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T1 Lumiere Insomnia
Therapeutics 1, Insomnia, Lumiere, Bastyr
| Question | Answer |
|---|---|
| What are normal sleeping problems: | Sleep difficulties usually relate to stress or pain, often self-limiting |
| Define Insomnia? | Insomnia defined as a chronic inability to fall asleep or to enjoy uninterrupted sleep |
| What percentage of population has difficulty falling asleep? | In 2002 the National Sleep Foundation research found that ~35% of 1000 people had at least one of the following sx every night or nearly every night for the preceding year: |
| What are the general types of insomnia? | Difficulty falling asleep Waking a lot during the night Waking too early and not being able to get back to sleep Waking feeling unrefreshed |
| Describe Factors associated w/ insomnia | A Canadian study found: Being female Being widowed or single Low education level Low income Unemployment Smoking Stress Physical health problems Pain Activity limitation |
| Is insomnia always a secondary disease? | May be secondary (associated with another health condition) or primary (independent) |
| Describe relationship between insomnia and age: | Worsens with age In a family practice study 57% of elderly patients reported insomnia. |
| Associated risks of Insomnia: | Heart disease Depression |
| General biomedical Treatment for insomnia: | Behavioral treatments highly effective, better than medication |
| What is the optimal amount of sleep: | Optimal amount of sleep is 7 hours, w/ 0 naps, or a nap of ~10 minutes |
| DDX of normal sleeping patterns: | Normal drowsiness present Early in am or Mid-afternoon If sleepy at other times then probably not getting enough sleep If tired but can’t fall asleep during the day then likely suffering from fatigue |
| Describe chronic fatigue: | Associated with illnesses and treatments such as chemotherapy Does not improve with rest or sleep |
| Define Insomnia in TCM? | Shen dysfunction |
| 3 Qualities of Insomnia in TCM | Overstimulation and/or agitation from heat Constrained by qi and/or blood stagnation Not anchored by sufficient blood, yin, or jing |
| TCM DDx of Insomnia? | Liver fire Liver blood deficiency Phlegm heat disturbing the heart Heart and/or kidney yin deficiency Heart and spleen qi and blood deficiency Heart and gallbladder qi deficiency Stomach Heat Restless organ syndrome |
| Main Sx of Lv Fire insomnia? | Insomnia, often chronic Irritability, anger Red face and/or eyes Sub-costal (Hypochondriac |
| Tongue and pulse of Lv Fire insomnia? | Tongue: red w/yellow coat Pulse: wiry |
| Tx principles of Lv Fire insomnia? | Clear heat from the heart Soothe liver Calm shen |
| Main points of Lv Fire insomnia? | LIV 2, PC 8, HT 8, HT 6, GB 44, UB 18, Anmian, |
| Other treatments for Lv Fire insomnia? | auricular electroacupuncture 2 Hz con. liver and heart points, or shenmen and liver |
| What Zang Fu are related to Ghost Points: | Heart, Liver, Gall Bladder |
| Heart Signs, symptoms, and indications for ghost points: | Absent-mindedness, mania (excess joy), hysteria, delusion, delirium schizophrenia, excess joy, inappropriate laughter |
| Liver Signs, symptoms, and indications for ghost points: | Irritability, anger, anxiety, fright, lack of muscular control |
| Gallbladder Signs, symptoms, and indications for ghost points: | Difficulty making decisions, mental confusion, suicidal ideation |
| Tongue and pulse for Ghost Points: | Red tongue with a yellow greasy coating Wiry pulse |
| Describe Ghost Point treatment: | Prick and bleed the jing well points on the hand or shi xuan to reduce heat |
| Which points are Ghost points: | Du 16, Du 23, Du 26, LU 11, SP 1, PC 7, PC 8, Ren 1, ST 6, KI 1, KI 4, LI 11, gui feng |
| Describe Gui Feng: | Gui feng is located at the mid point of the frenulum of the tongue, and is bled rather than needled. |
