Why we press on your abdomen when you come in for sleep problems

What follows combines several people's visits into one reconstructed account. It is not any one person's story, and anything that could identify someone has been removed.

What we often hear

• "I can't sleep — why are you looking at my stomach?"
• "On days my stomach is upset, I sleep especially badly."
• "If I eat dinner late, I sleep even worse."

Why press on the abdomen while talking about sleep?

Because many people who can't sleep also have an uncomfortable stomach. When your digestive system is still working at night, sleep becomes shallow.

People are often puzzled when we say we'd like to press on their abdomen. So we explain why first.

What do we check?

By hand, we check whether the area below the breastbone is hard, whether it feels tight and tender under the ribs at the sides, whether the belly is taut with gas, and whether the lower belly is cold.

In people who have been tense for a long time, the area from below the breastbone down to the navel is stiff like a board. We also note how much it hurts when we press.

If they also mention gurgling in the belly, or loose stools and never feeling fully done after the bathroom, we look at the bowels first.

How does that connect to sleep?

When your body is putting effort into digestion, it can't switch over to resting at night. And when absorption is poor, you also run short of energy for the day.

When energy runs short, the body tenses up even more to keep going. That tension in turn makes sleep shallow. Unless this cycle is broken, working on sleep alone usually doesn't help much.

How do we treat it?

We start by clearing what's blocked and softening the stiff abdomen. Once the belly is comfortable, we shift the focus to sleep.

With the first prescription, some people get looser stools. We tell you this before we start. But if it continues for more than a few days or is hard on you, don't just put up with it — let us know. We'll adjust the medicine.

We sometimes also use hands-on treatment of the abdomen and moxibustion.

How did people do?

The belly becomes comfortable first, and sleep follows. That's usually the order.

So early on, we hear, "My sleep is still the same." When we then ask how the stomach is doing, it has often changed.

What are the limits of this approach?

Feeling with the hands can't replace imaging. If you're losing weight, have blood in your stool or have trouble swallowing, an endoscopy comes first.

One more thing: we don't have numbers showing how much working on the abdomen improves sleep. What's written here is the order we've seen in our clinic.

If you have the same symptoms

1. Many people who can't sleep also have an uncomfortable stomach.
2. By hand, we check whether the area below the breastbone is hard, whether there's gas, and whether the lower belly is cold.
3. When the body is putting effort into digestion, it can't switch over to resting at night.
4. Often the belly gets comfortable first and sleep follows.
5. If you're losing weight or have blood in your stool, an endoscopy comes first.

We start by sorting out what kind of insomnia it is. Not being able to fall asleep and waking up during the night point to different places to look.

If poor sleep is wearing down your days, come and see us. We'll start by sorting out whether you can't fall asleep or keep waking up. Each points to a different place to look.

Because there are many possible causes, progress differs from person to person, even with the same care.