The idea of acupuncture for improving insomnia in obese people

Obese people often suffer from multiple problems such as endocrine disorders, metabolic disorders and psychological stress. These problems are intertwined and can easily lead to insomnia. Acupuncture can effectively improve insomnia in obese people by regulating the functions of internal organs, balancing qi, blood, Yin and Yang, and improving endocrine. The following are the specific ideas:

First, conduct a comprehensive diagnosis to clarify the cause and mechanism of the disease

Phlegm-dampness internal obstruction type: Obese people often suffer from improper diet, lack of exercise and other reasons, which lead to abnormal transformation and transportation of the spleen and stomach, internal retention of water and dampness, and accumulation to form phlegm. Phlegm and dampness block the meridians, affect the circulation of qi and blood, and further disrupt the mind, leading to insomnia. Such patients often have symptoms such as obesity, heavy limbs, chest tightness and fullness in the epigastrium, excessive phlegm, and sticky mouth.

The type of disharmony of stomach qi: Overeating or consuming too much rich and greasy food can cause stagnation of stomach qi. When the stomach is not harmonious, one will be restless when sleeping. The patient presents with insomnia and frequent dreams, belching and acid regurgitation, nausea and vomiting, abdominal distension and pain, and constipation, etc.

Liver depression and spleen deficiency type: Obese people may experience psychological stress due to their body shape, leading to liver qi stagnation, which adversely affects the spleen and causes the spleen to fail to function properly. When liver depression turns into internal heat and disturbs the heart spirit, symptoms such as insomnia, irritability and anger, distension and pain in the chest and flanks, loss of appetite, abdominal distension and loose stools may occur.

Deficiency of both heart and spleen type: Excessive fatigue and overthinking can deplete the heart and spleen, leading to insufficient production of qi and blood and failure to nourish the heart spirit. The patient presents with insomnia, frequent dreams, palpitations, forgetfulness, fatigue, sallow complexion, loss of appetite, etc.

Second, precisely select acupoints to regulate the qi and blood of the internal organs

Phlegm-dampness internal obstruction type: The principle is to strengthen the spleen, transform phlegm, calm the mind and soothe the spirit. Select acupoints such as Zhongwan, Fenglong, Zusanli, Yinlingquan, Shenmen and Neiguan. Zhongwan is the Mu point of the stomach and can strengthen the spleen and harmonize the stomach. Fenglong is a key acupoint for resolving phlegm. Zusanli is a point where the stomach converges and can strengthen the spleen and benefit qi. Yinlingquan can strengthen the spleen and promote diuresis. Shenmen and Neiguan calm the mind and soothe the spirit.

The type of disharmony of stomach qi: The principle is to harmonize the stomach, relieve upward movement, calm the mind and stabilize the will. Acupuncture points such as Zhongwan, Tianshu, Neiguan, Zusanli and Gongsun were performed. Zhongwan and Tianshu can regulate the qi movement of the gastrointestinal tract. Neiguan and Gongsun are the convergence points of the eight meridians, which can broaden the chest, regulate qi, harmonize the stomach and relieve upward movement. Zusanli strengthens the spleen and harmonizes the stomach.

Liver depression and spleen deficiency type: The principle is to soothe the liver, strengthen the spleen, calm the mind and soothe the spirit. Select acupoints such as Taichong, Xingjian, Qimen, Zhangmen, Pishu, Weishu and Shenmen. Taichong and Xingjian are acupoints on the liver meridian, which can soothe the liver and regulate qi. Qimen is the Mu point of the liver, and Zhangmen is the Mu point of the spleen. They can regulate both the liver and the spleen. The Spleen Shu and Stomach Shu points regulate the functions of the spleen and stomach. The divine gate calms the mind and soothes the spirit.

Deficiency of both heart and spleen type: The principle is to tonify the heart and spleen, nourish the blood and calm the mind. Acupuncture points such as Xinshu, Pishu, Shenmen, Sanyinjiao and Anmian are performed. The Heart Shu and Spleen Shu points are the back-shu points of the heart and spleen respectively, which can nourish the heart and spleen. The divine gate calms the mind and soothes the spirit. Sanyinjiao is the point where the liver, spleen and kidney meridians meet. It can strengthen the spleen, benefit qi, nourish blood and calm the mind. Anmian is an extraordinary acupoint outside the meridians and can improve sleep.

Third, flexible acupuncture techniques enhance the therapeutic effect

Tonifying and purging techniques: Adopt corresponding tonifying and purging techniques based on different syndrome types. For deficiency syndromes, such as those of both heart and spleen deficiency, the tonifying method is adopted, that is, the needle is inserted slowly and the needle is removed quickly, with light stimulation to stimulate the qi of the meridians and tonify the vital energy. For empirical conditions such as phlegm-dampness internal obstruction type, disharmony of stomach qi type, and liver depression and spleen deficiency type, the laxative method is adopted, that is, the needle is inserted quickly and discharged slowly, with heavy stimulation, to eliminate the pathogenic factors and regulate the functions of the internal organs.

Injection retention time: Generally, the injection is retained for 20 to 30 minutes. During the period of needle retention, the needle can be inserted every 5 to 10 minutes to maintain the sensation of the needle. For patients with severe conditions and good physical conditions, the retention time of the needle can be appropriately extended. For patients with mild conditions and weak constitutions, the time of needle retention can be appropriately shortened.

Complementary therapies: Moxibustion, electroacupuncture and other complementary therapies can be combined to enhance the therapeutic effect. Moxibustion has the functions of warming and unblocking meridians, dispelling cold and dampness, and strengthening the body’s resistance and eliminating pathogenic factors. It is particularly effective for patients with internal obstruction of phlegm and dampness and those with spleen deficiency and excessive dampness. Electroacupuncture can regulate nerve excitability and enhance the stimulation intensity of acupuncture, making it suitable for patients with severe insomnia symptoms.

Fourth, comprehensive conditioning and improvement of lifestyle

Dietary regulation: Guide obese people to have a reasonable diet, control calorie intake, avoid foods high in sugar, fat and salt, and increase the intake of vegetables, fruits, whole grains and other foods rich in dietary fiber. At the same time, pay attention to regular diet, eat at fixed times and in fixed amounts, and avoid overeating.

Physical exercise: Encourage obese people to engage in moderate physical exercise, such as walking, jogging, swimming, yoga, etc. Exercise can boost metabolism, consume excess fat, improve physical functions, and also help relieve stress and enhance sleep quality. It is recommended to engage in at least 150 minutes of moderate-intensity aerobic exercise every week.

Psychological adjustment: Obese people may develop psychological problems such as low self-esteem and anxiety due to their body shape, and these psychological issues can further aggravate insomnia symptoms. Therefore, it is necessary to pay attention to the patient’s psychological state, provide psychological counseling, help the patient establish a correct mindset and reduce psychological pressure. Psychological adjustment can be achieved through methods such as psychological counseling and relaxation training.

Fifth, plan the treatment course and conduct regular evaluations and adjustments

Treatment course: Acupuncture for improving insomnia requires a process. Generally, 2 to 3 treatments are conducted per week, and a continuous treatment course lasts for 4 to 6 weeks. The specific course of treatment can be adjusted according to the patient’s condition and treatment effect.

Regular assessment: During the treatment process, it is necessary to regularly evaluate the patient’s sleep improvement, including the time it takes to fall asleep, sleep depth, sleep duration, and frequent dreaming, etc. Meanwhile, observe the changes in the patient’s weight, physical function, psychological state and other aspects. Based on the assessment results, adjust the treatment plan in a timely manner to achieve the best therapeutic effect.