| How many ghost points do you use? | All these points are punctured or pricked to bleed in groups of three points per session. |
| Liver Blood Xu Main Sx: | Insomnia Blurry vision, floaters Tremors, numb extremities Dry skin and hair Scanty menses |
| Liver Blood Xu Tongue and pulse: | Tongue: pale, thin, dry Pulse: thin, choppy |
| Liver Blood Xu Tx principles: | Tonify liver blood Soothe liver qi Reduce liver wind |
| Liver Blood Xu Main points and methods: | LIV 3, LIV 8, SP 6, KD 3, UB 17, UB 18, UB 20, UB 23, GB 20 |
| Main Sx of Phlegm heat disturbing the heart: | Insomnia with a sensation of fullness in the chest Poor digestion, reduced appetite Dizziness, nausea Bitter taste in mouth |
| Tongue and pulse Phlegm heat disturbing the heart: | Tongue: greasy yellow coating, or white w/ deficiency Pulse: slippery |
| Tx principles of Phlegm heat disturbing the heart: | Clear heat from the heart Calm shen Transform phlegm Disperse damp |
| Main points and methods for Phlegm heat disturbing the heart: | ST 44, SP 4, SP 9, ST 40, HT 7, HT 8, PC 6, Ren 12, bleeding ghost points (3 max. per session) |
| Main Sx Heart and/or kidney yin deficiency : | Light, unrestorative sleep w/ frequent waking Difficulty falling asleep Five palms hot Night sweats Palpitations Poor memory Low back pain |
| Tongue and pulse for Heart and/or kidney yin deficiency: | Tongue: red, scanty or peeled coat Pulse: rapid, thin |
| Tx principles Heart and/or kidney yin deficiency: | Clear deficiency heat Calm shen Tonify kidney and heart yin |
| Main points and methods Heart and/or kidney yin deficiency: | KI 3, PC 7, UB 15, HT 6, HT 7, GB 20, UB 23, UB 52, Anmian |
| Main Sx for Heart and spleen deficiency (qi and blood) | Light and/or dream disturbed sleep Palpitations Poor memory Fatigue Low appetite Loose, soft stools |
| Tongue and pulse of Heart and spleen deficiency (qi and blood) | Tongue: pale, thin coat Pulse: thin, weak |
| Tx principles for Heart and spleen deficiency (qi and blood) | Tonify heart and spleen Tonify qi and blood Calm shen |
| Main points and methods for Heart and spleen deficiency (qi and blood) | HT 7, ST 36, UB 15, UB 20, UB 52, SP 6, HT 7, Du 20 |
| Main Sx of Heart and gallbladder qi deficiency: | Timidity, shyness Difficulty making decisions Easily frightened Waking with a start early in the morning |
| Tongue and pulse of Heart and gallbladder qi deficiency: | Tongue: possibly pale w/toothmarks, possibly red-tipped Pulse: wiry or thready, thin |
| Tx principles Heart and gallbladder qi deficiency: | Calm shen Tonify heart qi Tonify gallbladder qi Soothe liver |
| Main points and methods Heart and gallbladder qi deficiency: | HT 7, SP 6, GB 44, UB 15, UB 18, UB 19, Anmian |
| Main Sx of Restless organ syndrome: | Restless sleep Laughing and paroxysmal sobbing Yawning Melancholy Menopausal disorders Urinary incontinence Night sweats |
| Tongue and pulse of Restless organ syndrome: | Tongue: red body, scanty coat Pulse: thin, rapid |
| Tx principles of Restless organ syndrome: | Calm shen Tonify heart yin Tonify spleen qi Soothe liver |
| Main points and methods of Restless organ syndrome: | SP 6, ST 36, HT 6, HT 7, LR 3 + LI 4, auricular shenmen, liver and heart |
| Lifestyle recommendations for Insomnia: | Sleep hygiene Control environmental factors: Noise Light Temperature Timing Exercise (not within 2-3 hours of bedtime) Snacks (very individual as to person and type of snack – know thyself) Bedtime Sleep restriction (limiting # of hours in bed) |
| What insomnia conditioning factors do you avoid for lifestyle recomendations: | Avoiding insomnia conditioning behaviors: Reading or watching TV in bed Alcohol, nicotine, caffeine, or certain medications before bedtime |
Created by:
bastyr41
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