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

Natural Therapies for Insomnia

Natural Therapies for Insomnia
Acupuncture & Herbs
Massage Therapy
Energy Healing
Meditation / QiGong
Essential Oils & Ear Reflexology

Sleep disorders plague millions of Americans and can be attributed to a variety of causes. Perhaps the main cause of insomnia and restless sleep is the whirlwind pace that most modern people live with day in and day out. Our society emphasizes ‘doing’ much more than ‘being’.

From the perspective of acupuncture, the yin aspect of life is quite depleted for the average modern American.  [

In case you have never heard of yin and yang, these are the polar forces that are reflected in everything in the natural world. Yin is related to stillness, tranquility, and contemplation. Yang is related to movement, accomplishment, and function. We need yin and yang to be in balance within ourselves in order to experience true health and wellbeing.

When we are yin deficient, we easily become restless, irritable, and excessively busy. Our ability to rest and restore is compromised, as we never seem to get a break from the constant activity in our minds and our lives.

This is one of the main dilemmas that we face in terms of experiencing deep states of continuous sleep. We have forgotten how to turn our minds off due to the frantic speed of everything around us and we have become yin deficient.

The common word is stress, but there is a lot more to this picture than is implied. Another way to look at this is that the sympathetic nervous system is on overdrive. We are stuck in fight or flight mode, as we are trying to keep up with our hectic schedules and myriad responsibilities. We have excessive amounts of cortisol and adrenaline in our systems, which keep us feeling amped up and unable to rest.

With the pattern of yin deficiency and a hyperactive sympathetic nervous system, we often feel too warm, excessively thirsty, dried out, and anxious. This pattern is extremely common in menopausal women. Due to the fact that we are in fight or flight, we sometimes can’t tell if we are tired. We often feel wired or manic. Yet other times a deep-seated exhaustion is felt that penetrates into our bones.

There are many other factors that contribute to insomnia, but this is the primary issue that many people are facing. Other potential inputs are nutritional imbalances, suppressed emotions, relationship troubles, hormonal imbalances, and energetic imbalances.

Let’s take a look at a few of the top natural treatment options for insomnia:

1) Acupuncture: All of the major organs of the body are related to specific kinds of insomnia. For instance, there is a liver/gall bladder insomnia in which one is kept awake strategizing, planning and scheduling their lives at night. This person often can’t turn their minds off unless they read or watch TV before bed. Likewise, there are kidney, heart, lung and spleen forms of insomnia that all have specific manifestations. Acupuncture is an excellent treatment option for insomnia, regardless of its etiology.

For chronic insomnia, we generally recommend receiving acupuncture once a week for 4-6 weeks, then we can assess for progress. Acupuncture helps to restore balance to the central nervous system and harmonize Qi, the functional energy that underlies our general state of health. Qi can either become stagnant, meaning that too much energy is locked up in a certain area or organ, or it can become deficient, meaning that there is not enough energy in an area or organ. Either pattern can cause insomnia and both are treatable with acupuncture.

2) Herbs: There are many Chinese and Western herbs that can be very helpful for insomnia. Chinese herbs are typically used in combination to create formulas that treat specific patterns of disharmony. Western herbs are frequently used on their own. The great thing about herbs is that they don’t cause the drowsiness and disorientation that many of the Western sedative drugs do. Here is a great list, and our Acupuncturist can help you make an appropriate selection.

·         Valerian: Has mild sedative properties that help to relax the nervous system and calm the mind.

·         Chamomile: Has a mild tranquilizing and calming effect that soothes all major systems of the body.

·         Kava: A highly prized medicinal that is used to alleviate anxiety and induce deeper sleeping patterns. Kava is contraindicated for those with Liver disease.

·         Gui pi tang: A Chinese formula that nourishes the heart and spleen, for insomnia with low energy, nightmares, anxiety, depression, and possibly night sweats.

·         Tian wan bu xin dan: A Chinese formula that balances the relationship between the heart and kidneys, for symptoms such as insomnia, low back pain, anxiety, feeling of heat, thirst, and night sweats.

·         Suan zao ren tang: A Chinese formula that nourishes the heart and liver, for insomnia irritability.

·         An mian pian: A Chinese formula translated as peaceful sleep, for insomnia due to heart blood deficiency.

3) Massage Therapy:  This is the ultimate way of teaching our body how to go into a deeply relaxed state.  Through massage, our muscles relax, circulation flows smoothly, and our mind quiets.  For insomnia, we recommend getting a massage once per week for 5-8 weeks to start making full relaxation a welcome change. We like to reassess at this point to see if continued  weekly massage is still needed, or changing the frequency to a massage every 2-4 weeks would be of better benefit.  The goal is to re-train the body to attain and maintain a state of pure relaxation and great sleep on its own.

4) Energy Healing:  Many people find light touch/no touch energy healing helps them to reach a mind state that is so relaxed it becomes a mentally transformed experience.  In this altered state, it can feel like floating, energetic sensations throughout the body or in focused areas, and simultaneously being in a deep sleep while being aware of not being asleep.  Medical QiGong Energy Healing uses the same energy pathways as acupuncture, and externally re-balances energy (Qi) flow to assist in healing symptoms.

5) Meditation and QiGong: Meditation – either still or gently moving like QiGong, is a deeply restorative practice and can replicate many of the benefits of sleep. In fact, meditation is often considered to be even more beneficial because it can lead to a state of non-thought, which is said by many spiritual traditions to be the deepest state of relaxation and healing possible for human beings. In sleep, our minds are still processing and dreaming. Spend 15 minutes before bed meditating and it will quite likely allow you to fall asleep faster and to sleep more peacefully. Not sure how to do this? We can teach you, and there are many excellent guided meditations.

6) See our YouTube video on Essential Oil and Ear Reflexology for Insomnia. Click the image to access the video.

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.