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: 

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:

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

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