Treating Insomnia in Elderly with Traditional Chinese Medicine

Insomnia remains one of the most common disorders encountered in my clinic experiences. Sleep difficulties and several primary sleep disorders increase in prevalence with age, frequently characterized by difficulty falling or maintaining sleep, frequent awakening, and early morning wakefulness. In older adults, insomnia is most often associated with other conditions, such as ingestion of caffeine, alcohol consumption, sleep apnea, medical disorders, nocturia, anxiety, and depression. Medications such as beta-blockers, glucocorticoids, nonsteroidal anti-inflammatory drugs, decongestants, and antiandrogens may be one of the factors contributing to insomnia.

In TCM, imbalances of the inner organs can cause deficiencies, leading to insomnia. The most common cause of insomnia is Liver Yin deficiency. The liver metabolizes essential hormones that regulate the sleep-wake cycle includes both melatonin and cortisol. In patients with hepatic insufficiency, melatonin clearance is slow, and melatonin levels are high during the daytime leading to melatonin secretion patterns with the peak of secretion being delayed. Therefore, the sleep onset is delayed as well. Low cortisol levels are necessary for falling asleep. Cortisol begins its rapid rise after the first-morning awakening and continues. Cortisol in the blood is supposed to be cleared by the liver during the day and low at nighttime. Elevated cortisol levels at night can cause difficulty falling asleep. Recent studies have found that acupuncture increases biochemical concentrations that benefit sleep. Chinese herbal medicine has a long and established history of treatment protocols for the relief of insomnia. This includes everything from ancient writings to modern research.

To be successful for the treatment, we have to go to the underlying causes as well. TCM is a non-invasive way of treating insomnia by using Acupuncture, Chinese Herbal, Cupping and Massage. Also, I’d like to combine various disciplines that include everything from diet and exercise to mental conditioning and lifestyle changes to promote a good night’s sleep. 

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