A 7 years old girl visited my clinic with her mother because she couldn’t have fallen asleep with nervousness thinking too much before going to bed for about 2 months.
 
When I checked her neck and shoulder area, the area was tight. Before giving her the pediatric acupuncture, I shook her body from her legs laying her on her back, but her chest and above were not shaking so much due to the tightness.
 
I touched her neck and shoulder area with a round-tip needle to loosen the area in addition to the pediatric acupuncture and finished the first treatment.
 
When she came for the second treatment, her sleep was improved and when I shook her body from her legs, her chest and the above was shaking a little, but her neck was still tight.
 
After the second treatment, the tightness around her neck was gradually loosened up. When I gave her 3 more treatments, I ended the course of the treatments for her sleep and nervousness since she could sleep well and the tightness in her chest and the above disappeared.
 
It seems like this was the case that the nervousness caused the tightness in the chest, neck and shoulders, resulting in difficulty of falling asleep.

​Sleep apnea
 
Sleep apnea (obstructive) is a sleep disorder that is diagnosed when stop of breathing of more than 10 seconds is repeated more than 5 times within 1 hour during sleep.
 
The major causes of sleep apnea are said to be aging, overweight and so on.
 
Leaving sleep apnea as it is, the symptoms such as strong sleepiness during daytime or tiredness due to lack of sleep occur and there is a high risk that the various complications like heart failure, high blood pressure or diabetes are caused.
 
But it is difficult to check whether your breathing stops or not during sleep.
 
Actually, if you look at the inside of your mouth, you can check whether you have sleep apnea or not.
 
How to check whether you have sleep apnea or not
 
(1) Prepare a hand mirror and look upward at an angle of 45 degrees.
(2) Look at the inside of the mouth with putting your small finger at the corner of the mouth, saying “Ah” (Fig. 1 & 2).
 
Normal: The gap between the uvula and the tongue is wider than the width of the small finger. (Fig. 3 & 4)
 
Sleep apnea: The gap between the uvula and the tongue is narrower than the width of the small finger, or the uvula can’t be seen (Fig. 3 & 5).
 

​1st: Chosen by 31 out of 100 Acupuncturists
 
Indications
 
Stiff neck and shoulders, Headache, Cold intolerance, Edema, Stress, Anxiety, Insomnia, Tiredness of Eyes, Low back pain, Knee pain, Constipation, Menstrual cramps, rough skin, High blood pressure, Diarrhea, Pollen allergy, Sore throat, Toothache, Dizziness, Snoring, Ringing in ears
 
This acupuncture point is all-around and the strongest acupuncture point effective for various symptoms all over the body.
 
Acupuncture point
 
Large Intestine-4 (LI4)
 
Location of LI4
 
LI4 is located where the bones of the index finger and the thumb meets and is the index finger side (Fig. 1).
 
Pressing LI4 promotes the secretion of the substance having an analgesic effect and affects the symptoms all over the body.
 
How to press LI4
 
Push your thumb into the inside of your index finger and count 10 (Fig. 2).

4th: Chosen by 12 out of 100 Acupuncturists
 
Indications

Stress, Anxious Feeling and Insomnia

Pressing PC10 (Pericardium 10) calms the autonomic nervous system and is effective for various symptoms caused by tiredness of your heart.
 
Location of PC10
 
PC10 is located between the tip of index finger and the tip of the middle finger when you clench your hand (Fig. 1).
 
How to press PC10
 
(1) Press PC10 with the thumb of another hand (Fig. 2).
(2) Press the point toward the tip of fingers for 10 seconds (Fig. 3).
 
Pressing PC10 works instantly, so try pressing the point when you feel irritated.

​Do you sleep well?
 
Poor sleep has 2.4 times higher risk of death due to heart diseases or others, and 2 times higher increase ratio of cancer cells, compared to good sleep.
 
According to a research performed in Oxford University in England, 14 poor sleepers chosen randomly wrote about stressful events and emotional experience at that time for 3 nights. Before the experiment, the average of their sleeping onset latency was 40 minutes, but after the experiment, it became 14 minutes.
 
Writing about stressful events and the emotional experience at that time leads to looking at the stressful events objectively. That reduces stress, stabilizes the condition of autonomic nervous system and leads to the improvement of sleep.
 
This method is used as a treatment method for insomnia in England and some other countries.
 
