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Get Some Sleep: Using acupressure, yoga, tai chi
March 29th, 2011
10:55 AM ET

Get Some Sleep: Using acupressure, yoga, tai chi

Lisa Shives, M.D., is the founder of Northshore Sleep Medicine in Evanston, Illinois. She blogs on Tuesdays on The Chart. Read more from her at Dr. Lisa Shives’ Sleep Better Blog.
Ten to 15% of Americans suffer from chronic insomnia, defined as the inability to get to sleep or stay asleep, or the inability to get refreshing sleep.

Sleep medications are notoriously ineffective or cause dangerous side effects and dependency. Psychological therapies, much research reports, are as effective in the short term and more effective in the long run than hypnotic medications.

Unfortunately, there are few providers of the cognitive behavioral therapies that have shown to help treat insomnia.

The good news is that there is hope that alternative, non-pharmacologic approaches can improve sleep and daytime function. The term that we use for non-traditional, often non-Western approaches to healing is CAM, complementary and alternative medicine.

A recent review by Sarris and Byrne published in Sleep Medicine Reviews, April 2011, looked at all the randomized, controlled trials published in English and scrutinized the studies for their methodologies and outcomes data.

It turns out that there are some good data proving the efficacy of three CAM treatments: acupressure, yoga and tai chi. The evidence for acupuncture was mixed, as was the use of L-tryptophan, which is an essential amino acid that acts as a precursor to serotonin, which in turn can be converted to melatonin. The most studied herbal remedy, valerian, shows very weak evidence of improving sleep and cannot be recommended at this time.

Melatonin studies were not included in this review but from my own recent review of the literature as well as my clinical experience, the effectiveness of melatonin as a hypnotic agent is very unpredictable. Some people find it extremely useful in getting to sleep and most find it does nothing at all.

If you are going to try something like L-tryptophan or melatonin, one tip I have is to buy products manufactured in Germany, where a lot of research into phytomedicines has been conducted and where the production of these substances is overseen and regulated in much the same manner as pharmaceuticals. Therefore, you know that there is research showing that the substance is safe and effective, and you know that the bottle contains what it says it does in a pure form.

Acupressure uses the same pressure points as acupuncture but instead of needles, it employs gentle pressure from the fingers, or sometimes the feet. You can even learn to do some of the pressure points on yourself.

Both tai chi and yoga, as they are commonly practiced in the West, are slow, gentle forms of exercise that can benefit many chronic health conditions as well as help improve sleep quality and duration.

The information contained on this page does not and is not intended to convey medical advice. CNN is not responsible for any actions or inaction on your part based on the information that is presented here. Please consult a physician or medical professional for personal medical advice or treatment.

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Filed under: Sleep

soundoff (38 Responses)
  1. SoundGuy

    Here's a site that connects both topics: natural sounds that help you focus during meditative practices and also help you fall asleep: TranscendentalTones. Apparently the sounds of nature are very approrpiate to relax the mind because of their "flowing randomness". You can read more about it in the site, there's actually a great link to a TED talk on sound.

    March 29, 2011 at 11:46 | Report abuse | Reply
    • dave

      Love the pic of the chic doing the splits barefoot.... wow =)

      March 30, 2011 at 08:46 | Report abuse |
  2. Sleepless in NJ

    So, do you need to do the yoga before bed? Or if it is simply part of your daily routine, will it help? This article seems rather incomplete. Unless you were planning to use L-tryptophan or melatonin. There isn't even mention of where to go for more information.

    March 29, 2011 at 17:32 | Report abuse | Reply
    • Ashxlen

      I tried yoga the other night for the first time and it helped me get to sleep really fast. I have been having trouble sleeping for the past year. I don't like taking sleeping pills so I try to work out hard during the day to help me get sleepy at night. I also have tried these pillow mists at bath and body works. The lavender chamomile sleep pillow mist helps me drift and relaxes me. :)

      March 29, 2011 at 22:45 | Report abuse |
    • GARY

      MOST SIMPLE SITTING ONE CAN TRY IS:

      Sit crossed legs with eract spinal cord. Press index fingers of boh hands with respective thumbs and extend rest of the
      fingers while holding hands straight and resting palm on knee.

