Up to 35% of Americans struggle with insomnia, and for many of them, effective treatment can be hard to come by. Often patients with insomnia want to reduce their symptoms while avoiding medications that can be costly and have side effects.
Acupuncture, a type of therapy that is based in traditional Chinese medicine, offers a different approach. By stimulating specific pressure points in the body, acupuncture has been found in multiple research studies to improve the quantity and quality of patients’ sleep.
Because it is not a standard part of western medicine, many people don’t know about acupuncture, or they may have misconceptions about it. This article hopes to clear up the confusion by describing acupuncture, discussing its potential benefits and downsides, and addressing how it can contribute to better sleep.
What is Acupuncture?
Acupuncture is a medical treatment that is based on stimulating specific pressure points in the body. Thin needles inserted through the skin are the central means by which these pressure points are accessed. The needles may be moved, twisted, or heated in order to modify the effects on certain pressure points. In electroacupuncture, needles carry a low-voltage current.
Though needles are the most common means of manipulating pressure points, other methods may be employed. These include lasers, ultrasound, and acupressure, which simply applies pressure in particular parts of the body.
Acupuncture comes from traditional Chinese medicine and has been used for thousands of years. It is considered to be a type of complementary and alternative medicine (CAM), meaning that it may be used in conjunction or in place of other medical treatments.
The exact mechanisms by which acupuncture works in the body are still being researched. Traditional understandings of acupuncture in the context of Chinese medicine focus on how the pressure points fit within the flow of energy -- known as Qi, the basic life force -- within the body.
Because western medicine does not subscribe to this understanding of Qi, researchers have sought out other explanations for how acupuncture may affect the body. To date, however, there is a great deal that remains to be discovered regarding the mechanisms by which acupuncture impacts the brain and body.
What Are the Potential Benefits of Acupuncture?
Acupuncture has the ability to resolve or manage a wide range of health conditions. In some cases, acupuncture may be used as the primary treatment, while in others it may be used as an adjunct to other therapies.
Some of the biggest benefits of acupuncture may be found in treating pain (including lower back pain), fibromyalgia, addiction, headaches, depression, allergies, and nausea and vomiting (including from morning sickness). It can be useful for reducing side effects of treatment in cancer patients undergoing surgery, radiation therapy, and/or chemotherapy.
Acupuncture may be beneficial for many other health conditions as well, but in most cases, clinical evidence for its optimal role is limited. While acupuncture has centuries of anecdotal evidence supporting its use for a range of health issues, western medicine has only recently begun to thoroughly evaluate it using the standards of evidence-based health care. Those standards focus on controlled clinical trials, which are research studies involving people that attempt to isolate the effect of acupuncture as a form of therapy.
Clinical trials can be designed in many ways, and there are benefits and downsides to every type of clinical trial structure. The fact that these research studies are not centrally coordinated means that many studies focus on patient populations that differ based on their health problems, age, gender, and/or race. The studies may employ distinct methods of acupuncture including diverging schedules for therapy.
The end result of this diversity in research studies is that in many cases it is challenging to draw definitive conclusions about the exact benefit of acupuncture. Nevertheless, the World Health Organization (WHO) issued a summary that listed the conditions that acupuncture may help treat. This list includes those diseases that have clear evidence supporting the use of acupuncture and those that have positive early research but require further study.
Some research studies have compared health outcomes in patients who receive actual acupuncture treatment with those who receive “sham acupuncture,” a procedure that simulates acupuncture but does not actually activate pressure points. While acupuncture frequently outperforms sham acupuncture in research studies, many participants receiving the faux acupuncture still can benefit from that therapy. This indicates that a positive placebo effect may help contribute to the physiological effects of acupuncture and leads many practitioners to encourage patients to approach this therapy with an open mind.
What Are the Potential Downsides to Acupuncture?
When conducted by a trained professional, acupuncture rarely has any notable side effects. Even when negative effects do occur, they are generally minor. A 2012 review of research studies found that 95% of adverse effects caused little to no harm.
