Insomnia is defined by the books as a symptom of a "sleep disorder".  The books continue to explain that it is a "difficulty initiating or maintaining sleep, or both", followed by periodic "functional impairments" while awake.  Well, thank goodness for books, otherwise we would think insomnia was nothing to lose sleep over.

In terms of function, the late Sir Winston Churchill was, by all accounts, one of the most energetic elders of his time.  He did not start his career as British Prime Minister until the age of 64, when most of his peers were planning their retirement canasta games.  His time in office was not exactly easy, as World War II had broken out, and all of Europe was being overrun by Hitler's army.  His own army was defeated and routed back to England at Dunkirk, rescued by a galant convoy of  private skiffs and small boats.  His level of focus and function was heroic, the envy of men half his age.  How much sleep did he get?  Not even three hours a day, including cat-naps.  If he lived today, he probably would have been slammed on Ambien (along with antidepressants, etc), and would have been suffering from too much sleep, along with the 48-hour hang-over of the sleeping pills.  And a woman of that age would surely be treated with hormones, like Premarin.  Also not very effective, and full of side effects.  The only sure way to enforce an eight hour sleep in anyone would be to administer a general anesthetic every evening...hardly good medical practice. 

As people age, they often need less sleep.  For example, teenagers often need massive amounts of sleep, due to growth and activities.  At some point in the middle of our lives, around 6-8 hours is common, but certainly not universal.  As we get past 50 or 60, it is very likely that just half that will do fine, although at any age it will be common to have an occasional morning of "sleeping in" to catch up.   By the latest statistics, over 64 million Americans suffer from insomnia regularly.  No wonder the prescription-drug cartel is raking in the money for pills.

So the real measure of sleep is the quality of its results, not just the quantity of time spent.  For some these results refer to focus and function during the waking hours.  But another measure is one's appearance; hence the term "Beauty Sleep".  Nothing tells the world you are feeling tired like "insomnia face": dark circles under the eyes, sagging cheeks, droopy lids, and mattress-print lines all over the face. 

On this latter point comes a great piece of advice from the legendary Cary Grant.  In his late seventies, he noted that the key to maintaining his looks was to sleep on his back, not on his stomach, to avoid the evidence of linen-folds on his face. 

Functional Insomnia: So if you are awake when you should be sleeping, then asleep when you should be awake, take precautions.  Try a strategy of night time "hygiene" that includes keeping all work materials away from your bedroom, trying a hot bath a half-hour before retiring, and avoiding any big protein meals or vigorous exercise just before bedtime. If you wake up in the middle of the night, get up and do some of your next day's activities, eg reading, paying bills, catching up on email etc.  Don't just stare at the clock and get annoyed at being awake.  Consider carving out extra time each day for a "cat-nap" if needed; it certainly worked for Winston. Hot herbal teas can also help, as can meditation/hypnosis, acupuncture, soothing music, aromatherapy candles etc.  Only as a last resort ask for intervention with pills, as they are usually overprescribed (and over-demanded). 

Facial Insomnia: If you alarm yourself with the first glimpse in the bathroom mirror, and if you seem to be suffering from an acute attack of face, don't dispair.  Micro-current can come to your rescue, without having to go to a spa.  Try the FaceMaster® and you will be amazed; sagging muscles will firm up, lids will stop being baggy, and even the eyes themselves will look more open and bright.  Suzanne Somers correctly notes that this is the ideal cure for those "red eye" flights before going on the air.  We have also had the same comments from patients who were up all night with a sick child before they had to attend an important office meeting. 

Action tip: Remember insomnia is not a disease, and it is not caused by the lack of a brand-name drug. 

For more information on functional insomnia, consider medical acupuncture, a great drug-free way to solve the problem.  To find a doctor in your area, visit the link on http://www.peterhansonmd.com/. 

For more information on your face, visit http://www.facemaster.com/. 

Dr. Hanson welcomes your comments and questions.

Bell's palsy is a paralysis of the motor nerve to one side of the face. Most sufferers wish Sir Charles Bell would take it back, even though the Scottish surgeon has been dead a couple of centuries.  The nerve in question is the facial nerve, otherwise known as the 7th cranial nerve.  The cause of this paralysis is largely unknown, although it can be created by trauma to the nerve, including pressure from a tumor along its pathway, or surgical "nicking" during complicated operations.  Most often, however, it is considered "viral". 

