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Acupuncture Lowers Sleep Apnea By Almost 50% After One Treatment

In a follow-up study (PDF) to their previous paper (PDF) showing that 10 acupuncture treatments can lower the AHI by 50%, the same authors performed sleep studies just before and after one acupuncture treatment, and found a 49% improvement in the apnea hypopnea index. The apnea index improved by 86%, and the hypopnea index dropped 39%. This was in the traditional, manual acupuncture group. In the group that received electrical stimulation acupuncture, the results were slightly better. The study authors proposed that acupuncture somehow alters the serotonergic pathways that are related to the caudal raphe neurons that control the muscles of the upper airway. One of the needles was also inserted into the genioglossus muscle, which is the main upper airway dilator muscle.

Personally, I’ve had mixed results using the same protocol for sleep apnea. But when it works, it works really well. Regardless, there’s minimal risk of complications, and even if your sleep apnea doesn’t improve, you’ll get the relaxing benefits of acupuncture treatment.

Has anyone experienced better sleep after acupuncture treatment?

Complementary Options for Sleep Apnea: Acupuncture & Yoga

As many of you know, I incorporate acupuncture and yoga into my practice when treating sleep apnea and upper airway resistance syndrome. Of course, I don't do it myself—I refer to other trusted practitioners. Despite acupunctures' completely different paradigm of health and wellness compared with Western allopathic medicine, one thing it's great for is to realign any imbalances in your body. 

One major imbalance that occurs with sleep apnea is that you'll have too much stimulation of the sympathetic or fight-or-flight part of the involuntary nervous system, and not enough of the parasympathetic (relaxation) nervous system. Not sleeping long enough or not efficiently has been shown to increase sympathetic activity. Acupuncture has been proven scientifically to bring into balance the unevenness between your sympathetic and parasympathetic nervous systems.

Acupuncture won't cure your sleep apnea, but used in conjunction with standard treatment options, it can be helpful for many people. In fact, one recent study showed that it lowered the sleep apnea severity (AHI) by 50% on average. This is presumably due to its' effects on the nervous system, since neurologic dysfunction is a major component of sleep apnea.

I also routinely recommend yoga or yoga-based breathing techniques for my sleep apnea patients. It's not coincidence that by modifying your breathing patterns, you can dramatically alter your sympathetic and parasympathetic activity. A simple concept that you'll appreciate is that when you breathe in, you're activating your sympathetic nervous system, whereas when you breathe out, you're activating your parasympathetic nervous system. This is why when you take longer breathing out (such as with the relaxing breathe, singing, humming or playing a wind instrument), you'll feel more calm and relaxed.

I'm going to be talking about the importance of breathing and how it relates to chronic diseases at the Many Paths One Medicine Traditional Chinese Medicine Conference on May 15th in New York City. Hope you can join me.

Surprising News About Alternative Medicine

On Health And Healing

The other day, my 5 year-old son Devin accidentally bumped his leg on a table corner. After a brief pause, I could see the grimace on his face and tears starting to well up in his eyes. I went over to him, asked him where it hurt, and after rubbing my hand over the area that he pointed to, I gave him a kiss on the forehead, and told him that everything will be OK. Within 5 seconds, he was smiling and running around again. This incident reminded me about the importance of relationships in any form of healing, as well as how we even define what health or healing is.

One of my most memorable courses in college was called “Paradigms of Health & Disease.” It was a fascinating course which explored how various cultures perceived and defined heath. Some cultures (such as ours) defines health as an absence of disease. Other cultures define health as a state of balance, in harmony with your natural environment, world or universe. I’m sure I’m missing dozens of other definitions, but what I want to convey here is that even within our Western, modernized culture, all of us have different perceptions and ideas on what it is to be “healthy.”

The famous 16th century French barber-surgeon Ambroise Paré said (paraphrased), “I place the dressing, and God heals the wound.” Whether or not you’re religious, Paré’s quote emphasizes the human body’s innate ability to heal, given the right conditions. If you have a cut, what we do as physicians is to facilitate the wound to heal, by cleaning the wound and placing a dressing. The body does the rest. Doctors get into trouble (especially surgeons) when they take credit for the almost miraculous recoveries after treatment with an antibiotic or after major surgery.