The most common side effects have to do with bleeding and feeling faint. A small number of patients report bruising or bleeding, especially if they are on blood-thinning (anticoagulant) medications. Some people, especially those who have fears of needles, describe feeling light-headed, dizzy, or prone to falls after acupuncture treatment.
As with most medical procedures, risks can come into play if the treatment is not done correctly or according to standards. It is essential that the acupuncture provider use sterile needles and know where and at what depth to place needles. Incorrectly placed needles can cause damage including a punctured lung or internal bleeding. Some patients have reported needles still in the skin that were accidentally left behind after treatment.
Trained and qualified providers follow procedures that dramatically reduce these risks. For this reason, when carried out properly, acupuncture is well-tolerated and generally considered to be safe.
Can Acupuncture Help With Sleep?
Evidence from research studies indicates that acupuncture can help treat sleeping problems. In the WHO’s review of acupuncture, insomnia was listed as a condition for which the benefit of acupuncture has been shown but for which further evidence is needed.
A meta-analysis published in 2009 found that acupuncture could help resolve insomnia. In prior studies reviewed in this analysis, patients who received acupuncture consistently had better outcomes than those who received sham acupuncture or no treatment. Studies also pointed to the benefits of combining acupuncture with other therapies for insomnia.
One way that acupuncture may help with sleep is by improving the timely production of melatonin. Melatonin is a hormone that the body normally starts producing as the day moves into night. It helps to transition the mind and body from wakefulness to sleep. In one small study, acupuncture was found to boost nocturnal melatonin production and improve sleep in people with anxiety and insomnia.
There is some preliminary evidence that acupuncture may reduce sleep disturbances associated with obstructive sleep apnea (OSA). OSA is a health condition defined by frequent lapses in breathing at night that occur because of the blockage of air in the airway at the back of the throat. OSA is associated with significant daytime sleepiness and other serious health consequences. A research team in Brazil has found that acupuncture could help strengthen the tongue to reduce its obstruction of the airway. A 2016 meta-analysis also found that studies supported the idea that acupuncture can decrease OSA. Nevertheless, experts caution against using acupuncture in lieu of other OSA therapy, such as the use of a CPAP or BiPAP machine.
How Do You Get Started With Acupuncture?
The best way to get started with acupuncture is by talking with your doctor. A doctor can discuss your health concerns, the potential benefits and risks of acupuncture in your case, and how this therapy can fit within your overall plan for care.
You can ask your doctor for a referral to a specialist in acupuncture. To avoid potential problems, it’s important to work with a qualified acupuncturist, and many doctors can direct you to someone with a solid background in this procedure.
Getting a referral from your doctor may also help to have your acupuncture treatment covered by your insurance. It can be helpful to talk directly with your insurance provider if you have any questions about what acupuncture-associated costs will and will not be covered.
If you are already receiving treatment for a medical condition, do not stop those treatments to receive acupuncture unless you have already discussed this decision with the doctor who is overseeing your treatment.
Learn More About Acupuncture
- Mayo Clinic: Acupuncture. This page from the Mayo Clinic provides an overview of acupuncture and includes suggestions for finding a quality practitioner.
- Johns Hopkins Medicine: Acupuncture Q&A. This video features Rachel Waldman, an acupuncturist at the Johns Hopkins Integrative Medicine & Digestive Center, who answers a range of common questions about acupuncture.
- American Association of Acupuncture and Oriental Medicine (AAAOM). AAAOM is a professional organization that is made up of practitioners of acupuncture and other types of traditional Chinese medicine. Their website includes information for the public about acupuncture, including the likely costs and what to expect at your first visit.
- AcuTalks: Acupuncture and Connective Tissue. This video is an interview with Dr. Helene Langevin, Director of the Osher Center for Integrative Medicine at Harvard Medical School and Brigham and Women's Hospital. In the interview, Dr. Langevin explains how acupuncture affects connective tissue in ways that implicate our overall health.