Now a quick word of medical lingo is in order here.  When a patient wants to know what caused their disease, Doctors have hated to say "I don't know" .  So they substitute euphamisms such as "agnostic", "essential", or (my personal favorite here) "idiopathic".  If your doctor tells you your disease is caused by "essential agnostic idiopathy" then you KNOW he/she is stumped!

But an even more obvious clue your doctor has no idea what is causing something can be found with the word "viral".  A thousand years ago, medical writings would blame diseases  like this on "evil spirits".  If we substitute this for "viral" in the modern medical literature, we are right back in the dark ages!  When modern experts further want to sound knowledgeable, they may further identify said virus as "herpes simplex type 1" or whatever.  Sounds like a much more impressive bluff.   But why only one side of the face?  Wouldn't any virus find it just as easy to settle on both sides?  Why not on the back of the head, or for that matter the arm or the leg; they have nerves there too!  Don't ask too many questions, as the experts may start to confabulate here.  And yes, sometimes we just don't know it all!

 Bell's palsy affects men and women equally, from childhood to old age, and on either side of the face .  About 40,000 Americans each year will develop this condition.  Usually it appears spontaneously, with no fever or incedent to announce it. It can get better by itself, with about half the patients seeing recovery in a few weeks.  However, some cases will last months, and many will last for years.  Former Canadian Prime Minister Jean Cretien acquired his Bell's palsy in his youth, and still has it in his senior years.

In any event, when half your face is paralyzed, you do look odd, as this picture shows.  

But in terms of function, this half-faced paralysis can be a real problem.  The eyelids usually don't close fully, leaving the corneal surface of the eye to dry out.  Often eyedrops and tape are required to moisten and shut the lids at night.  Also, eating soup can be a catastrophe.  Not to mention spaghetti.   A crystal wine glass becomes a dribble cup.  You need to wear a bib just to give a toast.  

So the real question here (for those cases unlucky to not clear up quickly on their own) is not "what causes it?".  Rather it is: "can anyone please fix this?"

Oral steroids are the standard here, but they are more of a "hail mary pass" to use the football vernacular.  Side effects are a concern, and the drug goes everywhere, not just to the one nerve on one side of the face.  Much better results are seen with medical acupuncture, which inserts needles strategically into points along the underlying nerve branches.

 I have treated literally hundreds of Bell's cases with electrical micro-current applied to sterile acupuncture needles, with virtually full recovery in most, including some with over ten years of non-response to other treatments.  I have also trained dozens of M.D.'s from around the US in my offices in Denver, and they have had similar success in their own practices.  E-stim with micro current is particularly dramatic, as it can be seen to work immediately.  The muscles visibly "twitch" as they are selectively stimulated, and the nerve-muscle connection begins to resume its function.  Usually within a three visits we can start to demonstrate recovery, and further visits will take the face back to full normalcy.  We normally treat twice a week for the first six visits, then cut back to weekly or even monthly depending on speed of recovery. 

Between visits, find great improvement is seen with e-stim in a home machine version.  The same microcurrent is applied as that which we use through the needles, but no needles are used.  Simply by touching the moistened wand tips to the correct anatomical sites on the face, the home unit will make the 22 muscles on each side of the face start to twitch, and begin to resume their tone.  The machine I recommend to my patients is the FaceMaster.  Full disclosure (if not full modesty) compells me to  mention that I co-founded the FaceMaster company (with former Apple Notebook lead engineer Rodger Mohme), and have been delighted to see it pass through rigorous FDA study, to gain clearance as an effective cosmetic device for toning the facial muscles.  Suzanne Somers loves hers so much she tells everyone it is her "best beauty secret", and the first thing she wanted replaced when her home burned down. 

So, even if you don't have Bell's Palsy (and especially if you do!), use electrostimulation to tone your muscles.  Volume builds up beneath the skin.  Eyelids firm up their droopiness, cheek muscles lessen their sagging, wrinkles diminish, and the angles of the mouth turn from frown to smile.  Once my patients have seen how effective it is they do not want to stop using it on both sides of their faces. 

We welcome your comments and questions. 

For more information on Dr. Hanson's medical acupuncture practice, visit www.peterhansonmd.com For an MD in your area, visit http://www.medicalacupuncture.org/. 

For more information on the FaceMaster, and to read other blogs by Dr. Hanson, visit FaceMaster.com.