How Acupuncture Works to Improve Sleep Part 2: Pathways of Action
Acupuncture, a traditional Chinese medical (TCM) practice dating back thousands of years, has gained significant attention in healthcare because of its far-reaching therapeutic benefits. As we have discussed in our newsletters this month, scientists continue to find more and more evidence that sleep may be one of the most important factors determining our health. We have also discussed the role of acupuncture in contributing to a high quality sleep experience. But how do the tiny hair-like needles used in acupuncture change the processes involved in our sleep?
Mechanism of Acupuncture:
Acupuncture operates on the principle of Qi, or vital energy, which flows through the body along specific pathways known as meridians. Illness or discomfort is thought to arise from blockages or imbalances in the flow of Qi. The practice of acupuncture involves inserting thin needles into specific points along these meridians to restore balance and promote healing. Despite its ancient roots, this fundamental theory has found a parallel in modern medicine in the concept of homeostasis and the body's intrinsic ability to maintain a balanced internal state.
Neurochemical Perspective:
Recent research has highlighted the neurochemical effects of acupuncture, which are particularly pertinent to sleep regulation. Acupuncture stimulates the nervous system, leading to the release of a variety of neurotransmitters and neurohormones. Specifically, it has been shown to increase the production of melatonin, a hormone crucial to the regulation of the sleep-wake cycle (Spence et al., 2004). Additionally, acupuncture has been found to modulate the levels of serotonin and norepinephrine, both of which play key roles in sleep architecture and the maintenance of REM sleep (Zhao, 2022).
Endocrine and Autonomic Modulation:
Beyond neurotransmission, acupuncture also impacts the endocrine and autonomic systems, further contributing to its sleep-promoting effects. Stress, often associated with sleep disturbances, triggers the hypothalamic-pituitary-adrenal (HPA) axis, resulting in elevated cortisol levels. Acupuncture has been shown to regulate the HPA axis, thus reducing cortisol production and facilitating stress reduction (Li et al., 2013). Furthermore, by modulating the sympathetic and parasympathetic branches of the autonomic nervous system, acupuncture can promote relaxation and readiness for sleep (Huang et al., 2018).
Therapeutic Implications and Clinical Evidence:
The sleep-promoting effects of acupuncture have been supported by multiple clinical studies. A meta-analysis conducted by Cao et al. (2009) concluded that acupuncture had beneficial effects on both sleep quality and duration in patients with insomnia. Further, Li et al. (2019) demonstrated the efficacy of acupuncture in reducing sleep disturbances in peri- and post-menopausal women, a demographic particularly vulnerable to sleep problems.
Integrating Acupuncture into Your Healthcare:
Given the growing body of evidence supporting the role of acupuncture in sleep regulation, it is becoming increasingly important for traditional medical professionals to consider the modality of acupuncture as a potential non-pharmacologic therapeutic strategy. When considering the unique factors that are at play in your personal quality of sleep, it is important to keep in mind your other health conditions, your level of physical activity, and factors that may be affecting your emotional health.
Take-Home Points:
Current evidence supports the potential efficacy of acupuncture in improving sleep. By understanding these mechanisms, we hope that you may be better able to incorporate acupuncture into your health practice. Continued research and dialogue between TCM and Western medicine will only strengthen the therapeutic possibilities, improving patient outcomes.