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Leisa Bellmore, Shiatsu Therapist in the Artists’ Health Centre at Toronto Western Hospital demonstrates how to perform self-shiatsu on the hand to help with sleep. (Video: YouTube/UHNToronto)

There are so many tips and myths surrounding what it takes to get a good night's sleep. Does a warm glass of milk help you drift off easier? Or will counting sheep actually help you fall asleep?

While trouble sleeping can affect everyone at one point or another, for people with chronic pain sleep problems are a nightly issue.

According to a 2003 global study of pain prevalence by the International Association for the Study of Pain (IASP), "chronic pain is among the most disabling and costly afflictions in North America, Europe, and Australia."

Relationship between chronic pain and sleep

Leisa Bellmore, a shiatsu therapist in the Artists' Health Centre at Toronto Western Hospital, is hoping her pilot study on hand self-shiatsu is the beginning of helping people with chronic pain get a better night's sleep.

"There's a bi-directional relationship between chronic pain and sleep," said Bellmore. "If you have chronic pain, sleep deficiency is more likely, and if you're not sleeping that can sustain chronic pain."

Sense receptors in hands

Published in the Journal of Integrative Medicine, the study focuses on participants administering shiatsu on their own hands for 10-15 minutes every night.

"We focused on the hands for several reasons," said Bellmore. "The hands are easily accessible and we have lots of sense receptors in our hands, but most importantly people can do it themselves."

People dealing with chronic pain often feel like they lack control over their own bodies and their overall health. Self-management from being able to administer their own therapy can lead to more positive feelings about their health. 

Traditional Chinese Medicine 

Shiatsu is based on the principles of Traditional Chinese Medicine. Shiatsu practitioners apply thumb and finger pressure to different points on the soft tissues of the body in order to assess and treat a variety of conditions.

For the study, occupational therapy and physical therapy students were taught the basic shiatsu techniques and in turn trained participants.

For those who want to try hand self-shiatsu as a sleep intervention, Bellmore recommends repeating the patterns three times on the areas on the back of the hand and the palm, as well as on the top, bottom, and sides of the fingers to get the best results.

Falling asleep faster

 Twelve participants completed the study and Bellmore says some reported falling asleep faster – sometimes even while administering treatment. Participants also said they woke up less during the night at the two week and eight week follow-ups.

While the study focused on people with chronic pain, Bellmore says in theory anyone experiencing difficulty sleeping could trade counting sheep for hand self-shiatsu.

"The benefits of this method are that it's a non-pharmaceutical intervention, there are no side effects, it's not invasive or painful to administer, it's cost-effective, and the hand is easily accessible to people who may have limited range of motion," said Bellmore.

Avoid certain activities

Whether you suffer with chronic pain or just occasionally have trouble sleeping, Bellmore recommends avoiding certain activities that can make it harder to fall asleep.

"A lot of people watch TV in bed or use their computer late at night, which is terrible," said Bellmore. There has also been a lot written about how exercise can generate a better night's sleep, but she says that's not always the case.

"Exercising raises your core body temperature, increases your heart rate, and prompts your system to release adrenaline," she explains. "So if you exercise late in the evening or just before bed it actually has the opposite effect."

Smoking or eating a heavy meal late at night and even a stream of light coming through a door or window can all be added to the list of things that can disrupt sleep," said Bellmore.

Bellmore worked with Cary Brown and Geoff Bostick of the University of Alberta on the pilot study.  While the study had a small sample size, Bellmore is encouraged by the results. She says she hopes to expand the study to include more participants to get a better idea of the effects of hand self-shiatsu as a sleep intervention strategy.

To read the full study, please click here​.

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