Experiment
 
A 64 year-old woman who had been suffering from insomnia tried the experiment for 5 days. She has difficulty to fall asleep and wakes up 3 times at the middle of night.
 
The method is writing about stressful events and the emotional experience at that time before going to bed for about 15minutes.
 
It is important to take about 15 minutes to process the stressful events. The paper can be torn up and thrown after writing.
 
She didn’t think of any stressful events in her daily life before the experiment, but she recognized that she had complaints about her husband by writing.
 
After 5th night, she only woke up once for urination, but after that, she didn’t wake up until the alarm set off. She reported she could sleep well the first time in 2 years.

​Sleep debt or sleep deficit is the cumulative effect of not getting enough sleep. A large sleep debt may lead to mental or physical fatigue.
 
It is said that proper sleep time is 7 hours. In a study, when sleeping 6 hours for 2 weeks, the level of their brain became as low as they stayed up all night for 2 days.
 
Getting enough sleep elevates the strength of the immune system and activates the body cells, maintaining the health.
 
Sleep debt causes weakening of the immune system, lowering of the metabolism and accumulation of waste matters.
 
People who sleep less than 6 hours have about 1.6 times more risk of dementia, about 1.7 times more risk of diabetes, and about 1.4 times more risk of prostate cancer for men and about 1.7 times more risk of breast cancer for women, compared to people who sleep 7 hours.
 
Sleep time can’t be stored. It doesn’t compensate that people who don’t get enough sleep weekday try to get more sleep during the weekend.
 
Actually, there are people who sleep only 6 hours but don’t have sleep debt. On the contrary, there are people who sleep 8 hours but have sleep debt. Sleep debt is dangerous because it accumulates without knowing.
 
Let’s check sleep debt
 
How many clauses fit into you?

• My sleep time during weekday is less than 6 hours.
• I sleep additionally more than 2 hours on a day off.
• I feel sluggish or light headed when waking up.
• I feel sleepy in the morning (10 am to 12 pm).
• I feel sleepy on the way home after work.

 
Even if one clause fits into you, you can have sleep debt.
 
What food is good to decrease sleep debt?
 
To decrease sleep debt, it is necessary to improve the quality of sleep.
 
The key nutrition to improve the quality of sleep is GABA.
 
GABA is a type of amino acid which suppresses the excitement of the brain and relaxes the mind. GABA has instant effect, so taking GABA after dinner or right before going to bed has potential to lead to good sleep.
 
Amount of GABA (per 100 g) of the foods rich in GABA are:
Tomato: 62 mg
Potato: 35 mg
Eggplant: 20 mg
 
But a food contains 89 mg of GABA and in an experiment, when the food was eaten during dinner, the sleep-onset time became shorter and the depth of sleep became deeper.
 
The food which improve the quality of sleep is Kimchi (Korean pickle).
 
You can get kimchi everywhere, but Kimchi containing lactic acid is recommended.
 
Proper amount of GABA per day is about 100 mg. a small bowl of Kimchi should be eaten at dinner.
 
GABA is not broken by the heat, so you can heat up Kimchi to prepare any dishes.
​

Insomnia
 
There are 3 types of insomnia.
1. Difficulty falling asleep (hypnagogic disorder) - being unable to fall asleep for more than 2 hours after going to bed
2. Middle waking – Waking up more than 2 times before getting up in the morning
3. Early waking – waking up more than 2 hours earlier than a scheduled wake-up time
 
If you have any type of above conditions more than 2 times a week for more than 1 month, you are considered having insomnia.
 
One fourth of People aged 60 years or older wakes up during the night.
 
What kinds of diseases are caused by insomnia?
 
If you don’t sleep, ghrelin which is a type of hormone is secreted, resulting in obesity.
 
People who have insomnia have double possibility to have diabetes and high blood pressure.
 
What is a drink effective to improve the quality of sleep?
 
A drink contains theanine which increases alpha-wave in the brain according to the recent research.
Alpha-wave increases at the time of relaxation so increase of alpha-wave can improve the quality of sleep.
 
According to a research, waking-up time during the night of people intaking theanine decreased by 40 % compared to people not intaking theanine. Rested feeling in the morning was also 20 % higher.
 
The drink containing theanine and effective to improve the quality of sleep is Green tea extracted by cold water.
 
It is important to extract green tea using not hot water but cold water.
When green tea is extracted by hot water, major extracted substances are caffeine, catechin, theanine and arginine. But when green tea is extracted by cold water, only theanine and arginine are extracted. Caffeine is hardly extracted.
 
