Shiatsu massage has been described as Japanese acupuncture without needles, and some people think that it holds the key for those who struggle with poor sleep. For many, the word Shiatsu evokes images of Sharper Image massage chairs. Unfortunately my knowledge of Shiatsu and its effects on sleep do not run much deeper.
While the origins of Shiatsu are well over a thousand years old, the first formal Shiatsu school was established in the 1940s. Today Shiatsu teaches that through assessment and pressure therapy, the energy channels of the body can be manipulated in order to flow properly allowing us to be healthy and happier. But can this really improve sleep?
As a conventionally trained neurologist and sleep specialist, I took it upon myself to answer this question. Since Western medicine dictates that there must be double-blind, randomized, cross-over, placebo controlled studies before we can acknowledge something works, the obvious first step toward answering the question is easy: Is there published evidence to support the idea that Shiatsu massage helps with sleep or any medical disorder for that matter?
The answer is yes, but fairly little. Searching PubMed for “Shiatsu” returns only 81 entries. While the majority of these articles discuss Shiatsu in general or as a treatment tool in childbirth or within the cancer/palliative care community, a few did provide evidence of Shiatsu’s benefit specifically in a sleep context. A 2015 meta-analysis of several different massage modalities (Shiatsu, myofacial release, Swedish) by Yuan and colleagues showed Shiatsu specifically improved pain, fatigue and sleep.[1] This analysis included Yuan’s own 2013 study on Shiatsu in fibromyalgia patients.[2] A separate literature review found evidence that acupressure could be helpful in treating sleep disorders, but felt the evidence for Shiatsu in particular was lacking.[3] A 2008 European prospective study (based upon a 2003 preliminary study [4]) was suggestive that Shiatsu could help improve low energy and fatigue.[5] Finally, a 2008 study showed a trend towards Shiatsu reducing the time it took participants to fall asleep and suggested it lengthened sleep time.[6] Outside of a 2001 paper showing significant improvement in relaxation and energy levels in palliative care patients, that pretty much sums up the literature on Shiatsu and sleep.
Okay, so the evidence linking Shiatsu and better sleep is a little thin. To understand more about its potential sleep benefits, I decided to track down someone well versed in the subject. While Vermont and Massachusetts seemed to be promising hot spots for Shiatsu training, I chose to look for my expert in a decidedly warmer climate.
Margo Marver was first introduced to Shiatsu in 1979 and went on to study Shiatsu techniques both in Massachusetts and at the Shiatsu College of London. She has been a practitioner of both Shiatsu and reflexology for many years and recently moved her practice from Portland, Oregon to Sarasota, Florida. Bingo.
I meet Margo at her studio near downtown Sarasota. During my Shiatsu research, I did come across scattered case reports of vascular incidents including dissection and thrombosis as well as nerve injury with Shiatsu. [To be fair, there are countless reports of similar injuries with playing golf, sneezing, and even having your hair washed]. Prior to our session, Margo carefully asks me questions about my medical history. In my opinion, Shiatsu is perfectly safe if your provider knows what she is doing. Margo clearly knows what she is doing.
At last, I am on the table. Despite having a lavender filled sachet over my eyes, I can feel her intensely assessing my body, all the while breathing in and out purposefully as she works. While I had told her about some areas that were giving me some trouble of late, I get the impression the information is not necessary. As she manipulates my arms and legs, I am surprised how much better I feel despite not really feeling that poorly to begin with. Despite the intensity of the session, there are times I think that I may have drifted off a bit during my time on the table; the time she gives me to rest afterward is welcome.
As I reenter the real world, I ask Margo about how she feels Shiatsu and reflexology can lead to improved sleep. Her answer surprisingly jumps right to nutrition. She feels that not only is proper nutrition essential, but also the proper timing of one’s eating. She believes that if food is consumed too close to the time of sleep, it creates sleep difficulties within the individual as the energy necessary for proper sleep is being diverted instead to digestion.
For many people, their routine prior to bed is an important component to quality sleep. Margo teaches (and practices) methods of relaxation and visualization of energy draining out of the body prior to sleep. For her clients, she finds these to be effective techniques for sleeping better.
In a 2013 episode of The Office, Michael Scott said of Shiatsu, “The Japanese have this thing called Shiatsu massage, where they dig into your body very hard, and it is very painful. And apparently some people throw up, but the next day, they feel great. I’ve never had one. They sound awful.” I did indeed feel great afterward, the experience was not awful, painful or vomit-inducing. While I’m not certain there is an overwhelming amount of evidence supporting Shiatsu as a sleep aid, who knows…in the right hands, maybe some can find genuine sleep improvement.
References
1. Yuan SL, Matsutani LA, Marques AP. Effectiveness of different styles of massage therapy in fibromyalgia: a systematic review and meta-analysis.Man Ther. 2015 Apr;20(2):257–64.
2. Yuan SL, Berssaneti AA, Marques AP. Effects of shiatsu in the management of fibromyalgia symptoms: a controlled pilot study. J Manipulative Physiol Ther. 2013 Sep;36(7):436–43.
3. Robinson N, Lorenc A, Liao X. The evidence for Shiatsu: a systematic review of Shiatsu and acupressure. BMC Complement Altern Med. 2011 Oct 7;11:88.
4. Long AF, Mackay HC. The effects of shiatsu: findings from a two-country exploratory study. J Altern Complement Med. 2003 Aug;9(4):539–47.
5. Long AF. The effectiveness of shiatsu: findings from a cross-European, prospective observational study. J Altern Complement Med. 2008 Oct;14(8):921–30.
6. Brown CA, Bostick G, Bellmore L, Kumanayaka D. Hand self-Shiatsu for sleep problems in persons with chronic pain: a pilot study. J Integr Med. 2014 Mar;12(2):94–101.
7. Cheesman S, Christian R, Cresswell J. Exploring the value of shiatsu in palliative care day services. Int J Palliat Nurs. 2001 May;7(5):234–9.
Originally published at medium.com