia. Treatment will focus on improving quality of sleep but also accompanying symptoms according to the type of insomnia. Thus acupuncture can treat insomnia that consists of restless sleep combined with nightmares, irritability, headaches and dizziness. But it can also treat insomnia that involves difficulty falling asleep, combined with tiredness, poor appetite, anxiety, poor memory and palpitations. Or it can treat insomnia that involves waking up during the night combined with excessive dreaming, talking or walking in one’s sleep, irritability, sore, dry eyes, dry skin and hair, and dizziness. Each of these is considered insomnia, yet each represents a very different type of insomnia and the way that we approach treatment is also different.

In this way, acupuncture uses the body’s own energy to help it to rebalance and return to its natural rhythm, to correct the underlying cause of insomnia and prevent future problems from re-occurring.

James Kaufman is a Registered Acupuncturist at Okanagan Acupuncture Centre, 1625 Ellis St, Kelowna, BC.