      March 29, 2011 at 23:57 | Report abuse |
    • David J

      i do yoga after work (~5:30 pm) and go to bed around 10:30 pm. the nights i do yoga i am tired earlier, fall asleep quicker and sleep longer. i have no history of sleep problems though.. FYI. the yoga i do is part of the p90x system, its a very intense 1.5 hour routine that leaves me very tired out.

      March 30, 2011 at 09:20 | Report abuse |
  3. James

    I'm a 60 year old who took up hatha yoga and meditation 4 decades ago. In recent years I've taught mindfulness meditation (in hospital programs). I've also been the primary caregiver for elderly parents. (And I eat at Blind Faith Cafe every time I'm in Evanston! ;-) Dr. Shives writes, "Sleep medications are notoriously ineffective or cause dangerous side effects and dependency." This sounds a bit strong to me (especially when we consider the needs of insomniac elderly patients who may benefit more from "dependency" on a sleep medication such as Lunesta than they would from taking nothing). If someone who suffers from insomnia truly benefits from accupressure, yoga, and/or tai chi (or meditation or any other non-medical "complementary" approach), that's wonderful. Some insomniacs may find empirically verifiable relief via yoga, tai chi, or accupressure alone. Some may find that they need to "complement" an allopathic or conventional medical approach (taking a prescription sleep aid) with something like yoga, etc. And some may find that their only choice is to suffer from insomnia or take a prescription medication.

    March 29, 2011 at 17:59 | Report abuse | Reply
    • Yatin J. Patel MD MBA

      James, I can see how mindfulness meditation can help. Beth, I am glad sleep restriction is helping you. I stress sleep hygiene first and foremost regardless of the primary therapy. I have also had good luck with behavior therapy.

      March 29, 2011 at 21:58 | Report abuse |
  4. Lori L. Malkoff, MD

    Great article. Surprised no one mentions the Feldenkrais Method for insomnia. The Awareness through Movement lessons, especially when done before bed, can be extremely soporific, while improving breathing, posture and the effects of stress.

    March 29, 2011 at 21:24 | Report abuse | Reply
  5. Beth

    As a chronic insomniac for almost 30 years, I've been on many different medication to help me sleep at one time or another. I also tried melatonin, valerian etc. with no effect whatsoever. About six years ago, I decided to get off all the sleep medication I was taking, and try a sleep deprivation program (mainly because it was one of the few things I hadn't tried). I was very skeptical about the program.....There are very strict "rules" to follow and I really didn't think it would work. When I first started the program, it was brutal. But over time, for the most part, it worked!! I'm not saying I sleep a full 8 hours a night now. But, I AM sleeping between 6 and 7 most nights, although I wake up once or twice during the night. This is 100% better than the 0-2 hours I was getting before the medications, and the 4 or 5 hours (all broken up) on the different medications. After I started the program at a sleep clinic, I found a book ("Desperately Seeking Snoozin") that outlines the program. It's not easy, and demands some lifestyle changes....and a commitment to sticking with it. I'm not able to say that my insomnia is totally cured....but it sure is on the mend!! :-)

    March 29, 2011 at 21:35 | Report abuse | Reply
  6. Gurdeep

    I have been doing Iyengar yoga for 15 years. There are specific poses that we learn, which help us fall asleep. We can do them in bed. Though, just a 45 min – 1 hr practice cleans the mind and get your day going at a smooth pace; stress can sometimes overtake the benefits of a.m. yoga. Thus the evening ending with Viparitakarani is a good way to get some needed zzzzzzz

    And oh, by the way, where in the article do you talk about yoga for sleep and how to achieve it ?

    March 29, 2011 at 22:48 | Report abuse | Reply
  7. Ian

    Dr Shives is propogating a very common misconception held in Western countries regarding Tai Chi – that it is a gentle, slow exercise. This is far from the truth. Tai Chi was developped as a martial art and it is the pinnacle of Chinese martial arts. It is not gentle, but can be very brutal, and quite the opposite of slow when applied in real application. The traditional training is unimaginably challenging. From that point of you, it does help with sleep. If you trained to the proper limits and beyond, you will be exhausted and sleep like a baby. Dr Shives, contrary to popular believe, Tai-Chi is not for relaxing, believe me.