In this context, do doctors actually heal patients? Is the act of administering a medication or performing surgery the act of healing, or is the body actually doing the healing on it’s own, once the proper environment is laid in place? This health science issue is definitely up for debate, but one thing for sure is that the patients’ proper physical, emotional, and mental environment is critical for any kind of healing to take place. This is something that we as physicians tend to forget all too often.

Over the years, I’ve noticed that there are many terms used very loosely in the health-related medical fields, such as words like naturopathic, chiroprathic, osteopathic, and allopathic. Sometimes these words are used interchangeably, and other times they are used inappropriately. Hopefully, I can clear up some of the confusion surrounding these terms, as well as to give you some guidance as to who to go to when you have particular healthcare needs.

As I’ve mentioned in my other articles, I’ve come on a journey over the past 10 years in private practice, where I realized that to truly treat a simple ear infection or a sinus infection, you must address the entire person, including their diets, sleep habits, lifestyle and stress issues. Giving medications is only covering up the problem, a sort of a band-aid, until the problem comes back later on. It’s not surprising that it’s estimated that the vast majority of visits to the doctor’s offices are a direct or indirect result of diet, lifestyle, and stress-related issues.

Traditional Western, or allopathic medicine (supposedly) uses scientific reasoning, logic and methods to find the true cause of illnesses and attempts to leverage the latest technology towards achieving this goal. The term allopathy was originally used to describe a healing practice that used agents that are the opposite of what’s causing an illness (allo – against, pathy – disease). For example, an antibiotic is used for bacteria.

Homeopathy, on the other hand, uses substances that are similar to what’s actually causing the illness to treat the disease. An example of homeopathy is using very dilute concentrations of lead to treat lead poisoning. A basic foundation of homeopathy is that the substance or toxin in question must be diluted numerous times to the point where only a few (or less) molecules exist in the solution. Interestingly, Dr. Hannemann, the founder of homeopathy, originally coined the term allopathy and it was used in a derogatory manner. Modern allopaths like to think of allo- to mean all or inclusive.

Osteopathy is a form of medicine that focuses on proper bony alignment and it’s relations to the rest of the body. Modern osteopaths (Doctor of Osteopathy, or DOs) are the equivalent of MDs, with all the privileges rights, and responsibilities. In medical school, osteopaths take additional courses in spinal and bony manipulation and are more focused on addressing the whole person, rather than a body part or organ.

Chiropractic is similar to osteopathy, but focuses mainly on spinal and vertebral alignment and functioning. The inventor of chiropractic describes coming up with the concepts after a woman’s hearing loss went away after he resolved a bump behind her neck.

Naturopathy is a form of holistic healing that emphasizes the body’s innate ability to heal, using remedies such as light, water, food, herbs, and massage.

Last but not least, I should also mention Chinese medicine (with acupuncture) as well as Ayurvedic medicine. These ancient form of healing are thousands of years old and are still being actively used in many parts of the world.

To overcome all the shortcomings of each of the above mentioned disciplines, physicians have recently introduced terms such as alternative, complementary, integrative or holistic. Some of these words are sometimes used interchangeably, but it’s important to distinguish the true meanings of each of these terms.  Admittedly, there are many definitions and variations for each of these terms, but I’m going to present the more commonly accepted definitions that I have come across.

Alternative medicine is any modality that is not traditional, allopathic medicine. In the US, due to the many problems associated with our current health care system, many people are either rejecting it altogether or looking for alternative ways of dealing with their health. This involves preventive and wellness options as well as treatment for acute or chronic conditions. Examples of alternative medicine (in the US—it may be different in other parts of the world) include Chinese medicine, naturopathic medicine, chiropractic, and Ayurvedic medicine. I’m sure I’m missing many dozens on others.

Integrative medicine is the practice of integrating or combining all the different forms of medicine, drawing from each field the most useful and effective methods of treating certain conditions. It gives equal weight to all the different fields. Some would criticize the fact that integrative practitioners sometimes use untested and unproven ways of therapy to treat certain conditions.

Complementary medicine is similar to integrative medicine, but from what I understand, uses essentially one main modality, but draws on the the beneficial aspects of other “alternative” areas when necessary.

Holistic medicine involves looking at the whole person—the physical, psychological, emotional, and spiritual. In theory, all physicians should be practicing holistic medicine, but very few end up doing so.

