Insomnia - A Chinese Medicine Perspective
What is Insomnia?
Insomnia is a common sleep disorder in which it either difficult to fall asleep, hard to stay asleep, or cause you to wake up too early and not be able to get back to sleep. You may still feel tired when you wake up. It can sap not only your energy level and mood but also your health, work performance and quality of life.
Pharmacological treatment is effective but frequently with significant side effects. Acupuncture is traditionally used for the treatment of insomnia in China and now is widely accepted in the Western countries [1].
Symptoms may include:
- Difficulty falling asleep at night
- Waking up during the night
- Waking up too early
- Not feeling well-rested after a night’s sleep
- Daytime tiredness or sleepiness
- Irritability, depression or anxiety
- Difficulty paying attention, focusing on tasks or remembering
- Increased errors or accidents
- Ongoing worries about sleep
How Does Traditional Chinese Medicine (TCM) View Insomnia
In Chinese medicine Insomnia is categorised with somnolence and poor memory. Marciocia states that “the mind is rooted in the Heart and specifically in Heart-Blood and Heart-Yin. If the Heart is healthy and the Blood abundant, the Mind is properly rooted and sleep will be sound. If the Heart is deficient or if it is agitated by pathogenic factors such as Fire, the Mind is not properly rooted and sleep will be affected.
Causes of disturbed sleep include:
- Over exertion and worry
- Overwork
- Anger
- Irregular Diet
- Childbirth
- Residual Heat
Any one or a combination of these causes can lead to an imbalance in the organs and thus result in disturbed sleep. The most important distinction is that between Full- and Empty-types of insomnia.
Full-Types include:
- Liver-Fire blazing
- Heart-Fire blazing
- Phlegm-Heat disturbing the Mind
- Residual Heat in the diaphragm
Deficiency-Types include:
- Heart and Spleen Blood Deficiency
- Heat-Yin Deficiency
- Heart & Kidney not harmonising
- Heart and Gall-Bladder Deficiency, and
- Liver-Yin Deficiency
Each of these organ imbalances are treated differently and have different accompanying symptoms. For example Liver-Fire blazing (Full or Excess type insomnia) is associated with symptoms such as Restless sleep, unpleasant dreams, nightmares, irritability, headaches, thirst, dark urine, Red tongue body and Rapid pulse. Whereas Heart & Kidney not harmonising (Deficiency type insomnia) presents with symptoms such as: Waking up frequently during the night, difficulty in falling asleep, dry throat, night-seats, poor memory, palpitations, dizziness, mental restlessness.
From a TCM perspective, insomnia falls into 3 categories:
- Psychological: i.e.: – Mental/Emotional factors such as over-worry, anger, frustration, resentment and irritation
- Physical: i.e.: – Lifestyle Factors such as overwork, Irregular/bad diet, trauma (e.g.: Extensive surgery, Childbirth, etc.
- Environmental: Post viral syndrome, Chronic fatigue syndrome
Any one or a combination of the above factors can affect organs such as the spleen, lung, heart or liver/gallbladder and lead to sleeplessness.
The Chinese medicine patterns for insomnia fall into two types: (i)
Excessive conditions and (ii) Deficient conditions.
A close analysis of the patient’s symptoms will identify the particular TCM pattern underlying insomnia. For example, Liver-Fire (excess) may present with the following accompanying symptoms: Restless
sleep, unpleasant dreams, nightmares, irritability, propensity to outbursts of anger, bitter taste in the mouth, headache, red face, thirst, dark urine, dry stools and dizziness.
On the other hand Heart/Spleen Blood deficiency may present with difficulty in falling asleep, palpitations, tiredness, poor appetite, slight anxiety, blurred vision, dizziness, poor memory, pale face.
Treatment approaches used in Traditional Chinese Medicine (TCM):
Diagnosis: TCM practitioners utilise a comprehensive approach to diagnosis by considering various factors. They assess the patient’s medical history, sleep patterns, emotional well-being, and overall health. Additionally, they examine the tongue’s appearance and feel the pulse, which provides valuable information about the body’s energy imbalances.
Acupuncture: Research has shown that Acupuncture is a safe and effective treatment for insomnia [3,4,5]. Acupuncture involves the insertion of thin needles into specific points along the body’s meridian pathways. These meridians are believed to be channels through which Qi flows. By targeting specific acupuncture points, practitioners aim to regulate the flow of Qi, alleviate blockages, and restore balance. In the case of sleeplessness, points on the head, ears, wrists, and legs may be selected to help calm the mind, promote relaxation, and harmonize the body’s energy.
Herbal Medicine: TCM frequently employs herbal remedies, which are typically prescribed in the form of customised formulas based on the individual’s diagnosis. The formulas consist of a combination of herbs chosen for their specific properties. For sleeplessness, herbs with sedative, calming, and nourishing effects may be used. Suan Zao Ren (Sour Jujube Seed) is commonly included in insomnia formulas due to its calming properties, while Bai Zi Ren (Biota Seed) is known for its ability to nourish the heart and calm the mind. Huang Lian (Coptis Rhizome) may be used if sleeplessness is associated with digestive disturbances or excessive heat in the body.
