Have you ever been home alone late at night when a tiny creak in a floorboard suddenly becomes a gunman breaking in? That's your reticular activating system (RAS) triggering an adrenal response that's preparing you to fight or flee.

The RAS helps the body instinctively deal with issues of fear and survival. Unfortunately, it can't always distinguish between real and imagined threats. And according to Amy Lewis, LMT, an Upledger-trained CranioSacral Therapist, that dynamic is at the heart of much of the insomnia she's seeing now in her clients.

Insomnia, which means "no sleep" in Latin, is one of the most common sleep complaints among Americans. According to the National Center on Sleep Disorders Research at the National Institutes of Health, some 30 percent to 40 percent of adults report symptoms of insomnia within a given year, while about 10 percent to 15 percent report chronic insomnia lasting months or years.

"Insomnia comes in cycles that line up with our stress levels," Amy says. "I see it a lot in clients who present with complex pain patterns. But look at the stress that's happening worldwide. Then take that down to the level of the state, the county, the city, the neighborhood, the family and the individual. Add all that up and you've got recurring cycles of insomnia." 

While individual cycles and sources of insomnia may vary, Amy believes it ultimately comes down to the RAS, which Dr. John Upledger referred to as the "reticular alarm system." Located in the ventricular area of the brain responsible for regulating arousal and sleep-wake transitions, the RAS is the filter for everything in our lives that's "coming at us," she says. That's why, with her insomnia clients, she focuses on cranial techniques that are known to affect the RAS.

Three Cranial Techniques That Relax the RAS

The CV4

One of Amy's favorite techniques for relaxing the RAS is the "CV4." Named for its ability to compress the fourth ventricle, the CV4 is performed at the occiput to subtly stifle the expansion of the craniosacral system as it cycles through the phases of filling and emptying cerebrospinal fluid, which therapists can palpate as the cranial rhythm.

When you bring this rhythm to a "still point," fluid pressure builds in the membranes that surround the brain and spinal cord. By stretching these membranes ever so slightly, the fluid gently flushes the craniosacral system and moves the autonomic nervous system from a highly aroused sympathetic-dominant state to a relaxed parasympathetic-dominant state.

"What's different about using cranial work this way is its gentle, non-invasive nature," Amy says. "If I don't plow in there with my hands, I don't create a backlash or a rebound effect in the tissues, muscles or brain. I'm simply amplifying the parasympathetic nervous system. So we're moving from the adrenal fight-or-flight response to a parasympathetic response. We're just slightly moving that little diode on the scale."

Cranial Pumping

Another technique Amy uses to address insomnia symptoms is called "cranial pumping." To perform this technique, you find a place on the client's body where you're comfortable feeling the cranial rhythm. The rhythm reflects the motion of flexion and extension, which signals the filling and emptying of cerebrospinal fluid as it cycles through the craniosacral system.

Amy likes to palpate at all the cranial listening stations, which are areas of the body that can quickly give you a general evaluation of the cranial motion: the heels, dorsa of the feet, anterior thighs, ASIS, ribs, shoulders and several holds at the cranium.

After feeling the rhythm for about three to five cycles, you begin to gently "nudge" the rhythm a bit further. "But you do it so subtly," Amy says. "There's not even any physical movement. You're really doing it with your thoughts and intention to create what feels like a ripple of Saran wrap over water."

By then tuning into changes in the symmetry, quality, amplitude and rate of the craniosacral rhythm, you can bring the body into greater balance. And that helps expand the internal stress threshold so the RAS is less likely to leap into hyper vigilance.

The Rock and Glide

The third cranial technique Amy recommends for insomnia is called the "Rock and Glide." With the client lying supine, place one hand under the sacrum and one under the occiput. Then tune into the rocking motion the dural tube makes to see how it feels. "I'll follow it for a few cycles and then give it a very gentle nudge, about 1 to 5 grams, with my intention again. This helps release the transverse fascial rings of the dural fascia."

For the "gliding" aspect, place your hands in the same position and focus on the longitudinal glide of the occiput and sacrum as it moves in flexion toward the feet and then back toward the head. "As I tune into the gliding motion and it reaches the sacrum, I begin to nudge with 1 to 5 grams of traction toward the feet while I hold the occiput in neutral. Then as the motion glides toward the occiput, I give another little nudge toward the occiput with slight traction while I hold the sacrum in neutral." You may do this for several cycles.

"The glide helps with nerve roots and lengthening of the dural tube, but I think of it as a relaxing cosmic cradle," Amy says. What a soothing way to help your clients get a good night's sleep!

Resources

1. Upledger JE. "Life, Stress and Health." Massage Today, Sept. 2002;02:9.
2. Ventricular System. www.wikipedia.org/wiki/Ventricular_system
3. "Can't Sleep? What To Know About Insomnia." National Sleep Foundation. www.sleepfoundation.org
4. Stillerman E. Modalities for Massage and Bodywork. Mosby, December 2008.