Massage Therapy for Insomnia

Insomnia is a common sleep disorder characterized by difficulty falling asleep, staying asleep, or going back to sleep. This results in poor sleep quality and can lead to daytime impairment and distress. For many people, it’s common to experience short-term insomnia at some point in their lives, which can last for a few days or weeks. But for others, insomnia can become chronic, lasting for months or more. 

Most adults need 7 to 9 hours of sleep a night. If the body does not get enough sleep, it will lack the energy and ability to function completely and optimally. This can compromise things like the immune system, physical performance, cognition, hormonal balance, mood swings, and more — virtually all aspects of the human body. 

Causes of Insomnia

Insomnia is often associated with what western medicine refers to as the circadian rhythm. Also called the biological clock, the circadian rhythm is the series of physiological changes an organism experiences over a 24-hour cycle. The biggest influence on the circadian rhythm is light intake, followed by diet, stress, physical activity, temperature, and social environment. 

For example, things that may interfere with the circadian rhythm include:

• Not getting enough daylight during the day 
• Thinking about life concerns that keep the mind up at night
• Bedtime habits that prevent the body from relaxing before trying to sleep (such as working, eating, watching screens, etc.)
• Consuming any food, medication, or substances that contain stimulants (like caffeine) too late or too early in the day
• Medical conditions that cause pain or disrupt sleeping (such as sleep apnea, which inhibits breathing)

Insomnia is one of the most common symptoms of an irregular circadian rhythm. It is a natural consequence of an offset biological clock, reflecting the body’s inability to relax at appropriate times of the day. If the circadian rhythm is offset for an extended amount of time, it will result in negative health effects that may eventually compound into more serious health conditions later on. 

Treating Insomnia

In western medicine, there are two primary ways to treat insomnia: prescription medication, or cognitive behavioral therapy (CBT).

Prescription sleeping pills can help the body fall asleep and stay asleep, but generally doctors do not recommend relying on them for more than a few weeks, as they often come with negative side effects, such as cognitive or physical impairment. 

Alternatively, behavioral therapy, which is usually recommended as the first treatment for insomnia, involves developing habitual strategies to control or stop thoughts and actions that keep the mind awake. This includes stimulus control therapy (which helps associate the bed with sleep, specifically), light therapy, nutrition therapy, and sleep restriction (restricting naps). Some doctors may also prescribe certain relaxation methods, such as breathing exercises, meditation, or massage therapy. 

TCM and Insomnia

Traditional Chinese Medicine (TCM) approaches the causes and treatments for insomnia from a holistic perspective, focusing on the balance of the body's energy (Qi), blood, and organs. TCM recognises different types of insomnia, each with its unique set of causes and symptoms. Depending on the diagnosed type of insomnia, TCM will utilize a combination of herbal medicine, massage, acupuncture, dietary adjustments, and lifestyle modifications. 

From a TCM perspective, insomnia is heavily associated with stress and anxiety, which can correlate with certain organs and their meridians. Here are a few examples of the energetic causes of insomnia, according to TCM:

• Kidney Yin Deficiency. The health of the kidneys reflect the quality of energy, youth, and vitality in the body. A deficiency of yin energy in the kidneys can contribute to insomnia. 
• Heart Disharmony. The heart is affected by all emotions. Both deficiency or excess in the heart may contribute to insomnia by affecting its synergy with other organs. 
• Liver Stagnation and Deficiency. The liver is strongly affected by stress and frustration. Frequent stress can stagnate the liver energy, which can cause insomnia. Deficiency of liver blood can also be a cause.

Massage for Insomnia

Massage therapy can be an effective complementary treatment for insomnia, with no contraindications. However, for the best treatment, it is recommended to use all and any strategies to specifically promote relaxation. 

In the massage room, this can include using a combination of soft lighting, soothing music, and temperate heating. During the intake, using rhetoric that emphasizes thoughts of positivity and healing may also help promote the healing process on a psychological level by directing the mind away from current stressors. For the massage itself, techniques that are generally calming (rather than vigorous or energizing) should be prioritized. 

