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The key points of acupuncture for the Anmian point to relieve insomnia mainly include the following aspects:
First, precise positioning and operation
Positioning method
The Anmian acupoint is located at the midpoint of the line connecting the Yifeng acupoint (the depression behind the earlobe) and the Fengchi acupoint (the depression outside the outer edge of the large tendon at the back of the neck), or about 2 centimeters behind the earlobe. When locating the acupoints, the patient should be made to relax and keep their head and neck straight to facilitate the accurate identification of the acupoints.
Acupuncture depth and Angle
When performing acupuncture, it is generally advisable to use a straight puncture or an oblique puncture of 0.5 to 1 cun towards the tip of the nose. The depth should not be too deep to avoid damaging blood vessels or nerves. The direction of acupuncture should be adjusted according to the specific condition of the patient, with a local sensation of soreness and distension being appropriate.
Stimulation intensity and frequency
The acupuncture technique should be gentle to avoid strong stimulation that may cause the patient to be nervous. The technique of moderate tonification and moderate purgation can be adopted. The needles should be retained for 20 to 30 minutes. During this period, the needles can be administered 1 to 2 times appropriately to enhance the therapeutic effect.
Second, the combination of acupoints synergistically enhances the effect
Insomnia caused by deficiency of both heart and spleen
It can be combined with acupoints such as Shenmen, Neiguan and Sanyinjiao to strengthen the spleen and nourish the heart, calm the mind and stabilize the will. Shenmen is the yuan point of the Heart Meridian, Neiguan is the meridian point of the pericardium, and Sanyinjiao is the convergence point of the liver, spleen and kidney meridians. The combined use of the three can enhance the calming effect.
Insomnia caused by liver depression leading to internal heat
It can be combined with acupoints such as Taichong, Xingjian and Ganshu to soothe the liver, relieve depression and clear liver heat. Taichong is the Yuan point of the Liver Meridian, Xingjian is the Xing point of the Liver Meridian, and Ganshu is the back-shu point of the liver. The combination of the three can relieve the symptoms of liver depression.
Insomnia of heart-kidney disharmony type
It can be combined with acupoints such as Xinshu, Shenshu and Taixi to harmonize the heart and kidneys, nourish Yin and reduce internal heat. Xinshu is the back-shu point of the heart, Shenshu is the back-shu point of the kidney, and Taixi is the yuan point of the Kidney Meridian. The combination of the three can regulate the functions of the heart and kidney.
Third, the timing and course of acupuncture
Timing of acupuncture
It is recommended to have acupuncture 1 to 2 hours before going to bed. At this time, the human body is in a relaxed state, and the effect of acupuncture is better. Avoid acupuncture after meals or when hungry to prevent affecting the therapeutic effect.
Course arrangement
Generally, acupuncture is administered once a day or every other day, with ten sessions constituting one course of treatment. For patients with chronic insomnia, continuous treatment for 2 to 3 courses can be carried out to consolidate the therapeutic effect.
Fourth, Precautions and taboos
Patient status
Before acupuncture, it is necessary to ask the patient if they are tired, hungry or emotionally tense. If necessary, let the patient rest for a while first. Acupuncture can be performed only after their condition stabilizes.
Contraindications of acupuncture
Acupuncture is contraindicated for pregnant women, those with broken or infected skin, and those with coagulation disorders. For patients who are receiving acupuncture for the first time, explanations should be provided first to relieve their nervousness.
Post-acupuncture care
After acupuncture, the patient should be allowed to rest for a while and avoid getting up immediately or engaging in vigorous exercise. Inform the patient that there may be a slight sensation of soreness and distension at the acupuncture site, which is a normal phenomenon and usually subsides on its own within 1 to 2 hours.
Fifth, therapeutic effect evaluation and adjustment
Therapeutic effect evaluation
The therapeutic effect can be evaluated through the patient’s subjective feelings (such as sleep onset time, sleep depth, number of awakenings at night, etc.) and objective indicators (such as polysomnography). After 1 to 2 courses of general treatment, the patient’s insomnia symptoms should improve.
”Plan adjustment”
If the therapeutic effect is not satisfactory, the patient’s constitution and condition need to be re-evaluated, and the combination of acupoints or acupuncture techniques should be adjusted. For instance, for stubborn insomnia, acupoints such as Baihui and Sishencong can be added, or electroacupuncture stimulation can be adopted to enhance the therapeutic effect.
Sixth, combine with other therapies
Traditional Chinese medicine conditioning
It can be combined with internal administration of traditional Chinese medicine, such as Suan Zao Ren Decoction and GUI PI Decoction, to enhance the calming effect. The combined effect of traditional Chinese medicine and acupuncture can more comprehensively regulate the functions of internal organs.
Lifestyle adjustment
It is recommended that patients maintain a regular schedule and avoid staying up late. Engage in appropriate exercise, such as walking, Tai Chi, etc. Avoid drinking stimulating beverages such as coffee and strong tea before going to bed to improve the sleep environment.