TCM Treatment Principles for Insomnia
Insomnia is the inability to obtain sufficient sleep, difficulty falling asleep or being unable to asleep throughout the night. This leads to fatigue, low energy, diminished mental alertness and poor concentration during the daytime. Insomnia is usually due to temporary causes, such as jetlag, illness, stress or drinking too much coffee or tea. When it occurs nearly every night, lasts one month or longer, then you should seek help.
Traditional Chinese Medicine (TCM) views insomnia as a manifestation of a spirit disorder, that various internal disharmonies interrupt the body’s natural rhythm and make the spirit restless, creating sleeping problems. During a consultation, physicians will ask about the individual's sleep pattern and the degree of disturbance in daytime; furthermore, one's lifestyle as well as emotional and physical states also need to be taken into consideration. Typically, individuals will undergo special examination techniques for assessment, and based on the collected clinical information, physicians will diagnose a subtle pattern of disharmony and provide a specific treatment plan accordingly.
According to TCM experience, the sleep patterns are the basic criteria for clinical judgement. For example:
- Difficulty in falling asleep indicates the body has accumulated heat or fire pathogens;
- Restless sleep indicates the body has both pathogen accumulation and certain aspects of deficiency;
- Easily arousal from sleep and difficulty falling back to sleep are simply deficiency usually seen in a weakened spleen and heart;
- Unable to asleep throughout the night indicates either an excess or deficient disharmony;
- Long term Individuals tend to have insufficient yin and blood; while short term individuals tend to have intern fire irritation.
Furthermore, the accompanying signs and mental state of individuals are important for determining the diseased lesion.
- Irritability usually indicates liver fire irritation;
- Dream-disturbed sleep and panic usually indicate qi deficiency of heart and gallbladder;
- Paleness and fatigue usually indicate spleen deficiency;
- Foul belching, acid reflux and bloating indicate food distention;
- Chest stuffiness, head heaviness and dizziness usually indicate phlegm and heat irritating internally;
- Annoying, palpitations, dizziness and forgetfulness usually indicate disharmony between heart and kidney.
Since TCM regards insomnia as one of the signs of an internal disharmony, the treatment for insomnia always aims at rectifying the diseased organ systems, and restoring the harmony of yin yang, as well as blood and qi flowing. The therapeutic methods are generally divided into reducing the excessive pathogens, such as purging fire, clearing heat, resolving phlegm, promoting and harmonizing digestion; and invigorating the weakened parts, such as replenishing qi, nourishing blood, invigorating spleen, nourishing liver and fortifying kidney. The remedies work to achieve a general regulating effect to the overly active body system, making it shift to more quiet state and prepare for sleep.
 Fossil bone |
 Tuber fleeceflower stem |
 Magnetic stone |
For the herbal prescriptions, besides designing according to syndrome differentiation, certain ingredients are also prescribed side by side to exert the sedative effect and to ease the mental symptoms.
1. Ingredients for nourishing blood and calming spirit
The ingredients are usually seed or kernel, their properties are nourishing and lubricating, and are aiming to nourish heart and liver. Physicians will select them for relieving restless spirit that present with palpitations, insomnia, dream-disturbed sleep, forgetfulness, irritability or uneasiness:
| suan zao ren | sour jujube seed | Semen Ziziphi Spinosae |
| bai zi ren | Chinese arborvitae kernel | Semen platycladi |
| ye jiao teng | tuber fleeceflower stem | Caulis Polygoni Multiflori |
| yuan zhi | Chinese senega | Radix Polygalae |
| fu xiao mai | shriveled wheat | Fructus Tritici Levis |
| wu wei zi | schisandra | Fructus Schisandrae |
2. Heavily calming ingredients
The ingredients are usually shells or natural minerals, which can ease timidness, quiet excitement and calm the spirit. When the spirit is so irritated (usually by fire pathogens) that it causes serious mental derangement, epilepsy, distractibility and restlessness, TCM believes that these "heavy" ingredients should be added to calm down.
| zhu sha | cinnabar minerals | Cinnabaris |
| zhen zhu mu | nacre | Concha Margaritifera |
| long gu | fossil bone | Os Draconis |
| ci shi | magnetic stones | magnetitum |
| long chi | fossil teeth | Dens Draconis |
| hu po | amber | Succinum |
In general, TCM methods specialize in overall regulation to the body, the results are desirable and can avoid the adverse effects like western sleeping pills. Insomnia has a good prognosis for most individuals. When no underlying cause is found for the insomnia, the more acute and severe the sleeping problem, the easier it is to treat, because there are no extensive pathological changes. However, if insomnia becomes chronic, treatment may take months. It should be noted that insomnia remedies should be taken in appropriate time and amount, improper treatment or prolong courses can lead to mental disorders, or aggravate to more complex conditions.
Lifestyle modification such as regular exercise, healthy eating, and stress management is always necessary for insomnia individuals.
