Acupuncture for Insomnia: Sleep and Dreams in Chinese Medicine

Aglance at the back cover of this book reveals that few authors could be better qualified to write a definitive work on insomnia. Conventionally trained in France as a surgeon and gynecologist, Hamid Montakab, MD, has also studied acupuncture, Chinese herbal medicine, osteopathy, and the traditional medicines of the Philippines and India; and, in 1994, he conducted a formal scientific research study on acupuncture and insomnia. He has been refining, practicing, and teaching his knowledge ever since. I opened the book with some eagerness, and my interest was immediately piqued to see that the Foreword was written by Jeffery Yuen. ‘‘A good sign,’’ I thought. Chapter 1 opens with a thorough review of Western approaches to insomnia, complete with standard sleep laboratory studies and a discussion of about rapid eye movement (REM) and non-REM states, while Chapter 2 follows-up with a detailed analysis of insomnia from a Chinese Medicine (CM) point of view. As in all other aspects of CM, the basic Yin/Yang idea is very simple: Wakefulness is Yang and sleep is Yin. But Montakab does not stop there. He moves on to an increasingly complex analysis, touching on every aspect of CM from involvement of the Qi and the Blood to the Luo vessels, the Zang Fu and the 5 Shen. He also finds insightful ways of elucidating the roles of the emotions, the Gui, and dreams, and of course, underlying it all, there is the Dao. One key concept is how the Wei Qi interiorizes at night to return to its root in the Kidneys, starting at the eyes, then moving through the nose, neck, chest, and abdomen, while the Ying Qi simultaneously exteriorizes. In addition, a second major concept is how the extraordinary meridians (EMs)—in particular the Yin and Yang Qiao and the Wei Mai, regulate time and space, which are, respectively, the temporal and depth aspects of sleep. The author notes that the EMs maximally affect the 3 Yin energetic orbs for 2–3 hours sequentially overnight, leading to different point choices related to the timing of the insomnia. For the Yin Qiao Mai the order is: Shao-Tai-Jue Yin; while for the Yin Wei Mai it is: Tai-Jue-Shao Yin. He also notes that disturbances in time and space manifest as tender spots on the EMs at the Xi-cleft points: meaning KI 8 (Yin Qiao); BL 59 (Yang Qiao); KI 9 (Yin Wei); and GB 35 (Yang Wei). Practitioners may want to commit some of these basic principles to memory, because understanding them makes for fairly simple treatment strategies, in which patients who have temporal disturbance (which is probably the most common condition) may respond to the opening points of the Yin and Yang Qiao Mai (BL 62 and KI 6), combined with Yintang and/or BL 1. Indeed, this formula is one of the most common protocols for insomnia out there. Yet, by elucidating the logic behind the strategy, Montakab both demystifies it and brings it to life. Another common sleep difficulty is related to shift work, airplane travel, or other circadian rhythm disturbances. The author describes some acupuncture strategies that can help to reset the rhythm. One interesting protocol involves utilizing the 4 Inner Gates. These comprise CV 12, LU 1, and LR 14, followed by GV 20 and BL 1. Until I read this section, I had never heard of the 4 Inner Gates. For practitioners who want to go even deeper, there are emotional factors to explore, issues of the Gui, the use of the outer Bladder line points, and 7 Dragons and Ghost points. There is also a section on the meaning of dreams, viewed first from a Western psychoanalytical (e.g., Freud, Jung, Adler) view, then moving through Greek, Muslim, Daoist, Buddhist, and Vedic traditions. Although this material is largely philosophical, the author brings it all together through the rubric of CM. For example, practiced lucid dreaming can