A major part of being an acupuncturist is treating sleep issues. Acupuncture is very effective at helping people enter a state of balance, and herbs can also be very helpful in gently calming the nervous system without side effects.

Early in my career, I learned a key lesson to treating insomnia lesson.

One of my first patients in our school clinic, when I was in my second year of acupuncture school, Geraldo, was a 35-year-old mechanic with chronic insomnia. My mentor, a seasoned Chinese medicine doctor from northern China, taught us acupuncture prescriptions to use for him and prescribed herbal decoctions he prepared at home. Every week, Geraldo reported that his sleep was 20% better, but it stayed on that plateau and never resolved.

Then one day, after a few months, Geraldo came in with a big smile, triumphant.

“My insomnia is gone,” he said.

I remember thinking, “Wow. The power of herbs and acupuncture.”

But when I asked him what had changed, the answer surprised me. Geraldo told me he had gotten a new job. He had gone back to cutting hair—something he had learned years earlier and actually enjoyed.

That moment became one of my first major lessons as a health practitioner. Geraldo’s sleep didn’t resolve because we finally found the “right” needle combination or herb formula. It resolved because the root stress in his life was removed.

What’s Really Keeping You Awake

In my experience, for the majority of people with insomnia, stress is central.

Sometimes that stress is obvious, like a difficult sales job that involves traveling all over the world, or working long hours while relying heavily on stimulants like caffeine and sugar to get through the day. Other times, it’s about not getting enough exercise to help regulate the nervous system, or spending too little time outside during the day—especially in the morning—and too much time in front of screens at night, disrupting natural circadian rhythms.

And sometimes, it’s a more subtle emotional issue.

I once treated a 30-year-old saleswoman, Jennifer, who was waking up every night around 3 a.m. When I asked what was going on in her life, Jennifer told me she had just broken up with her boyfriend of five years.

I told her, “Of course you’re waking up at 3 a.m. You’re grieving.” I explained to her that we don’t want to use even a natural treatment to suppress the grief. We want to acknowledge it and let it work on us, teaching us the lessons it wants to teach us, so we can grow as a person.

As children and as young adults, we are generally not taught how to sit with difficult feelings. When sadness, grief, or fear shows up, we often try to fix it, numb it, or medicate it away. But emotions, when allowed to be felt, tend to move through the system on their own.

What does it actually mean to “sit with” a difficult feeling? One approach I often recommend is called somatic tracking—paying attention to where you feel the emotion in your body. When you wake at 3 a.m. with anxiety or sadness, instead of immediately reaching for a remedy or distracting yourself, you can lie there and notice: Where do I feel this? Is it tightness in my chest? A knot in my stomach? A heaviness in my shoulders?

For those interested in learning more about somatic tracking for insomnia, you can find helpful resources at The Pain Psychology Center’s guide to somatic tracking.

In cases like Jennifer’s, my goal is not to eliminate the feeling—but to support the body so it can move through it safely.

Use of Conventional Sleep Medications

When patients come into my office already taking sleep medications, I don’t judge them. Sometimes people are in too much distress to immediately address root causes, and they need short-term support. That said, I strongly discourage the use of sedatives like benzodiazepines or drugs like Ambien, which are highly addictive. I also do not recommend using antidepressants as sleep aids—there is no such thing as a trazodone deficiency.

It’s also important to distinguish between medications that are prescribed to help people sleep and medications that are prescribed for other medical conditions but end up disrupting sleep as an unintended side effect. Clinically, these are two very different situations—and they require very different approaches.

When Prescription Drugs Cause Insomnia

There is another category of insomnia I see often—particularly in older patients—and it’s one of the most difficult to treat: insomnia caused not by sleep medications, but by prescription drugs taken for other medical conditions.

Leah came to see me in her early 80s. She had high blood pressure and had undergone triple bypass surgery. She was on multiple medications to manage her conditions.

Neither herbs nor even prescription sleep medications seemed to help her insomnia.

As a practitioner, patients like Leah present a real challenge. The very drugs that are helping to keep them alive—blood pressure medications, heart medications, and others—can interfere with sleep by altering brain chemistry, suppressing melatonin, or disrupting the body’s natural sleep architecture.

For patients like Leah, my approach is to help them change their diet and lifestyle so they can decrease their dependence on drugs, always in cooperation with their doctors. Usually, patients who are overweight find that when they lose weight, their hypertension improves. Eventually, they can reduce or even eliminate those medications, and this often helps with the insomnia.

It’s a longer road, but it’s one that addresses the root rather than just managing symptoms.

Insomnia Is the Messenger, Not the Problem

Here’s what I’ve learned after treating hundreds of patients with sleep issues:

Most people with insomnia don’t actually need more sleep hygiene tips. What they need is to address what’s making them feel unsafe, stressed, or out of alignment in their lives.

Your body is not a machine that you can trick into sleeping with the right combination of tactics. Sleep is not just a mechanical function. It is a reflection of how safe, supported, and balanced your nervous system feels.

When sleep is disturbed, it’s often because something important is asking for attention. A job that’s draining you. A relationship that’s causing pain. Unprocessed grief. A lifestyle that’s running you into the ground with stimulants and stress.

When we listen—rather than silence the message with pills or even natural remedies—we often discover what actually needs to change. And when we make those changes, sleep usually finds its way back, naturally.

Until next time, may you sleep well.