Jeremy Riesenfeld
Acupuncture
1645 Connecticut Avenue Northwest, Washington D.C. 20009
15 years exp

Total years in practice: 15

Publish Date
December 10, 2019
Patient
28 Years, Female, White
Medical Condition
Insomnia
Therapies
Acupuncture
Medical History

"Jennifer" is a 28-year-old patient who came to my office in April with lifelong chronic insomnia, which had been getting worse in the last 6 months. Read her case study to determine how acupuncture, Chinese herbs, diet and exercise changes, and"sleep hygiene" alterations helped her completely overcome her chronic insomnia in 2 months.


Background


It regularly took her over 1 hour to fall asleep, even when she was exhausted, and she would wake up several times every night. In addition, her sleep had always been mild, and due to the lack of deep sleep, she woke up feeling lethargic, tired, and irritable. Her lack of sleep negatively affected her energy levels during the day. Her facial skin color was light, with an orange coloration under her eyes.


Her insomnia was getting much worse over the past year, so she decided to look for acupuncture as a natural way to heal her sleep difficulties.


I started by asking Jennifer what she'd already tried. She had tried a huge array of herbal teas and over-the-counter sleep aids and nutritional supplements. Some had some positive benefits for a time, but none had left a sustainable difference in her sleep patterns. She had tried stronger pharmaceutical sleeping medications, but was fearful of developing a long-term addiction, and ceased after she ended up feeling dependent on them.


She had also implemented other sleep strategies, like relaxing reading before bed, no TV at night, keeping the bedroom cool, and taking a warm shower to relax, but none of them had any significant effect.


Her diet consisted of"a lot of salad," chicken, occasional red meat, and much more than a liter of water per day. Her exercise routine consisted of a 20-minute walk per day.


Other health symptoms included headaches (2x/week, throbbing sensation on the temples), intermittent migraines, consistently cold hands, and anemia.


The anemia grabbed my attention, and I asked Jennifer further about this. She reported that she was a consistent blood donor for the last several years, and felt strongly about donating blood as far as possible. According to a blood test report done by the blood donation center, Jennifer's hemoglobin levels had dropped slightly below the minimum levels to be allowed to donate blood--that had happened 2 times in the past 3 decades. However, in the past 3 months, her blood hemoglobin levels had dropped precipitously, and she wasn't permitted to donate on her final attempt about a month before coming to see me.


Diagnosis


This caught my attention because two of the significant causes of insomnia in Chinese medicine fall in the category of Blood Deficiency. Heart Blood Deficiency causes difficulty with falling asleep, and Liver Blood Deficiency causes problems with the thickness of sleep and staying asleep through the night. Jennifer had all of these symptoms. Cold hands, pale facial skin, and orange facial skin coloration will also be signs of Blood Deficiency.


However, Blood Deficiency was not the only issue.

Case Management

Acupuncture and Chronic Insomnia Treatment 

First treatment

For Jennifer's first acupuncture treatment, I began with the overall energy balancing and clearing therapy known as AE (using the acupuncture points Bladder 13, 14, 15, 18, 20, 23, and Heart 7).


To nourish Blood Deficiency:

Greater intake of saturated fats from similar farm resources, including eggs, butter, bacon, lard, beef fat, and coconut oil


To launch Liver Qi Stagnation:

3 days per week of reasonably intense cardio.

To enhance"sleep hygiene" (these tips all help reduce stiffness to the body and mind )

Hide all clocks, to reduce worry over what time is spent awake at night

Turn off cell phones and all other electronics

Avoid eating too close to bedtime, but don't go to sleep hungry




Second treatment--one week later

Jennifer reported that she woke up half as often each night than she had the preceding week and that she had experienced no change with falling asleep.

For the acupuncture treatment, I used the Liver Global Balance treatment from Dr. Tan's Balance Method school of acupuncture. This therapy comprehensively addresses both the Liver and Heart Meridians. The acupuncture points used were Heart 3 and 7, San Jiao 10 and 3, Liver 3 and 8, Gallbladder 34 and 41.

Moreover, I added acupuncture points designed to promote sleep and encourage greater emotional peace (An Mian, Shen Men, Yin Tang).


Third therapy --one week after

Jennifer reported that the herbs were helping her get to sleep more easily and that waking up in the middle of the night was about 50% improved. She was also waking up more easily in the morning, requiring less recovery time. I repeated the Liver Global Balance therapy with additional points.


Fourth treatment--one week after

Jennifer reported that unusually for her, she remembered dreaming, and felt that her sleep was getting deeper. I replicated the Liver Global Balance treatment with added points and recommended an additional Chinese herbal medicine formula to nourish Heart Blood Deficiency, An Xin Pian (with added ingredients), which is designed to help with falling asleep more easily. I adjusted the dosage of each formula to 2-3 tablets each, 30 minutes before bed.


Fifth treatment--two weeks later


Jennifer reported that she was sleeping through the entire night, and the time required to fall asleep had reduced from the original 60 minutes to 20-30 minutes. She was feeling more lethargic upon waking up, and not wanting to get out of bed. However, in the past week, she'd experienced a greater level of anxiety than usual from work, due to a personnel shakeup in her workplace, requiring increased levels of productivity from her during the day.


I asked Jennifer if she had a stress management or meditation method for dealing with anxiety, and she reported that she did not. I introduced the concept of daily 5-minute meditation practice and instructed her in the meditation way of allowing all ideas, emotions, and sensations to be as they are, without making any effort to change them. I also advocated that the text Actual Meditation by Adyshanti, which clarifies this meditation approach.


I repeated the Liver Global Balance treatment with additional points and applied lavender essential oil to the points to reduce overall stress, and to assist with the stress-induced headaches that she had been experiencing.


Sixth therapy --one week later

Jennifer reported that she was still sleeping during the night, with occasional fantasies, but still took 30 minutes to fall asleep. In the mornings, she had no problems getting up, and throughout the day, the headaches had completely ceased.


I adjusted her dosage to 3-4 of a Xin Pian to help with falling asleep, and two of those Suan Zao Ren Tang, 30 minutes before bed. I repeated the Liver Global Balance therapy with additional points.


We also discussed the meditation practice instructions and clarified the point that in this sort of meditation, the objective isn't to clear the brain, but rather just to be present to the thoughts and emotions that arise, and allow them to be as they are, without trying to manipulate them.


Seventh treatment--two weeks later

Jennifer reported that she was now falling asleep in 15-20 minutes, and staying asleep through the night. She was having no issues with waking up, and her energy levels were good during the day. Her facial skin tone had brightened, and the orange shade underneath the eyes had largely disappeared. The flow to her hands had improved, and her headaches were much less frequent. Her eyes were brighter, and she reported that her husband was very happy about how different she was in the mornings. I repeated the Liver Global Balance treatment with additional points, and we discussed what she'd continue the herbs for another 1-2 weeks, and then take a break. She was able to recover from chronic insomnia after Acupuncture treatments.


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