Alternative and Integral Therapies for insomnia

Traditional Chinese Medicine (TCM)

Traditional Chinese Medicine views almost all sleep disorders as stemming from
either a deficiency in qi or from a surplus of qi in body organs, mainly the
kidneys and heart.

Causes of Insomnia from TCM Perspective

Kidney Energy (qi) Deficiency

The kidneys, like all the body's organs, store energy. When the kidney's ability to
store energy is compromised, sleep disorders can result. According to TCM,
kidney energy deficiency can prevent the kidney from holding the energy inside.
When this happens, the energy ascends and disturbs the heart (spirit). This, in
turn, keeps the person awake.

As a person gets old, as part of the natural aging process, the energy reserves of
the kidney are depleted. The energy can be restored by taking remedies that
tonifies the kidneys. This is done primarily with herbal remedies. In addition,
qigong postures and exercises are beneficial to the kidneys, and can thus help
the sleep process.

Deficiency of Endorphins

Studies have shown that some insomnia may be due to a deficiency of endorphins
(the body's own natural painkillers), and thus acupuncture is often a useful
therapy. During acupuncture, patients tend to become drowsy or even fall
asleep, possibly because of increased levels of central nervous system
endorphins.

Injury Due to Emotional Excesses 

Some violent emotions impair liver qi, which stagnates, transforms into fire,
invades heart shen and causes mental derangement and insomnia.

Improper Diet

Excess consumption of greasy or sweet foods can result in the retention of fluids
and phlegm in the stomach, causing stomach qi malfunctioning and, eventually,
insomnia.

Senility or Blood Qi Deficiency of the Heart

Palpitation and insomnia are the result of exhaustion of liver and kidney essence.
If vital essence is prevented from replenishing the heart, the breakdown of the
normal physiological coordination between the heart and the kidneys will occur.
These conditions may also result in excess heart fire or blood qi deficiency in the
heart and gallbladder. Anyone of these scenarios can manifest as fear and
timidity on the part of the patient.

Body's Natural Daily Cycle

Traditional Chinese Medicine also stresses the need to observe the body's natural
daily cycle. (Similar to ayurveda, Indian system of medicine.) The "organ time clock"
specifies certain times for restoring the energy of certain organs: 

11:00 P.M. to 1:00 A.M. for the gallbladder

1:00 A.M. to 3:00 A.M. for the liver
3:00 A.M. to 5:00 A.M. for the lungs
5:00 A.M. to 7:00 A.M. for the large intestine

It helps to go to bed early for optimum benefits. 9:00 P.M. sleep time is the most
preferable.

Types of Insomnia

Insomnia is classified under different categories such as:

The inability to fall asleep quickly

Awakening shortly after falling asleep and being unable to resume sleeping
The inability to sleep soundly
The inability to sleep at all

Diagnosis and Treatment

In order to treat insomnia properly, it is important to determine whether the

symptoms are from a deficiency in qi or from an excess of qi.  The deficiency of
qi is generally from the blood and yin deficiencies of the heart, spleen, liver and
kidneys. The excess of qi is usually caused by stagnant liver qi transformed into
fire or by the retention of food and turbid phlegm, which results in stomach
disorders.

If the cause of insomnia is from deficiency of qi, the treatment consists of

reinforcing qi, replenishing blood and nourishing yin to eliminate deficient fire.
The excess qi conformations are treated by clearing the liver, purging fire,
removing the retained food and phlegm, harmonizing the stomach and
tranquilizing the mind.
Stagnant Liver Qi Transformed Into Fire

Symptoms: Fidgeting, irritability, insomnia, a dry mouth with a bitter taste, a

bitter taste, headache, conjunctiva congestion, dark yellow urine, constipation,
a red tongue with a yellow coating, and a wiry, and rapid pulse.

Treatment:
Treatment attempts to purge liver fire, while simultaneously tranquilizing the
mind. 

The principal remedy is Gentian Combination (long dan xie gan tang), with 4 qian
dragon teeth (long chi) and 5 qian magnetite (ci shi). If dragon teeth is
unavailable, dragon bone (long gu) may be substituted for it.

Add 3 qian each of turmeric (yu jin ) and chih-ko (zhi ke) if the patient complain
of a feeling of oppression in the chest or if you observe distention in the
hypochondriac region.

Add 2 qian raw rhubarb (sheng da huang) if the patient is constipated.

Heat-phlegm Invading the Heart

Symptoms: Insomnia, dizziness, a feeling of oppression in the chest, a bitter

taste in the mouth, fidgeting, acid regurgitation, nausea, a yellow, greasy tongue
coating and a slippery, rapid pulse.

Treatment: The objective of the treatment is to clear the heat, resolve the
phlegm, harmonize the stomach and tranquilize the mind. 

Hoelen and Bamboo Combination (wen dan tang) with 1 qian coptis (huang lian)
is the principal remedy for this condition.

If the insomnia is caused by food retention due to stomach disharmony, add 3

qian pinellia (ban xia) and 10 qian husked sorghum (shu mi).

