Insomnia & anxiety

Been treating female patient in mid 20's for insomnia condition, with anxiety, sleep disturbance, whole body sweating for some time now.  Sleep condition improved slightly where before treatment sleep would be only 2-3 hrs.  After treatment improved to 4-5 hrs on weekdays, weekends 8-9 hrs.  Patient however still experiences difficulty in falling asleep for past 8 years. Her diagnosis is HT & KD miscommunication, Lv-Qi Stag, SP-Qi Def.

Points used are

HT7, PC6, HT6, KD3, KD6, ANMIAN, SISHENCONG, B23, DU4, SP6, ST36, B15, B17, GB13, DU24.

combining with electro-acu and herbs.

Are there any other points I should add or is there a different diagnosis?


Comments

Feng Mei's picture

For Liver Qi stagnation, you

For Liver Qi stagnation, you may add Lv3. Du4 is for increase Kidney fire, but the patient is kidney yin deficiency, you may cancel Du4, add Yin Tang. 

Chad Dupuis's picture

Without providing any

Without providing any diagnostic information outside of her symptoms or providing any of the herbs that you are using it would be impossible to comment further on this case.  Generally, however, it seems like you are doing well - although even that is difficult to say because you don't mention how long and with what frequency you have been treating her.

dcasinelli's picture

Add Moxa to tonify SP

I'd add just a little bit of moxa on ST36, rice grain, and if it doesn't make her sweats worse, add a little more.

Daria Casinelli

hagc's picture

Occasionally would add in LV2

Occasionally would add in LV2 & LV3 (soothe LV), ST40 (to calm shen) as well.

Been treating patient for almost 2 mos, 30 mins each session twice a week...some electro acu either on GB13, Du24, HT7

I've never tried moxa ST36 with rice grain for fear of her yin def sx...but will consider monitoring her with it.

thank you all for your help! 

 

Feng Mei's picture

How St40 can calm shen? can

How St40 can calm shen? can you explain?

hagc's picture

St40 actions is to resolve

St40 actions is to resolve damp/phlegm, clear heat, calm asthma, open chest, calm mind...all phlegm can be either visible or invisible...when phlegm mist the mind it causes cloudiness of the mind and patient thinking is not clear.  If patient experiences depression, anxiety, moodiness, mania, headache, etc this point can be used. 

Feng Mei's picture

Thanks. For mental problem

Thanks. For mental problem patient, the phlegm could be heart phlegm, you may add Pc5 to clear the phlegm, use Yin Tang to calm shen will be more better.

 

Jon Fellman's picture

Insomnia & anxiety

I think it depends on what your primary diagnosis is. 
You say the patient presents with HT & KD miscommunication, Lv-Qi Stag, SP-Qi Def.
If you think the patient is primarily deficient and the insomnia is stemming from the Hrt and K, I would use:


Left: Hrt 3, Hrt 7, GB 34, GB 41
Right: SJ 3, SJ, 10, K 3, K10 (+ add Li 4 and Lv 3 to adress the stagnation, 
and you might even add SP 6 or 3 as well)
AND
Yin Tang, Both Sides ear SHen Men

If the patient is primarily excess and it is stemming from the LV QI stagnation, I would use:

I would use:
Left: P3, P6, GB 34, GB 41
RIght: SJ 3, SJ 10, LV 3, LV 8 (+ add something for the K and Hrt... maybe K3, K7, and Hrt 7