Is anybody NOT feeling stressed these days and having that stress upset their sleep? If so, I haven’t heard from them. We’re in the midst of society-wide upheavals that have left just about everybody anxious and not sleeping great. And let’s be honest, many of us haven’t been sleeping well for a long while.
I always encourage my patients to explore and incorporate mind-body exercises and therapies into their daily routines, as a way to achieve better sleep and a more relaxed, positive mood and mind frame. I’ve written regularly over the years about mind-body practices and mindfulness for sleep. There’s so much appeal in these practices: they’re non-invasive and safe for just about everybody, they’re typically easy to adopt, and incorporate relatively effortlessly into daily rituals. And they can deliver some pretty significant benefits for sleep. The practice of reflexology ticks all those boxes. I have several patients who use reflexology as part of their nightly sleep routines, and rave about how much it relaxes them and eases their stress, helping them to nod off more quickly.
What is reflexology?
It’s an ancient therapeutic practice, with evidence of origins in Egypt, China and indigenous North American cultures. Reflexology is a form of touch therapy, where pressure is applied to points on the hands, ears and feet, intended to affect the function and health of different parts of the body. A reflex map—a highly detailed map of pressure points located on the hands, ears and feet—outlines the connection between each pressure point and a specific location in the body. In reflexology, every part of the body—organs and glands, nerves and tissue, bones and ligaments—can be connected to (and therefore affected by) a pressure point. Pressure points also connect to different physiological functions, including immunity and sleep.
The feet, in particular, are a focus of reflexology. The reason? The nearly 15,000 nerves found in the feet. (That’s also a reason why most of us love a good foot rub.) Foot reflexology is among the better studied form of this ancient therapy.
A few words about the scientific study of reflexology’s impact on sleep. Like a lot of traditional and complementary therapies for sleep and health, the study of this connection has been relatively light. That said, there is a body of research that indicates reflexology can have measurable benefits for sleep, through at least a few different pathways. And practitioners of reflexology make pretty compelling cases for its usefulness in helping sleep, by relaxing body and mind, easing anxiety and stress, and reducing pain.
What is the difference between reflexology and acupressure? Both are what’s known as “reflex touch therapies.” But each practice uses different touch point locations for applying pressure. Most of acupressure’s points are located not on the hands, feet, and ears but rather along 14 different energy lines, known as meridians, that run the length of the body.
How does reflexology work?
- The healing power of touch
- The de-congestion of nerve endings, as a result of pressure application
- A realignment of bones and muscles in the feet
- Restoration of the flow of vital energy, or qi, throughout the body
- Inhibiting of the sympathetic nervous system and activating of the parasympathetic nervous system, like what occurs from massage
- A placebo effect
When it comes to sleep, scientific research has shown some specific, measurable mechanisms by which reflexology can improve both quantity and quality.
The deep relaxation often achieved by reflexology is at least in part attributable to changes in brain wave activity that closely mirrors the activity of light sleep, according to research. In a study from 2017, researchers used polysomnography to identify changes to the activity of brain waves associated with reflexology. They found that after 35 minutes of reflexology, many participants experienced increased brain wave activity like that of stages 1 and 2 sleep, the lightest non-REM sleep stages.
Reflexology has been shown to lower the physiological markers of arousal, stress and anxiety, including blood pressure, heart rate, and respiratory rate. One study of reflexology in patients on mechanical ventilators found that reflexology reduced the patients’ need for medicinal sedation.
The science behind reflexology and sleep
These studies I’ve discussed above point to some of the ways that reflexology may have a positive impact on sleep quality and quantity. Reflexology appears to influence sleep, both directly and indirectly, through several different pathways.
Reflexology can improve sleep quality and reduce insomnia
Scientific studies have shown a direct benefit for sleep from reflexology, which can elevate sleep quality, reduce fatigue, and improve the symptoms of insomnia. A 2012 review of 40 studies of reflexology, acupressure and sleep found that using these therapies led to significant improvements to insomnia when combined with sleep hygiene practices, such as keeping a regular bedtime, eating well and exercising, avoiding excessive light exposure, and maintaining a quiet, dark, relaxing sleeping space free of electronics.
There are also specific reflex points that correspond to sleep and body functions that influence sleep. For example:
- The top of the toes connect to the brain, and can influence positive thinking. I’ve talked about the importance of a positive mindset before sleep, as a way to sleep better and to reduce nightmares and stressful dreams. That positive outlook is especially important right now, when a lot of us are doing what I call Quaren-dreaming.