Timidity Due to Deficiencies of Qi and Heart Blood

Symptoms: Insomnia, absent-mindedness, the propensity to daydream, frequent

awakenings from sleep which are due to fright, timidity, palpitation, a pale
tongue with a thin, white coating, and a thready pulse.
Treatment: TCM treatment for this condition replenishes qi and tranquilizes the
mind. 

Hoelen and Acorus Formula (an shen ding zhi wan) is the recommended remedy.

If the insomnia is due to anxiety, use Zizyphus Combination (suan zao ren tang)
instead.

Heart and Spleen Deficiency

Symptoms: Palpitation, a poor memory, drowsiness, the propensity to be easily

awakened at night, dizziness, lassitude, a loss of the sensation of taste, pallor, a
pale tongue with a thin, white coating, and a thready, weak pulse.

Treatment: The objective is to tonify the heart and spleen. 

Ginseng and Longan Combination (gui pi tang) is the recommended remedy.

If the patient's appetite is poor and if the abdomen is distended, delete the
astragalus (huang qi) from the combination and add 4 qian shen-chu (shen qu).

In case of a serious blood deficiency, add 4 qian cooked rehmannia (shu di huang)
and 3 qian lycium fruit (gou qi zi), or use Ginseng and Longan Combination (gui pi
tang) in combination with Astragalus and Zizyphus Combination (yang xin tang).

Hyperactivity or Fire Due to Yin Deficiency

Symptoms: Fidgeting, insomnia, dizziness, tinnitus, a dry mouth and throat, a

burning sensation in the palms and soles, lower back pain, a red tongue and a
thready, rapid pulse.

Treatment: Treatment consists of nourishing yin and removing fire. 

Coptis and Gelatin Combination (huang lian a jiao tang) is the recommended
remedy for this condition.

If insomnia is due to anxiety or other emotional instability and if excess fire is

not severe, Ginseng and Zizyphus Formula ( tian wang bu xin dan) can be given
instead.
Acupuncture and Moxibustion Treatment

Basic Points for Any Type or Insomnia 

Heart 7 
Spleen 6

Additional Points for Heart and Spleen Deficiency 

Bladder 15 
Bladder 14 
Bladder 20

Additional Points for Kidney Deficiency 

Bladder 15 
Bladder 23 
Kidney 3

Additional Points for Heart and Gallbladder Qi Deficiency 

Bladder 15 
Bladder 10 
Pericardium 7 
Gall Bladder 40

Additional Points for Excess Liver Yang 

Bladder 18 
Pericardium 5 
Liver 3

Additional Points for Spleen and Stomach Disharmony 

Bladder 21 
Stomach 36

See Also: Acupuncture/Acupressure for Insomnia

Acupuncture Infocenter in Holisticonline.com

Next Topic:

Insomnia

According to Traditional Chinese Medicine theory, a human body is considered as a mini

nature. When the sun descends, the night is coming; meanwhile the Qi (vital energy ) and
blood slip into the interior and human fall into sleep. This is a wellbalanced status for
person. Now ,you can get a conclusion that if Qi and blood can not enter into the body in
the evening because of any reasons, you will get into insomnia. 
There are kinds of reasons that cause vital energy and blood can not go into the inside, such
as disharmony between the heart and kidney, deficiency of Qi and blood of the heart and
spleen, lack of yin of liver and eat too much or starve. Person can not sleep peacefully,
manifesting be difficulty in going into sleep, easy to wake after sleep and not easy to sleep
again and so on. It is just a Traditional Chinese Medicine theory-"yang can not enter into
yin”. 

Moreover, it is should be realized that Qi and blood go into the interior in the night in order
to exert the function of nourishing visceral. "not sleep in the night, not energetic in day
time", so the concomitant symptoms must be distractibility, listlessness and dizziness in the
daytime. 

The main treating principle of  insomnia in Traditional Chinese Medicine include
communicating heart and kidney, nourishing Qi and blood of heart and spleen, promoting
digestion and removing retention of food .The representative formulae are “Harmony-
Preserving pills, Mid-Reinforcing and Qi-Benefiting Decoction, Rehmannia Bolus with six
Herbs”. Acupuncture and massage has a fine effect on insomnia too.

The definition of insomnia, according to the American Sleep Disorders Association

(ASDA), is difficulty falling asleep or staying asleep. If it occurs every night or most nights
for an extended time, it's called chronic insomnia. If it only lasts for a few days and short-
term insomnia for no more than three week, we call it Transient insomnia.

Perhaps the most important point to realize about insomnia is that it is not a disease, but
rather a symptom. This symptom can occur with many different types of illnesses or
conditions. In the majority of cases, underlying causes exist for the insomnia. When no
other underlying causes can be found, the patient is said to be suffering from primary
insomnia. As you catch on, Primary insomnia is not due to any other sleep disorders, such
as restless legs syndrome, medical conditions, drugs, or mental disorders and so on.