All of the above forms of medicine incorporate good nutrition and proper exercise as a basic foundation. Some may argue that Western, allopathic medicine has moved too far away from a “holistic” form of medicine where there used to be a much stronger doctor-patient relationship, to more of a technology-driven, algorithm-based, guided missile type of treatment. Due to obvious limited resources, time constraints, information overload, and medical-legal problems associated with our current medical system, the problems that we currently face are not surprising. Andy Kessler, in his book, The End of Medicine, predicts that with rapid advances in technology, doctors won’t have to rely on clinical judgement and experience. Rather, they can just order a test to make any diagnosis.

Another concept that needs clarification is timing. There is a major difference between treatment after an accident or infection, versus taking active steps to prevent an accident for infection from taking place at all. The former considers health as and absence of a disease (no more sinusitis), and the latter will take active steps to balance the body so that even if exposed to a cold or allergies, they won’t progress into a sinus infection. This is what differentiates someone that takes a reactionary approach to their health care issues, versus someone who takes an active or preventive approach so that illness is less likely to happen.

So ultimately, what is healing? Different modalities will have different definitions. An allopathic doctor will define it as total eradication of a bacterial infection from the body. A Chinese medical doctor will define health as a sense of balance in all the different forces, as well as between opposites. Can healing occur spontaneously, or is a second person needed for more optimal healing to occur?

If the patient feels significantly better, but the infection is not completely gone, has healing taken place? What if the infection is completely gone, but the patient doesn’t feel any better? Different medical paradigms will give different answers.

One interesting common feature amongst all the major healing arts, with the exception of traditional allopathic medicine, is that treatment always involve some sort of hands-on manipulation of skin, muscle or other body parts. Allopathic doctors will use manual techniques only briefly for diagnostic purposes, but rely mainly on tests to make the main diagnosis and resort to pills or surgery for any further treatment. In essence, we’ve abdicated the personal, relationship-driven healing arts in favor of technology and science.

I vaguely remember a study on newborn babies where one group had frequent manual touching, contact and stroking, whereas the other group did not. The group that were constantly touched had much faster rates of development, weight gain and other various measures. If babies need constant touching and reassuring to thrive and survive, why can’t adults benefit from “touch” therapy as well, no matter who lays on the hands?

This also explains why as a child, whenever my mother rubbed her hand on my belly for a tummy ache along with a soothing song, I always felt better. This goes to show that in a sense, whenever tactile relationships are involved, all of us are healers.

Acupuncture: Sham or Science?

Amy R. Hausman, L.Ac, Dipl. OM. (NCCAOM)

Guest Columnist

As a licensed acupuncturist, it’s empowering to see your profession cast in an approving light, especially when it’s reviewed by a well respected medical journal. However, since I have witnessed the effectiveness of acupuncture for a myriad of disorders, I am always curious as to why its efficacy is not positively portrayed in more clinical trials. Having reviewed this study for Dr. Park, I now know why. 
 
STUDY OVERVIEW 
 
The purpose of this study was to investigate the efficacy of acupuncture in the treatment of moderate obstructive sleep apnea syndrome (OSAS). It was a randomized, placebo-controlled, single-blinded study, with blinded evaluation of 36 patients presenting with an apnea/hypopnea index (AHI) of 15-30/hour. The patients were divided into 3 groups: an experimental group of 12 people receiving acupuncture once a week for 10 weeks, a sham group of 12 patients who received “fake” acupuncture once a week for 10 weeks, and a control group of 12 patients who received no treatment. The results showed that out of the 26 patients who completed the study, there were significant changes for those in the experimental group that received acupuncture. Not only did the number of respiratory events (or number of obstructions) decrease in the acupuncture group, but there were also marked improvements in the outcome measures as displayed by the SF-36 and Epworth questionnaires. The investigating team concluded that acupuncture is more effective than sham acupuncture in relieving the respiratory events of patients presenting with moderate OSAS. 
 
SHAM VERSUS REAL LIFE RESULTS 
 
My first question regarding this study has to do with the conclusion made by the investigating team. While the research showed that acupuncture is more effective than sham acupuncture in relieving respiratory events in moderate OSAS, there was no mention of a comparison of the experimental group (those receiving acupuncture) to the control group (those not receiving acupuncture).  
 
Granted, real acupuncture versus “sham” acupuncture may prove that there is such as thing as a “good” treatment versus a “bad” treatment. Especially as the research team here utilizes the sham group in the same way that a pharmaceutical company would compare those who were taking ”placebos” to those who were taking the “controlled substance” in question. However, some TCM (Traditional Chinese Medicine) practitioners may disagree with the 
study’s conclusion citing faults in its design. 
 