Overall, any general relaxation massage will help treat insomnia. However, by identifying the organs involved with insomnia, according to TCM, certain acupressure points can be integrated into the massage pattern, thus improving the effectiveness of the treatment. Here are some acupressure points that can help insomnia, taken from “Acupuncture Points Handbook” by Deborah Bleecker: 

Head

• Du 20. Top of the head, aligned with top of ears. (p.71)
• Si Shen Cong – Four Alert Spirit. A group of four points located one finger (1 cun) away from Du 20 in each direction. (p.247)
• Yin Tang – Hall of Impression, or Spirit Gate. Midway between medial ends of eyebrows. (p.251)
• An Mian – Peaceful Sleep. Calms the spirit. Treats insomnia. Located 1 finger behind the earlobe. (p.236)

Hands

• Heart 7. Important point for calming the body. Located in the ulnar side (little flinger) wrist crease, on the later side of the tendon. (p.103)
• Heart 8. Between fourth and fifth metacarpal bones, where the little finger can touch the palm. (p.104)
• Pericardium 6 – The Insomnia Point. “Acupressure done with a magnetic pellet is very effective to treat insomnia. Just place the magnetic pellet on the point an hour or so before bed, and take it off in the morning. It will help you get to sleep and stay asleep all night.” Located 2 fingers (2 cun) above the wrist crease, between the tendons in the midline of forearm. (p. 159).
• Pericardium 7. In the middle of the wrist crease, between the tendons. (p.161)

Feet

• Kidney 1. Sole of foot in center depression when the foot is flexed. (p.106)
• Kidney 3. The “most important point of the Kidney”. Treats insomnia due to kidney weakness. Located in the depression in midpoint between the medial ankle bone and back of leg. (p.107)
• Kidney 6. Major point for insomnia. Located in depression directly below ankle bone. (p.111)
• Spleen 6. A multifunctional point that regulates and strengthens the Spleen, Stomach, Kidneys, and Liver. Very calming and treats the underlying cause of insomnia. Located 3-4 fingers (3 cun) above the tip of the medial ankle bone. (p.189)
• Liver 2. Major point that treats stress and excess liver energy. Located between the big toe and second toe, in the web margin. (p.137)
• Liver 3. Relieves stress and anger. Very relaxing. Slightly above the web of Liver 2. (p.139)

Back

• Bladder 15. On back erectors, between T5 and T6. (p.42)

References

Insomnia. https://www.mayoclinic.org/diseases-conditions/insomnia/symptoms-causes/syc-20355167

The beneficial effects of massage therapy for insomnia in postmenopausal women. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4521661/

Circadian Rhythms. https://www.nigms.nih.gov/education/fact-sheets/Pages/circadian-rhythms.aspx#:~:text=Study%20Circadian%20Rhythms-,What%20Are%20Circadian%20Rhythms%3F,and%20temperature%20also%20affect%20them.

Circadian Rhythm Sleep Disorders. https://my.clevelandclinic.org/health/diseases/12115-circadian-rhythm-disorders

The Different Types of Insomnia in Chinese Medicine. https://healthinflow.com.au/the-different-types-of-insomnia-in-chinese-medicine/

The effect of classical foot massage on insomnia and anxiety in preeclamptic pregnant women: a randomized controlled study. https://pubmed.ncbi.nlm.nih.gov/38422316/ 

Massage Therapy Can Help Improve Sleep. amtamassage.org/about/position-statements/massage-therapy-can-help-improve-sleep/

New Research Continues to Support Massage for Improving Sleep Quality. amtamassage.org/about/news/massage-for-sleep-research/

Randomized control trial evidence for the benefits of massage and relaxation therapy on sleep in cancer survivors—a systematic review. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8448699/