Dietary and Lifestyle Recommendations: TCM emphasises the importance of maintaining a healthy lifestyle and making dietary adjustments to support overall well-being and improve sleep. Recommendations may include avoiding stimulating substances such as caffeine, alcohol, and spicy foods, especially closer to bedtime. Establishing a regular sleep routine, going to bed and waking up at consistent times, can help regulate the body’s internal clock. TCM practitioners may also suggest incorporating relaxation techniques, such as meditation or deep breathing exercises, into daily life. Engaging in moderate exercise, such as Qi Gong or Tai Chi, can help promote overall relaxation and balance.
Qi Gong and Tai Chi: Qi Gong and Tai Chi are ancient Chinese practices that combine gentle movements, breathing exercises, and meditation. These practices aim to cultivate and balance the body’s Qi, calm the mind, and improve overall well-being. Regular practice of Qi Gong or Tai Chi can help reduce stress, anxiety, and tension, which are often contributing factors to insomnia.
It’s important to note that TCM takes an individualised approach to treatment, recognising that each person’s constitution and underlying imbalances are unique.
At Kurrajong Natural Medicine Centre our highly qualified and experienced team of practitioners are happy to develop a personalised treatment programme with you. Simply call (02)4573 0784
What You Can Do to Help Yourself If You Suffer From Insomnia
Keep regular sleep hours
A consistent routine signals to your body that it’s time to wind down and prepare for sleep. Engage in calming activities before bed that help you relax and de-stress. This can include reading a book, taking a warm bath or shower, practicing relaxation techniques like deep breathing or meditation, or listening to soothing music. Find activities that work best for you and make them a regular part of your nightly routine.
Create a restful sleeping environment
Your bedroom should be a peaceful place for rest and sleep. Temperature, lighting and noise should be controlled so that your bedroom environment helps you to fall (and stay) asleep.
If you have a pet that sleeps in the room with you, consider moving it somewhere else if it often disturbs you in the night.
Make sure your bed is comfortable
It’s difficult to get restful sleep on a mattress that’s too soft or too hard, or a bed that’s too small or old.
Exercise regularly
Moderate exercise on a regular basis, such as swimming or walking, can help relieve some of the tension built up over the day. But make sure you do not do vigorous exercise, such as running or the gym, too close to bedtime, as it may keep you awake. Find out more about how to get active your way.
Cut down on caffeine
Cut down on caffeine in tea, coffee, energy drinks or colas, especially in the evening. Caffeine interferes with the process of falling asleep, and also prevents deep sleep. Instead, have a warm, milky drink or herbal tea.
Do not over-indulge
Too much food or alcohol, especially late at night, can interrupt your sleep patterns. Alcohol may help you to fall asleep initially, but it will disrupt your sleep later on in the night.
Do not smoke
Nicotine is a stimulant. People who smoke take longer to fall asleep, wake up more frequently, and often have more disrupted sleep.
Try to relax before going to bed
Have a warm bath, listen to quiet music or do some gentle yoga to relax your mind and body. Your GP may be able to recommend a helpful relaxation CD.
Write away your worries
If you tend to lie in bed thinking about everything you have to do tomorrow, set aside time before bedtime to make plans for the next day. The aim is to avoid doing these things when you’re in bed, trying to sleep.
If you cannot sleep, get up
If you cannot sleep, do not lie there worrying about it. Get up and do something you find relaxing until you feel sleepy again, then go back to bed. Avoid napping. If you’re having trouble sleeping at night, it’s best to avoid daytime napping. If you must nap, keep it short (around 20-30 minutes) and avoid napping late in the day.
Limit exposure to electronic devices
The blue light emitted by electronic devices, such as smartphones, tablets, and computers, can suppress the production of melatonin, a hormone that regulates sleep. Avoid using electronic devices at least one hour before bed. If you must use them, consider using apps or settings that reduce blue light emission, or wear blue light-blocking glasses.
Evaluate your sleeping environment
Your bedroom should be a comfortable and relaxing space dedicated to sleep. Make sure the room is dark by using blackout curtains or blinds to block out external light. If needed, consider using a sleep mask to create complete darkness. Keep the room at a cool, comfortable temperature, as a cooler environment promotes better sleep. Additionally, remove any sources of noise or use earplugs or a white noise machine to mask disruptive sounds.
Make an appointment to see your healthcare professional if lack of sleep is persistent and it’s affecting your daily life.
References
- Zhao K. (2013). Acupuncture for the treatment of insomnia. International review of neurobiology, 111, 217–234. https://doi.org/10.1016/B978-0-12-411545-3.00011-0
- Marciocia, G. (1994) The Practice of Chinese Medicine: The Treatment of Disease with Acupuncture and Chinese Herbs, Edinburgh: Elsevier Churchill Livingstone.
- Yin, X., Gou, M., Xu, J., Dong, B., Yin, P., Masquelin, F., Wu, J., Lao, L., & Xu, S. (2017). Efficacy and safety of acupuncture treatment on primary insomnia: a randomized controlled trial. Sleep medicine, 37, 193–200. https://doi.org/10.1016/j.sleep.2017.02.012
- Lin, Y. F., Liu, Z. D., Ma, W., & Shen, W. D. (2016). Hazards of insomnia and the effects of acupuncture treatment on insomnia. Journal of integrative medicine, 14(3), 174–186. https://doi.org/10.1016/S2095-4964(16)60248-0
- He, W., Li, M., Zuo, L., Wang, M., Jiang, L., Shan, H., Han, X., Yang, K., & Han, X. (2019). Acupuncture for treatment of insomnia: An overview of systematic reviews.
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Page last updated: 24th June 2023
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