EASTERN VERSUS WESTERN STUDY DESIGN 
 
The study noted that there were some improvements in the sham group over those in the control group. This implies that even though no real acupuncture points were used on specific meridians, there was some sensation or response that provoked an outcome for the patient. This can lead to conflicting ideas as to whether the sham acupuncture is in fact a real treatment or if it is truly placebo acupuncture as it is meant to be. For this reason, a future study with only 2 study arms, an experimental group and a control group, omitting a sham group altogether in favor of simply comparing the results of acupuncture to no acupuncture may be better from a TCM perspective. 
 
Furthermore, if it is true that a clinical trial must show a certain reliability and reproducibility in order for it to be deemed valid, this same criteria makes it difficult to assay the full impact of acupuncture and other forms of TCM for the treatment of illnesses confined within a Westernized paradigm of disease and health.  
 
DIFFERENT PARADIGMS, DIFFERENT PERSPECTIVES 
 
When I was in graduate school, I was part of a research team that put together a proposal for studying the effects of acupuncture in post-stroke rehabilitation. Our analysis of previous studies addressing the use of acupuncture revealed several fundamental difficulties in the assessment of an ancient Eastern medical paradigm within the framework of modern Western medical research protocols. These difficulties occurred primarily when attempting to apply scientific demands of reliability and validity to the TCM treatment approach based on individual presentation and pattern diagnosis.  
 
TCM sees each person as an individual with a unique set of patterns and presentations regardless of the disease diagnosis. That being said, 5 people presenting with OSAS to a TCM practitioner may be diagnosed with 5 different TCM disease patterns and therefore treated with different acupuncture point prescriptions. While some of the points may be the same, as noted in this pilot study being reviewed, there may be other points specific to each individual that addresses the root of his/her sleep apnea syndrome. Treating the root of the disorder or what is considered the underlying cause is a fundamental treatment principle in TCM. Not only can such a treatment reduce the severity of the symptoms, but it may also reduce the occurrence or recurrence of such disorders altogether. Therefore, it would be interesting to note the long-term effects of using the same point protocol on different patients and whether or not further evaluation at a later date would show more variance in results. Unfortunately, there is no mention in the original article of the different TCM disease patterns used to come up with their acupuncture point prescription or if that was even taken into consideration.  
 
In essence, the basic differences in approach may make a true study of TCM impossible within a Western medical framework. Thus, trying to adhere to strict TCM protocols usually results in studies being conducted with discrepancies in design, intervention and control procedures—all things that in a more statistical evaluation like the study mentioned would compromise the scientific relevance and validity of their results. 
 
Perhaps the future of clinical trials investigating the efficacy of acupuncture lies within a setting that allows for both a TCM approach of customized treatment along with a Western standardization that will be statistically measurable, reproducible, and scientifically valid. While the efficacy of acupuncture has been seen for thousands of years, it seems the progress of acupuncture research is 
slow indeed, and the gap between TCM and Western medicine may be the sticking point when trying to conduct a valid clinical study using acupuncture. 
 
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Amy R. Hausman, L.Ac, Dipl. OM. (NCCAOM) is board-certified in Chinese Medicine. As the founder of Co-Creative Healing Arts and Acupuncture, Amy brings her experience as a licensed acupuncturist and psycho-spiritual counselor to those suffering from anxiety/depression,reproductive issues, sleep disorders, pain management, addictions, chronic sinusitis, migraines, and other acute and chronic illnesses. 

 
Focusing on the body as a whole rather than only the part that is sick is a key to healing all types of disorders. It is this subtle yet powerful approach that Amy integrates using her background in both Chinese medicine and Integrative Energy Medicine in order to help initiate the person’s own healing process. 
 
For a limited time, mention this article and receive $50 off your first consultation and treatment. You can contact her directly at: 917-334-8907. 
 
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*Treatment of Moderate Obstructive Sleep Apnea Syndrome with Acupuncture: A randomized, placebo-controlled pilot trial Anaflavia O. Freire, Gisele C.M. Sugai, Fernanda Silveira Chrispin, Sonia Maria Togeiro, Ysao Yamamura, Luiz Eugenio Mello, Sergio Tufik: Sleep Medicine, 2006, xx(xxxx), 1-8, © Elsevier