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T1 Lumiere Insomnia

T1 Insomnia, Luniere, Bastyr

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 Positive control on environmental factors Noise Light Temperature Avoid insomnia conditioning behaviors Reading or watching TV in bed Alcohol, nicotine, caffeine, or certain medications before bedtime Timing Exercise (not within 2
Created by: bastyr41