    March 29, 2011 at 23:06 | Report abuse | Reply
  8. TJ

    Tai Chi definitely helped me. Quite a few years ago I nearly died from excessive sleep deprivation (20 days without sleeping – probably a serious contender for a world record)...started doing Tai Chi...and my sleep, which at the time was still poor, improved dramatically as did many other physical issues I was having. 17 years later I feel fit as a fiddle, sleep great and practice everyday. If I may quote a line from the 80s cop show Hunter – "Works for me!". ;)

    March 29, 2011 at 23:10 | Report abuse | Reply
  9. TJ

    Geez louise Ian, you should take up theater with that kind of melodrama. Chen stylist? Student of B. K. Frantzis? The "brutal" level of any martial art mostly depends on the teacher. I wouldn't call something like learning tui-shou and/or the application of peng energy to be "unimaginably challenging"...difficult at times, yes, requires lots of practice with a good teacher, yes again. Just doing the form slowly will provide many health benefits to the average American, and I feel that's a good thing.

    Relax man -

    March 29, 2011 at 23:16 | Report abuse | Reply
  10. Ian

    Hi TJ. Agreed, modern Tai Chi does appear to offer such benefits. I practiced it for also for over 15 yrs, and can attest to some of those benefits that you speak of. Then 6 yrs ago, I completely abandoned my modern Tai Chi practice, and I started to train from a practically obsolete original lineage. Now, I don't need to sleep as much, quite different from just improving sleep.

    March 29, 2011 at 23:20 | Report abuse | Reply
  11. Ian

    No, not Chen style, but a lost Yang style. Read up on your history pre Yang Cheng Fu. That's when the art really went on a permanent tangent. My teacher is unknow in the west, and prefers to stay that way. Tui-shou does not exist in the original training. It is called rou-sau, and is very difficult to coordinate even single hand. Doing form slowly is modern tai chi, and highly incompatible with the spirit of the original art. Sounds strange, eh? T

    March 29, 2011 at 23:28 | Report abuse | Reply
    • TJ

      Hey, apologies if my original post was a bit negative. Pre Yang Cheng Fu...that sounds very interesting...I would imagine it would look a lot different. Truthfully...I'm not a big fan of the doing the forms myself (I hope my current teacher doesn't see this)...and never really have been. Most of my practice is lots of one legged standing/balancing and foundation drills...other classmates always ask me what I do that enables me to plow through most of them with ease save our teacher (and I hold back even with his senior students...no reason to go down that road)...but since I know those who ask don't have the desire or discipline to do the more intense training..there's nothing I can show them (sorry, no magic formula here, just lots of hard work). I also trained in other internal styles for a few years and one of my teachers just drilled us over and over with some very intense yet beneficial basic drills...and a lot of that I still use today.

      Sounds like you have found a very unique path in your training. I greatly admire and respect that. :)

      March 30, 2011 at 01:51 | Report abuse |
  12. diego

    Damn, nothing like a really flexible, dark haired beauty in red on a bed....just waiting. After an hours with her, I'll be sleeping good...real good.

    March 29, 2011 at 23:35 | Report abuse | Reply
  13. TheLeftCoast

    I've been doing yoga and meditation for years, and I'm the only adult in my family who doesn't have any prescriptions for anything. They also think yoga and meditation are weird, and I think choosing to take drugs rather than take care of yourself is kinda weird, too.

    March 29, 2011 at 23:47 | Report abuse | Reply
  14. Jane

    Melatonin is illegal in Germany therefore probably not manufactured there.

    March 30, 2011 at 00:13 | Report abuse | Reply
  15. mell

    Mysticism from India or China is still Mysticism. Anti Scriptural. Yoga os praying to a Hindi diety, Tai Chi is Confucianism (Kong Fuzi). Read scripture- there are other things beside these waste of time Yoga and Tai Chi.

    March 30, 2011 at 00:49 | Report abuse | Reply
    • diego

      Read what scripture?

      March 30, 2011 at 01:48 | Report abuse |
    • Go watch your Pat Robertson Rapture Re-Runs and shooo

      BEFORE YOU PREACH TO US CLEAN UP YOUR OWN HOUSE!!!
      The list of Evangelical Scandals goes on and on: Jim & Tammy Baker, Jimmy Swaggart, Peter Popoff, Robert Tilton, WV Grant, Paul and Jan “Hairstyle Nightmare” Crouch, Ted “BJ Lips” Haggard, George Alan “Rent Boy” Rekers and now Eddie Long – Welcome to the Club Eddie!

      March 30, 2011 at 02:13 | Report abuse |
    • Blasphemer

      Other things like that "waste of time" scripture.

