Insomnia is common in Hong Kong, so it is not surprising that people are looking for more natural-based treatments and remedies.
Traditional Chinese medicine (TCM) regards insomnia as a symptom and not an illness; the result of an imbalance of various organs, which ultimately affects the heart.
TCM believes the heart ‘houses’ the shen (spirit), which in turn is nourished by the blood. Disturbances in the heart’s ability to house the shen—such as too much heat or too little blood—will lead to restlessness, insomnia, palpitations, anxiety or agitation.
Unlike in Western medicine where the same medication can be prescribed for all patients, in TCM there is no one pill that fits all. Each patient receives an individualised treatment depending on their signs and symptoms.
The patterns of disharmony
The most common patterns of disharmony that cause insomnia include liver fire, stomach disharmony and Heart Blood and Spleen Deficiency.
Liver fire is due to excessive stress, which if left unchecked creates heat in the body. This disturbs the heart so that it is unable to house the shen.
Stomach Disharmony with Phlegm Heat is the result of poor digestion over a prolonged period of time. This leads to the formation of excess mucus or phlegm, which blocks the flow of energy and obstructs the heart and disturbs the shen.
Heart Blood and Spleen Deficiency is a pattern caused by malnourishment, prolonged sickness, or loss of blood such as after childbirth. When there is blood deficiency, the heart cannot house the shen so that it tends to “float” at night time, causing insomnia.
Treating the root cause
When a qualified TCM practitioner like myself makes the correct diagnosis, we can then address the root cause of insomnia without causing harm to the body.
To determine the pattern of the disharmony or cause of insomnia, I usually starts by asking questions such as: Do you have difficulty falling asleep? Do you wake up frequently during the night? Do you dream a lot? Do you toss and turn during the night?
I also investigate other pre-existing symptoms and aggravating factors. An individual symptom or sign means nothing on its own and all the symptoms must be considered in relation to one another.
Based on the patient’s complexion, voice, bodily movements, I can then determine whether the patient has a pattern of deficiency or excess. A deficient pattern will require a nourishing treatment, and an excess pattern will require a sedating one. Checking the tongue and pulse can also indicate how serious the problem is and whether herbs should be prescribed.
Herbs and acupuncture
In simple cases of insomnia, such as a recent emotional upheaval, acupuncture alone is sufficient. For more serious and chronic cases, a combination of acupuncture and herbs is recommended. Sometimes I prescribe herbs at night time but in other cases I may prescribe herbs for both day and night. The daytime herbs are generally more invigorating while the nighttime herbs, which are taken half an hour before bedtime, are more relaxing and sedating.
The length of treatment for insomnia varies and depends on the severity of the condition. Generally I recommend 5-10 treatments. The first 5 treatments are ideally every 2 or 3 days apart. Once there is some improvement, treatments can be reduced to one per week.
TCM treatments promote natural sleeping patterns without the significant hangover effect as in the case with many sleeping pills. If you are currently taking sleeping medications and are bothered by some of the side effects, I would suggest contacting a TCM practitioner to explore the alternatives.