Chinese medicine insomnia theory

According to Chinese medicine insomnia theory, the causes for insomnia are as follows:

1. Gastrointestinal function and eating disorders. Eating disorders would damage gastrointestinal function easily, which leads to stagnation of food and phlegm-heat;
2. Liver function disorders. Liver can be impacted easily by negative emotions. The folded functions of liver can result in stagnation of Qi and blood stasis. Therefore, people with negative emotions tend to feel upset and suffer from insomnia;
3. Dysfunction of heart and kidney. People who are with physical weakness or chronic illness are usually deficient of kidney Yin. The disharmony between the heart and kidney tends to contribute to heart-fire hyperactivity. The heat can injure shen (spirit), which is stored in heart. Therefore, it would lead to restlessness and insomnia.
4. Function disorders of spleen and stomach. Anxiety and stress injure the heart and consume heart Yin furtively, which will lead to mentally wandering and insomnia. The injured spleen can result in loss of appetite and deficiency of blood, which in the end fail to nourish the heart and lead to insomnia;
5. Gall bladder dysfunction. A guilty conscience, cowardice and the feeling of frightened and upset easily can lead to insomnia as well.

The root of Chinese medicine insomnia theory

From the perspective of Traditional Chinese medicine insomnia theory, there are many causes for insomnia. But the root is basically related with the sickness of the “heart”. For example,

• Deficiency of heart blood;
• Deficiency of kidney Yin fails to eliminate heart-fire;
• Excessive liver-fire can lead to excessive heat-fire;
• Confusion of heart (mind) by phlegm;
• …

All these causes, more or less, are relevant to the “heart”. Actually, a considerable portion of the “heart” in Chinese medicine insomnia theory is relevant to brain in modern medicine.

Chinese medicine insomnia remedies

The principles of Chinese medicine insomnia remedies are subject to the syndrome, which refers to the so-called syndrome differentiation.

The regular Chinese medicine insomnia remedies are as follows;

• Soothing the heart and tranquilizing the mind;
• Clearing heat and eliminating fire;
• Nourishing yin to reduce pathogenic fire;
• Clearing heat and expectoration
• Promoting blood circulation to dissipate blood stasis;
• …

Although the principles of Chinese medicine insomnia remedies might vary, the results tend to be good if used properly.

Regular used herbs for insomnia

In Chinese medicine, insomnia can be treated by many herbs. The list is so long that it is hard to list them all.

Some regular used herbs for insomnia are as follows:

• Tian Ma (Rhizoma Gastrodiae);
• Lingzhi mushroom (Ganoderma lucidum);
• Ge Gen (Radix Puerariae);
• Du Zhong (Cortex Eucommiae Ulmoidis);
• Shi Chang Pu (Rhizoma Acori Graminei)
• Yuan Zhi (Polygala tenuifolia);
• Bai Zi Ren (Semen Platycladi);
• Suan Zao Ren (Zizyphus spinosa);
• Lian Zi Xin (Plumula Nelumbinis Nuciferae);
• Hu Po (Amber);
• Niu Huang (Calculus Bovis);
• Zhu Sha (Cinnabaris);
• …

All these herbs have the effect of soothing the heart and tranquilizing the mind. No doubt using these herbs in appropriate combination according to the principles of Chinese medicine, insomnia can be cured or improved.

In addition, Chinese medicine insomnia remedies are more than that. Acupuncture, ear acupuncture, electro-acupuncture and laser acupuncture are also the regular and proven remedies to treat insomnia. In most of cases of the combination of herbs and acupuncture in Chinese medicine, insomnia tends to be cured more quickly and effectively.

When it comes to the causes of depression in elderly, there are a variety of them. In general, from the perspective of Chinese medicine and western medicine, the following five are the most popular ones.

Causes of depression in elderly: theory of correspondence between man and universe

Now we think that Chinese medicine was originated from the theory of correspondence between man and universe. Ancient Chinese considered that human body was a small universe, which runs synchronously with the big universe. According to this theory, everything in the nature can be found the corresponding one in human body.

Chinese medicine thinks the fall responses to the lung in organs, sadness in emotions and aging in physiology. As we know that the fall is the transitional phase between heat and cold, in which Yang qi begins to restrain itself and it is the time for Yin qi.

Due to the reduction in sunshine and the temperature drops gradually, the grass withers, the leaves falls and the flowers fades gradually. In the face of this kind of shabby scene, the elderly, who are in the same nature of the fall, are prone to be empathized and the feeling of desolation, depression and sadness would come to mind naturally. It is especially true to the elderly who has troubles in daily life.

Causes of depression in elderly: theory of biothythm disorders

Usually the elderly has shorter and poor quality of sleep. Especially when the fall comes, human body is in the physiological period of rehabilitation. Due to lack of sleep, the elderly are prone to suffer from the symptoms such as depression, tiredness and melancholy and so on.

