(281) Treatment for Insomnia

[HB KIM]

TREATMENT FOR INSOMNIA

A.   Regular Points 

1. HT7
HT7 works similarly as the herb Suan Zao Ren or Long Yan Rou to treat insomnia.  They both nourish HT Blood and calm the Shen.  The name "Shen Men" means "Spirit Gate," and this point nourishes the Heart and calms the Shen.  HT7 and the auricular point Shen Men have the identically same name, so they are often combined as a Dui-Xue (point pair) to increase the calming effect. 
HT7 has other applications besides insomnia.  Clinically, HT7 is good for constipation caused by stress-induced qi stagnation.  The constipation caused by qi stagnation from retaining the needle too long at ST34 can also be relieved by HT7.  In this way, we can say that HT7 is the "antedote" for misuse of ST34.
For pain on the calcaneal aspect of the sole of the foot, needle HT7 on the opposite side.  It can treat heel pain because it resembles the heel, and it can balance the KD Foot Shao Yin channel since it is the Hand Shao Yin channel.

2. SP6
SP6, a famous gynecological and yin-nourishing point, can treat insomnia due to hormonal imbalance (which is usually associated with Kidney yin). 
Although it's one of the basic points for insomnia, it is more famous for treating gynecological disorders.  It can simply be used for most gynecological disorders including amenorrhea, dysmenorrhea, leukorrea and difficult labor.  However, it shouldn't be used in cases of excessive uterine bleeding or pregnancy since it has a strong descending energy.  Some texts note that ST36 is the "Upper San Li" while SP6 is the "Lower San Li," which makes these points a good combination for lower abdominal pain.

3. An Mian & GB12
An Mien and GB12 are very close in location, and both treat insomnia effectively.  An Mien is a famous empirical point for the treatment of insomnia, while GB12 is described as a "hypnotic" point.  GB12 acts like a sink to drain away disturbing thoughts, help to forget bothersome things and fall asleep more easily.  Some texts even warn that long term use of GB12 may cause some loss of memory.
Besides the treatment of insomnia, GB12 can treat certain types of pain.  The pinyin name of GB12 is "Wan Gu," which is the same name as SI4.  If there is a pain in the GB12 area, SI4 can treat it and vice versa.  GB12 is also used for neck area pain or pain at the root of the eye.

4. GB31
Lastly, GB31 is the only lower-body point with "Wind" in its name. "Wind Market" (GB31) reflects its ability to treat internal or external wind, such as skin issues or wind-related insomnia.  Clinically, GB31 is more famous for treating lower leg or foot weakness and insomnia.  Moxa on GB31 is also good for increasing energy and combating fatigue.  GB31 is usually located where the tip of the middle finger touches the thigh when the patient is standing erect,  but you can also use the tender spot above or below the traditional location.


B.   Master Tung Points
1. Lower Three Emperor + Zhen Jing (Yin Tang)
The Lower Three Emperor points include Tian Huang Fu, Di Huang, and Ren Huang.  Tian Huang Fu is located 1.5cun below SP9 and is called the "heaven emperors Fu".  Di Huang is located at SP7 and is called the "earth emperor", while Ren Huang is located at SP6 and is called the "human emperor".  These three points are famous for KD tonification, can tonify the SP as well because they are on the SP channel, and have strong calming properties.  In herbal medicine, these points are similar in effect to Tian Wang Bu Xin Dan (KD and HT) and Gui Pi Tang (SP and HT).  Zhen Jing (Yin Tang), which shares the same location as the third eye and the Brow chakra in the Indian system, is called the upper Dan Tian in Oriental philosophy, and is very effective as a calming point.  The grouping of Lower Three Emperors and Zhen Jing together is a strong point combination for the treatment of insomnia.  Three points in the lower body on a yin channel balance well with one in the upper body on yang channel.

2. Jian Gu
Jian Gu is located midway between LI3 and LI4.  Ling Gu is at the junction of the first and second metacarpal bones.  Jian Gu is less well known than Ling Gu, He Gu, and Da Bai.  LI3 (Da Bai) is used to treat the face area, LI4 (He Gu) is more for middle Jiao and intestinal problems, and Ling Gu is used to treat the lower Jiao and sciatica.  In holography, or holographic theory, one part of the body represents the entire body.  The second metacarpal bone can represent the entire body in a holographic relationship, and therefore the points along this bone can be used to treat those areas.  As LI3 treats the face, and LI4 treats the middle jiao, Jian Gu is between these two points and so can treat the space between the face and middle jiao on the body, the chest.  This point, Jian Gu, is a great choice for patients with insomnia and stagnation or stuffiness in the chest, where there are no particular symptoms in the head or brain area. The combination of Jian Gu + LV2 is an "anterior version" of the Four Gate treatment which addresses insomnia well.

3. Wu Ling
These 25 points on the back are used for chronic insomnia, and are needled with a bleeding technique.  Chronic insomnia often involves blood stasis, so bleeding technique is used because it is good for treating the blood stasis.  A description and the location of these points will follow in a later article.


C.   Formulas For Chronic Insomnia
If someone has insomnia for 20-30 years, they have chronic insomnia, and usually either blood stasis or phlegm is involved.  Typically any chronic diseases will have blood stasis or phlegm as part of the diagnosis, and so it is very important to treat these problems.  Xue Fu Zhu Yu Tang is good for blood stasis patterns for chronic insomnia; Gui Pi Tang +  Wen Dan Tang is a great combination as well for chronic insomnia.  Additionally, ST40 bleeding can take care of phlegm and stasis in chronic cases or difficult diseases, because ST40 is indicated for phlegm, and bleeding technique can be used to treat blood stasis.


D.   Concurrent Pain and Insomnia
If the patient has pain and insomnia together, including fibromyalgia, arthritic pains, and traumas with insomnia, then GB31 is a good choice.  GB31 has a calming and analgesic action at the same time.  Yan Hu Suo, Corydalis, is also a good treatment for that as well.  It does not directly calm the shen, but by relieving the pain, it treats insomnia.  So in this case, Jian Gu plus GB31 is a good combination.  Jian Gu is a Tung style point, and GB31 (Zhong Jiu Li) is another Tung point.  The combination of these two points is quickly effective, and the patient will be able to sleep longer and will be able to fall asleep easier.