- A point on the outer side of the big toe connects to the brain’s pineal gland, which produces melatonin. Pressure on this point is thought by reflexology practitioners to stimulate melatonin production.
- Points along the ridges of the toes are connected to the neck and shoulders, and pressure here can help the body let go of tension and physical stress.
- A point at the ball of the foot that connects to the chest and lungs can quiet and slow down breathing.
- A pressure point at the center of the ball of the foot connects to the solar plexus and diaphragm and is understood to boost relaxation.
Hat tip to this really helpful article at MindBodyGreen, by reflexologist Laura Norman, for showcasing these foot reflex points that can have an impact on sleep.
There are acupressure points that are connect to sleep problems, including the H7 point, or Heart 7, located on the wrist. (Here’s an illustration of where to find the H7 acupressure point on the body.) H7 has been the subject of several scientific studies, which have found that acupressure at this point can reduce anxiety and improve insomnia symptoms. A fascinating study on the effects of H7 on sleep found not only did attention to this acupressure point improve anxiety and insomnia, but it also may have influenced melatonin production, restoring melatonin levels to normal range.
In addition to the direct effects that reflexology may have on sleep, reflexology may help sleep indirectly, through its impact on other health conditions. There’s a growing body of research showing the benefits of reflexology for improving anxiety, depression and stress, and for reducing physiological pain. And there’s emerging research indicating that reflexology may deliver boosts to the immune system.
Targeting sleep through anxiety and stress relief
Stress and mood disorders are well known obstacles to sleep. That’s especially the case right now, of course, as we all continue to live and work our way through the ongoing global coronavirus pandemic. I’ve been writing a lot about the impact of stress and anxiety on sleep, and steps you can take to relieve anxiousness and low mood, so you can relax and sleep more soundly. Reflexology may offer another therapeutic outlet for sleep, by way of its stress and anxiety-reducing capabilities.
Reflexology research shows well documented effects on stress and anxiety. A series of studies of middle-aged women demonstrate reductions in stress and fatigue, along with improvements to circulation and blood pressure, with routine reflexology sessions. And other research conducted in people with specific health conditions, including cancer and heart disease, show improvements to depression and anxiety as a result of practicing reflexology. Improving and stabilizing mood and reducing stress are overwhelmingly likely to deliver secondary benefits for sleep.
Improving sleep by reducing physical pain and strengthening immunity
Physiological pain is another major, common barrier to sleep. Physical pain can prevent us from falling asleep, and cause us to wake more frequently throughout the night. (I’m hearing from a number of patients these past weeks and months about an uptick in their physical pain and a corresponding uptick in sleep problems, likely a result of the fact that so many of us have had our exercise routines disrupted by the pandemic.)
Research has documented how reflexology can reduce physical pain, both in healthy adults and in people with specific pain-inducing health problems, including cancer, arthritis, and multiple sclerosis.
And there’s some limited, but interesting evidence of reflexology’s ability to strengthen the immune system, including this study which showed an increase in the immune system’s disease and pathogen-fighting cells, as well as a specific type of antibody. Strengthened immunity can have profound implications for sleep, via everything from the common cold to chronic disease to—yes—Covid-19. I’m particularly hoping to see more research in this area.
The impact of reflexology has often been examined by scientists in the context of illness and disease, and its therapeutic value studied in groups of people with specific health conditions. As a result, there’s a pretty strong collection of studies that illustrate the benefits of reflexology for sleep, pain, fatigue and anxiety in people with cancer, cardiovascular diseases, and autoimmune disorders such as multiple sclerosis and rheumatoid arthritis, to name a few.
How to practice reflexology at home
One of the things that’s appealing about reflexology as a sleep therapy is that it can be practiced at home, on your own. There’s tremendous value in seeking expert assistance for reflexology therapy. Right now, most of us are staying at home as much as possible. So therapies that can come to us and don’t require another person’s close involvement are especially useful and welcome. A little DIY instruction can get you on your way. The MindBodyGreen article I mentioned above gives a simple, specific tutorial of several key pressure points for sleep and talks you through how to apply pressure correctly. Here is another step-by-step article that covers DIY reflexology for sleep and stress, as well as pain problems that can interfere with sleep. And of course, it won’t surprise you to hear there are many YouTube videos showing how to apply reflexology to yourself or a partner at home.
Michael J. Breus, PhD, DABSM
The Sleep Doctor™