Sometimes nothing can seem more intolerably disturbing than lying awake, tossing and turning for hours at a stretch. The ability to sleep soundly ought to be a birth right, like breathing. For the sleep deprived, attaining that illusive night’s sleep is a constant source of frustration and anguish. About one third of Americans experience sleep problems. Many remedies are tried from prescription drugs to warm milk and counting sheep. Drugs often cause dependencies, and many of these treatment approaches are not able to solve the problem. What about acupuncture and Chinese herbs, can they bring about a restful night’s sleep? The answer is a resounding YES.

Different Causes for Poor Sleep

There are many different causes of poor sleep, and sleeping problems manifest differently in different people. Some have difficulty falling asleep. Others can fall asleep easily, but wake frequently during the night, perhaps due to disturbing dreams, or feeling hot and restless. Still others fall and stay asleep, but wake at pre-dawn hours of the morning.

Sleeping problems may be caused by an internal problem, or an external or environmental cause. Examples of environmental causes include noise, room temperature (too hot or cold), stimulants (such as coffee), or worrying due to an emotional upset. Other environmental causes include pain, asthma or itching from rashes. Environmental causes are not considered true insomnia because once the cause is identified and treated, sleep returns to normal.

The Mind Connection

The amount and the quality of sleep one receives depends upon her/his the state of mind. Traditional Chinese Medicine (TCM) recognizes that body and mind are inter-related: an integrated whole that must be treated together as an entirety. Sleeping problems exemplify this relationship. The mind cannot rest peacefully; therefore, the body is not able to attain sleep. The TCM practitioner (acupuncturist) must treat mind and body together in order to satisfactorily resolve insomnia.

TCM Looking for Pattern Diagnoses

Another important factor accounting for Chinese medicine’s clinical effectiveness in treating insomnia is TCM’s diagnostic method called ‘pattern diagnoses. Chinese medicine sees that every patient presents with a unique constitutional landscape, or pattern. Disease processes vary from person to person, depending on their particular constitutional pattern of disharmony. Even though five different patients may present with poor sleep, the symptomatology will vary from person to person depending on their individual, constitutional pattern. Therefore each patient will receive an individualized TCM treatment plan that addresses his/her particular pattern or constellation of symptoms.

TCM Patterns in Insomnia

What are some of the TCM patterns involved in insomnia? Acupuncturists begin by differentiating between deficiency and excess causes. We determine whether there is too little blood or substance to ground the mind, or too much heat disturbing the mind. What does this mean? TCM theory recognizes that the mind/spirit (we call this shen, in Chinese) lacks substance: it is formless and pure energy. At night, the mind requires blood or substance to anchor it so that it can rest peacefully. If one does not have enough blood or substance for the mind (shen) to sink into, it will wander and stay awake. By blood deficiency, we do not mean the western medical condition of anemia. We are using this term metaphorically to describe a group of related symptoms in the body that form the TCM pattern of blood deficiency. TCM symptoms of blood deficiency include difficulty falling asleep, heart palpitations (not enough blood to nourish the heart), fatigue (not enough nutrition from blood to nourish the body), blurred vision or seeing spots, dizziness, poor memory and anxiety (not enough blood to nourish the eyes and brain), pale skin (no redness from blood), dry skin (no moisture from blood to moisten the skin).

Another TCM cause of insomnia, commonly seen in clinic, is too much heat in the body which disturbs the mind. Heat causes activity and movement. For example, molecules move faster causing water too bubble and boil. These patients have restless sleep (too much heat causing excess activity) or wake during the night feeling hot, or with night sweats. The excess heat and activity disturbs the mind (shen) causing profuse dreaming, or nightmares. These patients frequently experience dry mouth, or a strong thirst, or may have hard or dry stools or constipation: too much heat dries up the body fluids
Having diagnosed the cause of insomnia, how do acupuncturists treat this disorder? If the cause is due to deficiency, we tonify or build up the body, by needling acupuncture points or prescribing Chinese herbs that have the function of nourishing or building blood and calming the shen (mind). When the cause is due to excess heat, we choose acupuncture points and herbs that clear heat.

Efficacy of Chinese Herbal Formulas

In my practice, I have found that Chinese herbal formulas are remarkably effective in treating insomnia. What makes Chinese herbs particularly safe and effective is the art of combining herbs to form a carefully balanced prescription, or herbal formula. (Chinese herbs are seldom taken individually.) Chinese herbal formulas are based on standard, classical prescriptions that have been tried and tested through more than two millenniums of clinical use, and are modified to fit the individual needs of the patient. When treating sleep disorders, I add high doses of individual herbs known to calm the mind and promote sleep, such as jujube seed (zizyphus) and licorice. I find sleeping problems usually resolve within five to seven weeks of herbal therapy.

An interesting side note is, according to Chinese medical tradition the best sleeping position is lying on the right side with the legs and arms bent. The heart is in a high position so that blood can circulate freely, the liver is in a low position so that blood can collect there and root the shen (mind/spirit), and the stomach and intestines are in a position that facilitates the downward movement of food (preventing food stagnation from causing a poor night’s sleep).1

Sleep well

1Maciocia, G. The Practice of Chinese Medicine. 1994 Churchill Livingstone, p. 282.