The Different TCM Patterns That Give Rise To Insomnia

Insomnia is lack of sleep and can be any of these sleeping issues: incapacity or trouble falling asleep, restless sleep, waking throughout the night, dream-disrupted sleep, restless sleep, and waking in the wee hours of morning and being unable to go back to sleep. If it recurs for at least two months, insomnia is deemed chronic. Throughout their lives, about a third of adults suffer from some sort of recurring or occasional sleep disturbance.

People with good health get good sleep. The body is in a state of imbalance if sleep is poor. Besides affecting your mood and energy level, frequent disturbed sleep also impacts your health as sleep helps reinforce the immune system. Sleep is as precious to your health as exercise and diet. Insomnia impacts both your body and mind and if you suffer from chronic insomnia, you are more at risk of developing anxiety disorders or depression more than others. Mental faculties related to decision-making and problem solving are both affected by lack of sleep. It may take longer to recuperate from illnesses and chronic diseases may increase if you suffer from chronic sleep deprivation.

According to TCM or traditional Chinese medicine, insomnia is not a disease but a symptom. It classifies insomnia into two types: “transitory insomnia” and “true insomnia”. Transitory insomnia is usually brought about by temporary or external changes like a recent emotional distress, eating very late at night, stimulants such as coffee, changes in the weather, and outside noise. True insomnia is typically caused by a weak constitution due to prolonged illness, too much sexual activity, poor diet, and extended emotional stress and upset.

Sleep disruptions caused by itching, pain, or breathing problems such as asthma are not considered true insomnia. To enable a good night’s sleep, these conditions need to be treated.

In TCM, insomnia is related to shen (mind/spirit) being perturbed. Shen is a type of chi (vital energy) and is the most unstable, least significant, and “lightest” type of chi. Shen prefigures in the higher mental faculties and relates to consciousness’ spiritual aspects and the intellect. Because Shen is subtle and light, it therefore needs to be anchored by the blood and jing (the yin aspect of chi) lest it “floats away”. At night, the shen is housed by the heart during sleep and needs to be calm. If it is disturbed, insomnia and disrupted sleep will be experienced.

A unique interdependent connection exists between the shen and the Heart. The shen resides in the heart, which is especially true when you are asleep. Sleep, according to Chinese medicine, is yang going inward and enveloped by yin. Hence, insomnia is a defect in the shift of yang going into yin.

A qualified therapist/practitioner determines the patient’s TCM pattern via TCM diagnosis based on TCM medical theory. The therapist/practitioner performs an exhaustive diagnosis that can help identify the underlying root of the insomnia and address it appropriately. From time to time and to a certain extent, the patterns can overlap and other associated symptoms can also manifest. The exhibited patterns can be resolved using herbal or acupuncture treatment that, more often than not are utilized simultaneously. The following is a broad outline of the most common TCM patterns related to insomnia.

Deficient Spleen & Heart Blood

The spleen can be injured by eating raw/cold food; too much cold combined with irregular diet; worry, mental and physical exhaustion; and overwork. Blood is produced in the spleen and blood also furnishes nutrients to the heart. A weak spleen typically causes blood deficiency. This issue can also be brought on by a protracted illness or difficult pregnancy or difficult labor that saps the body of blood and energy. Insomnia of this form is marked by dream-disturbed sleep and problems falling asleep (particularly inability to turn off the mind). A spleen and heart blood deficient person can also manifest signs of a pale complexion, loss of appetite, and listlessness.

The aim of TCM treatment is to calm the shen and increase blood production by nourishing and strengthening the spleen and heart.

Phlegm Heat and Disharmony in the Abdomen

Food stagnation can be caused by poor eating habits (eating too fast, eating while angry or sad, eating very late at night) and food overindulgence/gluttony. Phlegm and dampness may arise due to too much consumption of foods that tend to create phlegm (alcohol and spicy, sweet, greasy, rich foods) or a weak spleen. Stomach blockage due to food (weak digestion) leads to phlegm heat that bothers the shen.

This pattern leads to symptoms like insomnia with possible acid reflux, abdominal fullness and distention, and bloating as well as waking in the early hours with problem going back to sleep and excessive dreaming.

People with this specific pattern can also struggle with discomfort/fullness of the abdomen and chest, heaviness in the head, dizziness, excess phlegm, and belching.

The plan of treatment in TCM is to calm shen, transform phlegm, dispel heat, balance abdomen, and alleviate food stagnation.