0.5 degrees C (33 degrees F) is most effective, so it is better to use iced water to extract.
 
It is important to slowly extract green tea in iced water for 2 to 3 hours. It is effective to drink a glass of the green tea 1 hour before going to bed.

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According to some researches,
 
Less than 6 hours sleep makes the risk of a cold 4 times more.
Less than 5 hours sleep makes the risk of high blood pressure 2 times more.
Less than 5 hours sleep makes the occurrence of heart diseases 1.5 times more.
 
Q1. To improve the quality of sleep, it is better not to run at night. True or False?
 
A1. True.
 
Intensive exercise at night such as running or weight training can be a cause of insomnia.
 
We can sleep good by decline of the core body temperature, which is not the body temperature measured by a thermometer but the body temperature of deep inside body. It is important to control the core body temperature lowering at night. If you exercise intensively at night, that prevents the decline of the core body temperature and you can’t sleep. To get sleep of good quality, it is recommended to fish intensive exercises like running by the evening. If you need to exercise at night, it is better to do light exercises such as walking.
 
Q2. To improve the quality of sleep, it is better to drink a glass of water right before going to bed. True or False?
 
A2. False.
 
It is important to have water before you sleep because you sweat during sleep. But if you drink water right before going to bed, the pressure in the bladder elevates during sleep and wakes you up to go to the bathroom, lowering the quality of sleep. Not to wake up at night to go to the bathroom, it is recommended to finish drinking water at least 1 hour before going to bed.
 
Sleep and alcohol
 
Alcohol makes you feel sleepy, but 2 hours after sleep, alcohol stimulates the nerves that move the body actively and you can’t sleep deeply. As a result, your brain and body have not rested sufficiently. It is not good to drink alcohol right before going to bed. If you really want to drink alcohol, it is recommended to drink only a glass of alcohol by 3 hours before going to bed.
 
What is lack of sleep?
 
Lack of sleep is equal to debt of sleep. People who sleep sufficiently don’t need to sleep more. People who sleep longer during weekends don’t sleep enough during weekdays and they are in the condition that they repay the debt of sleep.
 
Q3. To get sleep of good quality, it is better to drink a cup of miso soup in the morning. True or False?
 
A3. True.
 
Soy which the material of miso soup contains melatonin that is the substance inducing deep sleep. It takes about 15 hours to produce melatonin after eating miso soup. If you drink a cup of miso soup, melatonin is produced when you go to bed, leading to sleep of good quality.
 
The reason that it is better to eat breakfast
 
The clock in the brain is called the central clock. The clock in each organ is called the peripheral clock. The peripheral clock is often off. It is necessary to set the peripheral clock with the central clock to get sleep of good quality because the body can’t recognize what time it is now if there is difference between the clock in the brain and the clock in each organ. Eating breakfast is important to set the peripheral clock. The brain recognizes the food after you don’t eat anything for more than 8 hours as breakfast. Eating breakfast resets the peripheral clock with the central clock, leading to good sleep.
 
Q4. When you can’t sleep, it is good to wear gloves. True or False?
 
A4. True.
 
Hands of babies are warm. They release heat from their hands and feet to lower the core body temperature. In winter, the core body temperature can’t lower down due to the coldness of hands and feet, leading to low quality of sleep.
 
There is an area you should not warm up. That is the head. Warming up the arteries running behind the head makes it difficult to sleep because that elevates the core body temperature. It is said traditionally to cool the head and warm the feet. There is a research result that icing the head by something like an ice pillow leads to easier sleep.
 
Q5. When you can’t sleep, it is good to listen to music you like. True or False?
 
A5. False.
 
It is important to relax before sleep. Listen to the music you like excites the brain. Music without lyrics can be expected to lead to sleeping. Even relaxing music disturbs the rest of auditory sensation if it is kept on, leading to shallow sleep. It is necessary to turn off the music when you feel sleepy.
 
Q6. When you can’t sleep, it is good to wear an eye mask to darken the sight. True or False?
 
A6. False.
 
Many people tend to think that it is easier to sleep when the sight is dark. In antient time people slept making a fire to protect them from other animals. So it is thought that darkness makes people anxious instinctively. To eliminate the anxiety, it is better to keep a dim light by a foot light or opening a curtain slightly.
 
Does watching a smart phone before sleep lower the quality of sleep?
 
