The pursuit of a good night’s sleep
It’s mid-afternoon on a mild spring day at Artemisia Clinic in Taos. Dr. Clara Wetmore, a doctor of Oriental Medicine, is treating Amy Dondanville, who has difficulty sleeping. Soothing music plays and fragrant herbs in orderly rows surround the treatment table of the well-lit clinic.
Wetmore consults with Dondanville and then checks her pulse at various points on her body, asking questions in a quiet voice, “How is your stress level? Energy level?” She asks how much caffeine Dondanville consumes.
Dondanville is experiencing a high level of stress, having just returned to her job as a clinical social worker after being gone for three weeks. She reports that she is not sleeping well and feels more frantic, like she is running on adrenaline that causes her to crash. She has removed most caffeine from her diet, drinking just one cup of black tea a day.
While Dondanville relaxes on the treatment table, Wetmore places needles in various parts of her body: her forehead, wrist, midsection and lower legs. “I place needles at specific points along the relevant or affected meridians, based on symptoms, presentation and pulse diagnosis. Each point has unique indications, and I pick the points that relate to or address the symptoms and underlying health concerns,” Wetmore explained. Today, she is inserting needles to help calm the mind, as well as reduce racing thoughts, anxiety, pain and insomnia. As the needles are placed, Dondanville explains that she’s not feeling any pain, although sometimes she experiences a sensation.
Wetmore uses another tool, known as an ear or auricular seed, which is a tiny stainless steel pellet with a latex-free adhesive patch. Ear seeds are a type of auriculotherapy rooted in Chinese medicine. They’re meant to promote comfort and relaxation and have become very popular in the West in recent years, despite some disagreement among medical professionals as to their efficacy. Occasionally, Wetmore uses gold pellets, depending on the treatment, or even small pellets with crystals on the top that look like little earrings if brought in by a patient.
Wetmore cleans and disinfects the ear and then places the tiny pellets in specific spots on the left ear that are tender, indicating trouble somewhere in the body. Dondanville will wear them for a week, after which they fall out or she will remove them. The ear seeds do their work while in place, Wetmore says, and their effectiveness can be increased by periodically pressing on them. “Right now, I am placing an ear seed to regulate the nervous system and treat an insomnia point,” she explains. “I also checked the liver point, usually aggravated by stress but that spot wasn’t tender, so I am moving on to the heart spot which is calming to the mind.”
Dondanville is experiencing difficulty powering down and falling asleep, which is her most common sleep struggle, although she does sometimes wake up in the middle of the night and have a hard time going back to sleep. She usually comes in weekly, but since she has been out of town, this is her first appointment in almost a month. She says, “I’ve had chronic sleep problems since I was a kid; it’s always been a struggle for me. The practice of coming regularly allows me to connect with my body and speak to what is specifically happening with my digestion, sleep, mood and energy levels. The act of reflecting is helpful itself. When accessing treatment regularly, I
find I can fall asleep with great ease, which I wasn’t previously able to achieve.”
Wetmore also gives Dondanville a Chinese herbal formula for sleep. At the beginning of treatment, she was taking three to four doses per night and that has been reduced to one or none. “This is what I want for all my patients: to get to the point where their bodies remember how to sleep without external help,” says Wetmore.
Dondanville has been seeing Wetmore for about two and a half years. She sought Wetmore out for help with another issue, but through the comprehensive checkins done at each appointment, the two discovered the extent of Dondanville’s sleep disturbances. “The practice of attending appointments and engaging in reflection
has created a sense of mindfulness and awareness about what is happening outside appointments and brought a deeper sense of noticing about which routines and habits nurture my body and which ones harm them,” reflects Dondanville.
When asked what advice she would give to people struggling with sleep problems, Dondanville recommends that people become aware of what content is stimulating to the brain in a negative way, whether it be watching TV, listening to audio recordings or scrolling on the phone.
According to a study by Harvard Medical School, the blue light emitted by smartphones “can affect your sleep and potentially cause disease.” The study notes a well-known fact about the brain — that the absence of light signals to the brain to prepare for sleep and the presence of light triggers wakefulness. As such, turning down any bright lights before bed can help people to achieve deeper sleep. Conversely, exposure to daylight upon waking can boost alertness and mood.
Wetmore added, “I’d suggest that people establish a routine that cues the body that it is time to move towards sleep, which might be stretching, taking a bath or shower, or applying cream to nurture the body.”
Sleep disorders and effective treatment
Wetmore opened her practice five years ago. She earned a Master’s of Science in Oriental Medicine degree from the Southwest Acupuncture College in Santa Fe and is licensed by the state and certified nationally. For the best results, she sees patients on a regular basis, but even a single treatment can help. One new patient who was skeptical of acupuncture came to see Wetmore to get help with her racing thoughts. Wetmore treated her with acupuncture, ear seeds and an herbal formula. When Wetmore saw the patient next, she had gone from sleeping for about an hour a night to sleeping seven hours. “Sometimes it’s dramatic like that, and other times it can take weeks or months to see results like hers,” says Wetmore.
More than 100 different types of sleep disorders have been identified, according to the Sleep Foundation. Wetmore sees many of them at her clinic. “People come to me with sleep issues ranging all over the insomnia spectrum; some who can’t fall asleep, some who can’t stay asleep or wake up too early, some light sleepers, some with crippling nighttime anxiety, some who can’t turn their minds off at night,” she says. “Some patients sleep for a few minutes per night — if at all — some for a few hours and some just don’t get quite enough for their particular needs.” The causes range from trouble sleeping due to menopausal or perimenopausal hormone shifts, which account for about half of her patients, while others are dealing with stress, anxiety, trauma, grief, pain or other issues. Sometimes, there is no obvious cause.
“Because sleep disorders are so unique to each individual, being able to tailor acupuncture treatments and herbal formulas to each patient’s needs is hugely important in my work,” says Wetmore. “My goal is to regulate the sleep cycle so that patients don’t need to take herbs and supplements forever to get a good night’s sleep. It’s like giving a gentle nudge and reminder for the body to remember how to do such a fundamental and necessary regenerative process on its own. Another advantage is that I spend a lot of time with each patient, so I really get to know each person’s life, physical health and emotional health, giving me the insight to treat very specifically.”
As part of her approach, Wetmore checks for any medications being taken by the patient to make sure there won’t be interactions between the medications and herbs she recommends for sleep. In addition to making recommendations about nutrition, Wetmore refers patients to other needed services, such as therapy, meditation, exercise, primary care and other physicians.
When asked how her approach is different than a medical doctor’s might be, Wetmore said, “In some ways, my approach probably isn’t all that different than that of Western medicine; we’re all trying to help people feel better, and are using the tools, knowledge and skillsets we have. I have tremendous respect for my medical colleagues, and although folks don’t always expect it, I’m very much in support of Western medicine and science, and love to work in tandem with my patient’s other providers.”