      March 30, 2011 at 08:53 | Report abuse |
  16. Adam9

    Well, as long as you don't have severe psychological issues, I think you're gonna be okay :)

    March 30, 2011 at 01:52 | Report abuse | Reply
  17. Evangelicals go back to the Farm where you belong!

    WARNING: Evangelical Thought Police or E.T.P. Virus detected – Administer Anti-Mind Programming Counter Measures. Clearing Sequence to begin in 1,2,3,………..Clearing Complete – E.T.P. Virus Removed.

    March 30, 2011 at 02:11 | Report abuse | Reply
  18. gunit

    at the end of the day all you gotta do is smoke a big fat joint. you will go to sleep right away and will have the sweetest dreams of your life.

    March 30, 2011 at 03:15 | Report abuse | Reply
  19. jim

    yoga is evil , causes spiritual possession of evil spirits dont mess with this stuff

    March 30, 2011 at 05:34 | Report abuse | Reply
  20. RaeAnn Banker, R.Y.T.

    As a yoga teacher, I recommend Viparita Karani (legs up the wall) and reclined baddhakonasana (cobbler's pose) for insomnia. The book "Relax and Renew" by Judith Lasiter is also excellent, with very clear instructions. If you can find a good recording, Yoga Nidra (a guided visualization practice) is wonderful. I recommend the CD "Yoga as Sanctuary" by Kirin Mishra. (can't find it? contact office@sryyoga.com)

    March 30, 2011 at 07:25 | Report abuse | Reply
  21. Blasphemer

    Whatever happened to a good roll in the sack with your partner to help you sleep? You could use yoga as foreplay.

    March 30, 2011 at 08:47 | Report abuse | Reply
  22. Jess

    I've tried everything

    http://www.fourgreensteps.com/community/blogs/fourgreensteps/abzs-of-sleep-natural-insomnia-remedies-for-your-best-nights-sleep

    March 30, 2011 at 08:59 | Report abuse | Reply
  23. EmperorObama

    If Michelle is asleep I usually just rub one out. Sleep like a baby ;-)

    March 30, 2011 at 09:16 | Report abuse | Reply
  24. THE MARIJUANA GOD

    All you have to do is consume some marijuana before you go to sleep no need for all that other extra stuff.

    March 30, 2011 at 09:29 | Report abuse | Reply
  25. Dr sandra smith

    Use Pran Yantra or tesla plates india as a natural sleep inducer.These plates are based on the principles of light, sound andd colours. Simply keeping the plate beneath the pillow does the job. These are the same plates and disks which the famous American Astrologer and Author, Linda Goodman writes in Star Signs about these purple plates that’s it’s a best tool for pregnant mothers. It relieves back pain, migraine, spondalities, etc within 20 minutes and controls nausea and vomiting and much much more.
    For chronic pains, use regularly. Use it as a free energy tool, Meditation: Deaddiction: Food & Liquid Freshener: Telepathy: insomnia, etc

    March 30, 2011 at 22:18 | Report abuse | Reply
  26. LeiShun

    Is there any scientific evidence that meditation techniques help with falling aslieep, and devices based on meditation such as Nightwave or Zonkopia.com?. They help you breath in a rhythm, similar to meditation. Zonkopia also has sound of nature.

    Some people seem to rave about them. I tried zonkopia and it knocked me out :-)

    March 31, 2011 at 03:40 | Report abuse | Reply
  27. Mell 2

    RE: Go watch your Pat Robertson Rapture Re-Runs and shooo

    BEFORE YOU PREACH TO US CLEAN UP YOUR OWN HOUSE!!!
    The list of Evangelical Scandals goes on and on: Jim & Tammy Baker, Jimmy Swaggart, Peter Popoff, Robert Tilton, WV Grant, Paul and Jan “Hairstyle Nightmare” Crouch, Ted “BJ Lips” Haggard, George Alan “Rent Boy” Rekers and now Eddie Long – Welcome to the Club Eddie!

    I agree they are all Secular Christianity – which is also false They are bad too but Yoga is praying to a Hindi Diety FACT.

    April 23, 2011 at 05:06 | Report abuse | Reply
  28. john

    is to much sleep bad for u really i think it might be but dont know

    April 25, 2011 at 13:13 | Report abuse | Reply
  29. Esther

    intersting

    September 22, 2011 at 00:32 | Report abuse | Reply

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