Recently is said that the light of the screen doesn’t affect the quality of sleep because the light is not so strong. What affects the quality of sleep is the contents you read such as you are worried about no reply to your emails or reading something interesting excites your brain.

​If you fall asleep right after going to bed, there is high possibility that you have sleeping disorder.
 
There are people who say, “I can fall asleep within 5 minutes after going to bed” or “I have never had a problem about sleeping because I can fall asleep right after going to bed.”
 
But if they can fall asleep immediately, that means the amount of their sleep is insufficient so they possibly have behavior induced insufficient sleep syndrome. Their brain is sleepy but is in a state that is forcibly awakened by giving stimulation. The symptoms of this disorder are feeling strong sleepiness suddenly during the daytime, tiredness or lassitude that you can’t recover from, etc.
 
How long should we take to fall asleep?
Our brain is designed to fall asleep about 10 minutes after going to bed. The 10 minutes is time to doze off comfortably
 
How can we improve this sleeping disorder?
It is recommended to go to bed 15 minutes earlier than usual and increase accumulated sleeping time, resulting in 7.5 hours’ additional sleeping time in a month.
 
How can we know whether we sleep enough or not?
Check if you are sleepy 4 hours after you wake up. Brain should be most active 4 hours after waking up. If you don’t feel sleepy at this time, even if you only sleep for 3 hours, you are successful to adjust your body. On the contrary, even if you sleep for 10 hours, if you feel sleepy, that means you had low quality sleep for a long time.
 
What should we do when we can’t fall asleep?
The structure of the brain makes us not able to sleep for at least 1 hour if we can’t fall asleep within 15 minutes. So when you can’t fall asleep, it is better to get out of the bed and sit on a chair in the dark room. We have antigravity muscles which support our body and relaxing these muscles makes us sleepy. There is a part of antigravity muscles at around the jaw. While sitting on a chair, look up raising the jaw up and keep the posture for 5 seconds and then slowly lower the jaw down. If you repeat this movement 3 times, your body relaxes and you feel sleepy so go back to the bed to sleep.
 
What is the good way to sleep deeply?
Before you go to bed, warm the ankles by showering with warm water.
We can sleep deeply when our core body temperature goes down. Warming the ankles induces the sweat on the bottom of the feet. When the sweat vaporizes, heat of vaporization occurs. The heat of vaporization cools down the blood in the feet and the blood circulates the body, resulting in cooling the core body temperature. 1 hour before going to bed, warm each ankle for 10 seconds with shower.

If you sleep less than 5 hours, the risk for onset of diabetes will be about 5 times.

The risk for onset of diabetes of people whose average sleeping time is less than 5 hours is about 5.4 times compared to people whose average sleeping time is more than 7 hours.
 
Lack of sleep increases the secretion of a hormone which raises blood sugar, and also lack of sleep decreases the function of insulin. As a result, the risk to have diabetes becomes higher.
 
To prevent diabetes, it is better to sleep more than 7 hours.

Who has sleep apnea?
 
Sleep apnea is considered as the condition that fat people tend to have, but women aged late 40s or above who have sleep apnea are increasing. Women tend not to have sleep apnea compared to men because progesterone which is a female hormone to help breathing is secreted. After late 40s, the secretion of the hormone decreases, and the muscles around neck and throat tend to become loose due to aging, leading to narrow air way. The risk of sleep apnea increases about 3 times.
 
Miso soup in the morning improves your sleep?
 
It is important to take a substance of Tryptophan to sleep well at night. Tryptophan is contained a lot in soy beans, daikon radish, spinach, Abra-age (deep fried curd) or pork so it is good to have miso soup with these materials.
 
Why is it good to have miso soup in the morning?
 
Because it takes 15 hours that tryptophan changes to melatonin which is a hormone accelerating sleeping. Having miso soup in the morning is important to sleep soundly.
 
Simple stretch to sleep well
 
(1) Extend one arm and pull the arm with another arm stretching the shoulder blade of extended arm. (Fig. 1)
(2) Keep stretching for 10 seconds.
(3) Do the same thing for another arm.
 
Stretching around shoulder blades before going to bed leads to good sleep. Sleepiness occurs when the core body temperature goes down. There are a lot of cells raising the core body temperature gathering around shoulder blades. If you do this stretch, the core body temperature goes up once but after that it gradually goes down. So it is recommended to do this stretch 1 hour before going to bed.
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