The Big Ea-zzz-y (sleep & acupuncture – part 1)

Forgetting how to fall… ‘You don’t know what you have till it’s gone’ goes the old adage. Falling asleep seems to be one of the simplest and most natural things to do. And yet large (and increasing) percentages of us seem unable to simply… fall…

This reminds me of Arthur Dent learning how to fly* in the ‘Hitchhiker’s Guide to the Galaxy’ (if you have not read this book, put it near the top of your list!). But I digress…

Science of Sleep The science of sleep may appear, at first glance, to be sophisticated and accurate. iPhones made the leap from pocket-companion to bed-partner with the promise of tracking our sleep rhythms and diagnosing problems. But the reality is that even sleep researchers, with arrays of sensors tracking alpha, beta & delta waves, will admit that understanding the why’s and wherefore’s is embarrassingly elusive.

There are endless arguments about the requisite number of hours that humans need to sleep. From the perspective of acupuncture theory, the answer can vary depending on the season, amongst other factors. One thing we can be sure of, however, is that there can be too little and indeed too much sleep.

Disagreements abound regarding why we sleep at all. There are even some who lament the loss of time to this apparently wasteful and inconvenient necessity. For a necessity it is:

We are all familiar with the spectacular loss of normal functioning capability that we experience when we lack decent sleep. But what we have mostly forgotten is just how remarkably good it can feel to simply be alive – and how formidably capable we feel – when we have not just sufficient, but optimal, sleep. Both in terms of quantity and quality.

Side-stepping the why’s and wherefore’s, let’s take a look at how oriental medicine views sleep.

Yin & Yang We can’t really talk about much in oriental medicine without considering Yin & Yang.

During the day, the Yang (warm) Ki (which animates us, allowing us to think, move about and manipulate the world around us) is concentrated in the head, sensory organs and limbs. We can call these places the “Exterior” or “Yang”.

In the night time when the external environment becomes dark and cooler, the warm Yang Ki of the body withdraws inwards and downwards. It accumulates in the internal organs, especially in the abdomen. We can call these places “Interior” or “Yin”.

Without this warm Yang Ki activating the Exterior, our sensory organs shift towards standby mode and our conscious activity slows down. We also snuggle deep under the duvet because the warming Yang Ki is concentrated internally rather than keeping the Exterior (where our temperature sensory apparatus are located) warm.

Switching Off vs Switching In There are some people, usually highly driven and active, who find it difficult to sleep because the idea of wasting so much time is abhorrent. They would probably resonate with Thomas Edison who said:

“Sleep is a criminal waste of time and a heritage from our cave days.”

These people are usually placated a little when they understand that sleep is anything but a period of inactivity. Your Yang Ki does not go inside to ‘chill out’ and do nothing. Yang Ki is, by definition, active. It does not do ‘relaxing’. This means that at night, when the Yang Ki accumulates in the Interior (Yin places), the Interior becomes highly active. There is a lot of work going on beneath the apparently motionless surface… Rather than switching off, we are really just switching in!

Physical Restoration On a physiological level this equates to the western scientific hypothesis of sleep as necessary for deep restoration and repair. And indeed, there are a large number of metabolic pathways and genetic arrays associated with restoration of your organs and tissues which have been shown to be activated only during sleep.

Mental Capacity On a mental level, things may at first appear at odds with these concepts proposed by oriental medicine. Western science has (counter-intuitively) demonstrated huge amounts of activity in the brain during sleep. In fact, some areas of the brain are actually more active during sleep than waking.

However, looking at this more closely, we discover that the cerebrum and the lobes of the brain are indeed much quieter. (These are the outer levels of the brain, involved in alertness, attention, decision making, cognitive processes and also with movement and sensory input).

The increased activity (at a level far greater than when awake) all takes place in the deep brain. In terms of the development of our brains, this deep area is much more ancient. It deals with primary metabolic functions and deep-rooted sub-conscious activity. We can consider both the location and the functions of this increased activity to be ‘Yin’ from the perspective of acupuncture theory.

Creativity Interestingly, our ability to come up with novel solutions to complex problems is hugely enhanced by a night of sleep. In fact, it’s been estimated to give us a threefold advantage. Despite his frustrations, Edison’s literal “lightbulb moment” would have been impossible without the very sleep he so abhorred!

Ki & Blood A bit like ‘Wallace & Gromit’ or ‘Don Quixote & Sancha Panza’, we can’t talk of Ki without also thinking of Blood.

In the daytime, the Blood circulates throughout the body (with about 15% of the flow to the brain alone!)**. During sleep, acupuncture theory tells us that the Blood too moves from the extremities to the interior. And in particular, the Liver becomes particularly gorged. Western medicine concurs:- the heart beats about 15-30 bpm slower, resulting in a significant drop in blood pressure and peripheral circulation. Western medicine also recognises the Liver as a major reservoir of Blood.

It is within the blood-gorged Liver that the part of you that creates your consciousness and builds logical models for understanding the world, descends and is submerged for the night***. It is only this submerging of the conscious, logical function that allows the subconscious, creative activity in the deep (Yin) brain to emerge and become dominant.

Dracula All this talk of blood makes me think of our friend Count Dracula – and kindles a certain sympathy for him. The poor fellow suffers from extreme blood deficiency.

The result is that he is so exhausted during the day time – when he literally has not a drop of blood to power his muscles or mind – that he is basically dead to the world. And without the warmth of Blood, he is as cold as death. (So cold, in fact, that sunlight would burn him immediately on contact with his skin, such is the extreme difference in temperature.)

Conversely at night time his conscious mind floats about “un-dead” and “un-buried” as there is no Blood-filled Liver within which it can be immersed. He is condemned, of course, to be a chronic insomniac.

Can we blame him for his sleep deprived antics and desperate thirsting for blood?

To sleep, Perchance to Dream In less extreme cases of blood deficiency, rather than total insomnia, the consciousness is submerged sufficiently to allow some measure of sleep. But there is enough of it rising above the surface to allow it to observe and interfere with the deep brain’s sub-concious activity. This can result in excessive dreaming, disturbed sleep and waking in the night.

“Give me a Place to Stand… …And I will move the Earth” is a well known quote by Achimedes. He is talking about the need for a solid, unmoving place in order to be able to generate movement or activity elsewhere. In the martial arts, when there is external movement, the interior (movement of Ki) is still. When the exterior is still, the Ki is able to move and work internally.

For our purposes, we can consider sleep to be the phase of Yin “non-external” activities that provides a solid physiological base from which all the Yang external activities of our busy days can be launched.

Health In very simple terms, Acupuncture treatment can be thought of as stimulating your body to do work or make changes internally. In this regard we can think of Acupuncture as being similar to the ‘magic’ of sleep – and good treatment can be very effective in resolving insomnia. Thomas Dekker put it like this:

“Sleep is the golden chain that ties health and our bodies together.”

These fundamental concepts of Blood and Ki accumulating in the abdomen give rise to some useful strategies for understanding sleep. And for helping us to remember how to fall…. and how to stay fallen.

In Part 2 of this Newsletter we will discuss a few simple strategies, but for now, just remember that it is really more about not doing… It is, after all, the Big Ea-zzz-y!

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Notes * “There is an art, it says, or rather, a knack to flying. The knack lies in learning how to throw yourself at the ground and miss. … Clearly, it is this second part, the missing, which presents the difficulties.” ** The brain also uses about 25% of the body’s oxygen supply which effectively translates into 25% of the body’s total energy consumption. *** Note that this is a passive process. Rather like the effect of gravity. The consciousness falls….