Sleep Toolkit: Tools for Optimizing Sleep & Sleep-Wake Timing | Huberman Lab Podcast #84. https://www.youtube.com/watch?v=h2aWYjSA1Jc

Massage For Insomnia

I was given the assignment of blogging about a "disease" and the benefits of massage therapy, as a homework assignment. Near and dear to my heart, I chose insomnia. For years I have been dealing with this issue and until recently just thought it was something that I needed to find the right prescription for. Why do people have insomnia? I read a concept a couple months back, that changed it all for me. Internal disharmonies make the spirit restless and it cannot be properly housed, and the spirit will wander.
So, how do we fix that? First, we need to address the disharmony. Treatment for this disease should include massage therapy. Regular massage can decrease your stress level on a physical and psyche level. If pain is a factor in insomnia, therapeutic massage relieves pain, promoting better sleep. Massage also increases seratonin levels, which produce melatonin, which governs our circadian rhythm that regulates our sleep cycle.
There are several acupressure points/protocols that a massage therapist can stimulate to encourage sleep. Application of essential oils can also be very beneficial. Fill a 15 dram bottle with a carrier oil, add 4 drops of lavendar, 2 drops of bergamot, 2 drops of marjoram, 1 drop of clary sage and 1 drop of ylang ylang.
I definitely recommend seeing your TCM (Traditional Chinese Medicine) practioner to find the source of your insomnia, then find a massage therapist that you vibe with and enjoy the peaceful sleep you will find.

Cynthia's Top 10 List for Insomnia

Sleep is so incredibly important to our health in ways that we often forget. Good sleep helps us lose weight, improves our creativity, and even lifts our mood. Because the lack of quality sleep is such a common complaint, I would like to offer my top 10 suggestions for insomnia. None of these have any bizarre or undesirable side effects like many of the medications prescribed, and they all help your body get back to doing what it's naturally supposed to do, sleep like a baby:

1. Massage Therapy - on a regular basis if needed. Once a week for 2 months can work wonders to re-train your body into a relaxed state that can be maintained.


2. Meditation - the slow, deep abdominal breathing and gentle calming of the mind quiets the heart and preps the spirit for good sleep.


3. Self Acupressure - first, use your middle and index fingers to rub the area at the bottom and behind your ears. Second, massage your inner wrist crease at the indentation on your pinky side. Third, massage along your shin bone from your inner ankle, up about 4 inches and back down. Last, rub the bottom of your feet with special attention to the area just under the ball of your foot and also the middle of your heel. Spend 1-5 minutes on each of the above areas just before you go to sleep.


4. Essential Oils - Try Lavender, Rose, Vetiver, or Sandalwood. Either use topically by diluting them in a carrier oil or lotion and applying to the above acupressure areas, or diffuse them into the air by adding about 4-5 drops to a bowl next to your bed, then fill with boiling water.


5. QiQong or Yoga Practice - both of these mind-body exercises are excellent to smooth your energy and make you more aware of unhealthy responses to stress you may have. The breathing involved, like in meditation, gives you a different response to that stress.


6. Valerian Tea or Tincture - Valerian is a strongly relaxing herb that can even be used for anxiety attacks. Drink a cup of tea or put several tincture drops in water and drink just before going to bed, but don't use it for more than about 2 months. If too much valerian builds up in your system it can cause anxiety or nervous symptoms instead of relieving them.


7. "Body Like Jello" Relaxation - Go through each bodypart head to foot and focus on it while saying, for example "I feel my right arm. Release and relax. My right arm is so relaxed it feels like jello." Your mind is actually strong enough to evoke this physical response in your body.


8. Chinese Herbs - these formulas are very individual. Consult a professional herbalist or acupuncturist for a formula appropriate for you.


9. Hot Foot Bath - get a home foot bath/spa, fill it up with hot water, add 4 drops of Lavender essential oil, and turn it on. If you have the time, a full body hot bath works great too.


10. Just Turn It Off! - make the decision and follow through with just turning off your TV or computer. It's a choice and you're in charge.

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