Deficient Gallbladder & Heart Chi

This pattern is typically the result of intense shock or shock within the womb. People suffering from this pattern often worry and are anxious. They also are very timid, are frightened easily and may have difficulty dealing with new situations coping with changes in their routine.

Insomnia of this form is caused by periodic bad dreams that cause frequent waking, often characterized as “waking with a start”. People with this type of insomnia are very often easily frightened.

TCm treatment aims to calm the mind and shen and relieve fearfulness by beefing up the chi.

Heat with Deficient Yin

Aging, lack of rest, too much sex, and overwork can exhaust the yin of the Kidney. If the Kidney yin is unable to balance Heart Fire, it can burn without control. Over time, the yin will literally be burned away from too much fire. A deficient yin and blood cannot adequately anchor the shen resulting in insomnia.

This form of insomnia is usually marked by night sweats and constant waking throughout the night due to feelings of heat. Heat with Deficient Yin insomnia is usually chronic. Symptoms related to this pattern include warm feet and hands, dry mouth, vertigo, dizziness, and irritability.

TCM plan of treatment is to calm the shen, dispel heat, and nourish the yin of the kidney, liver, and heart.

Stagnation of Liver Chi Causing Fire or Heat

Chi can stagnate due to factors like repressed emotions, emotional turbulence, resentment, anger, and frustration. Stagnated chi can lead to weak blood circulation which may result in inadequate supply of blood to the heart. This heart is then poorly nourished making it less able to house the shen.

Chi stagnation, over time, can produce heat that disturbs the shen and the heart. The heat makes it very difficult for shen to calm down.

Usual insomnia symptoms caused by this pattern are: insomnia exacerbated by stress, problems going to sleep, and waking time and time again from around two to four in the morning.

Additional symptoms may include: probable anxiety coupled with palpitations, sleep bruxism at night, neck and shoulder tension, headaches, moodiness, restlessness, irritability, and depression.

TCM plan of treatment focuses on calming the shen, eliminating heat, and relaxing liver chi.

TCM treatment often works well against insomnia. It may take weeks or months to wean off sleeping drugs if the person being treated is currently taking them.

In Toronto’s Centre for Addiction and Mental Health, researchers have recently conducted studies on people with problems sleeping. The people treated with a course of acupuncture therapies experienced relief of anxiety and their sleeping times extended by 1.4 hours, on average. Tests also showed a major rise in their body’s production of melatonin. This led the researchers to conclude acupuncture a valid form of treatment for people suffering from anxiety and insomnia and should be considered an option to pharmaceutical approaches.

In the treatment of insomnia adjunctive therapy can be extremely helpful. Meditation and/or relaxation practices are often indispensible in the calming of the mind. These practices produce effects that are cumulative and when a person attempts to go to sleep, the longer he/she works on easing the mind the easier it will be for him/her to go into a state of relaxation.

It is often necessary to make certain positive lifestyle changes especially if your insomnia is caused by severe stress associated with emotional, family, or work problems. The calming and soothing effect of acupuncture treatment coupled with relaxation practices can help address the effects of longstanding emotional turbulence and stress. Dietary modifications need to be done if certain dietary factors aid in the rise of insomnia and the need to avoid late night eating is also highly advised.

In curing insomnia the following good practices before bedtime are recommended:

• During the day, stay active and exercise. Each day, at least allocate twenty to thirty minutes of vigorous exercise, if possible, five to six hours (at least) before bedtime. Exercising can over stimulate your body if you do it very close to bedtime.

• When you have problem sleeping avoid “trying very hard” to fall asleep. The harder you try, the more awake you’ll become. A good way to fall asleep is to do an activity that is relaxing and quiet until you feel drowsy. You may then go to bed.

• It important to not be stimulated before going to bed. You can be over stimulated by watching TV or taking drugs, alcohol, or caffeine. You may find it difficult to fall asleep when you take nicotine or caffeine after lunchtime. While it may make you drowsy at first, alcohol can lead to frequent waking throughout the night and restless sleep. According to TCM, coffee and alcohol are extremely heating. The quality of your sleep can be negatively affected when you have internal heat that disturbs the liver and the heart.

• Keep a constant wake time and bedtime schedule.

• Take a light snack if you’re kept awake by hunger. Just right before bedtime, do not eat heavy meals.

• Relax. Listening to calming soft music or taking a warm bath can help promote sleep. You can also get a massage to help you relax. Meditation, yoga, qigong, or tai chi can be a very good way to calm both the body and mind.

You don’t need to suffer from the effects of insomnia as you can avail yourself of very safe and effective TCM treatments anytime.