Causes of depression in elderly: theory of stimulation by temperature variation

Due to the declined function of nervous system, the body temperature of elderly suffers more severe impact by outside interference. Therefore, the consequence is that it affects the coordination between body and mind in the elderly and finally make it difficult to maintain a stable mental state.

Causes of depression in elderly: theory of dryness in fall

The weather is dry in fall. Chinese medicine thinks that the elderly is susceptible to the pathogenic dryness. Therefore, Due to the decreased resistance and tolerance for elderly to combat the external adverse stimulation, the elderly is hard to calm down and become restless and depressed.

Causes of depression in elderly: theory of short nights and long days

After the fall, the nights become shorter and the days become longer for the inhabitant in northern hemisphere. The longer time people have spent in the dark, the more sleep-related hormone would be generated. Therefore, the high-level of sleep-related hormone would very easily lead to depression, change of sleep and eating habits, loss of interest in activities and so on. If left untreated, it may lead to the chronic depression.

In general, the phenomenon of the elderly is prone to suffer from depression in fall is the adverse reaction to external adverse stimulation. To find out the causes of depression in elderly is very important for us to find ways to prevent and cure depression. For the elderly, it is important to keep in mind that in fall they should have a good attitude and a good mental state. What’s more, they should not ask the trouble to be empathized by the nature of the fall.

Why most of them are sleep-deprived moms, rather than sleep-deprived dads. Is it possible that sleep deprivation and moms are connected with some kind of invisible link?

What behind sleep-deprived mom

Traditional Chinese medicine tends to think that mom is susceptible to suffer from static blood due to her special physical structure. Chinese medicine also thinks that static blood is a pathological product and the new source of diseases. The concept of static blood, in some extent, is equal to the thrombus in western medicine.

Ancient Chinese medicine practitioners viewed static blood as evil blood, which was likely to go upward and impact on the brain along with blood circulation. Therefore it would cause mental abnormalities, in which sleep deprivation is the most commonly seen presentation.

Sleep-deprived mom and Gui Zhi Fu Ling Wan

For sleep-deprived mom caused by static blood, Gui Zhi Fu Ling Wan is the highly recommended herbal medicine. Gui Zhi Fu Ling Wan is a classical formula for adjusting systemic disorder of blood circulation and also the representative of formulas to remove static blood in Chinese medicine therapies.

According to Jin Gui Yao Lue

“A young woman always suffered from period disease and her period suddenly stopped one day. Three months later, she started her period again but had bleeding and not stopping, and she felt fetal movement above the navel. All the signs indicated she was likely pregnant. However, this was not pregnancy but suffering from chronic static blood. If it was a pregnancy, her period should be normal before her period stopped. And normally the fetal movement started only after six months and the position should not be above navel.

Given that the above reasons, the inference was that the woman were suffering from chronic static blood, which resulted in non-stopped bleeding. And Gui Zhi Fu Ling Wan should be adopted to remove the chronic static blood. “

First of all, it needs to clarify that this above text is just my personal understanding for the text from Jin Gui Yao Lue. Actually the original test is much more obscure and difficult to read. Anyway, this text at least conveys us the following meanings:

1. During pregnancy if non-stopped bleeding and fetal movement occurred due to static blood in abdominal cavity, the mass should be removed and the fetus would be safe.
2. Static blood can result in non-stopped bleeding.
3. Gui Zhi Fu Ling Wan can promote blood circulation for removing blood stasis.

Let’s get back to the topic about sleep-deprived mom. From the above inferences, we come to know that Gui Zhi Fu Ling Wan can cope with sleep deprivation as long as sleep deprivation is caused by static blood.

Key presentations for sleep-deprived mom to use Gui Zhi Fu Ling Wan

• Sleep deprivation;
• Hard lumps in lower abdomen;
• Abdominal pain and refuse to press;
• Or the blood is in dull color and with small lumpy bits;
• Blue tongue quality;
• Deep hesitant pulse.

Sleep-deprived mom case

Female, 38 years old.

She was a chronic sleep-deprived mom since years ago and ever tried different medications but failed in the end. During her first visit, she told that she was difficult to fall into sleep, and it was always the nightmares to wake her up even she could sleep finally. After examination, her tongue coating was pale greasy and her period was normal. Apparently, it would be the pathogenic phlegm-dampness to make her a sleep-deprived mom. So Wan Dan Tang combined with Yuan Zhi, Chang Pu and Suan Zhao Ren would be the right choice. But after 14 doses, this formula did not work at all and sleep deprivation was still there.

During her second visit, she told that sleep deprivation occurred only after a miscarriage when she was inquired about her medical history. And the following abdominal diagnosis also indicated that there were lumps in the position left and underneath her navel. And she felt painful during pressing.

Therefore, the formula described as follows:

• Gui Zhi (Cinnamomi Ramulus) 10g;
• Fu Ling (Poria) 20g;
• Mu Dan Pi (Moutan Cortex) 10g;
• Chi Shao (Paeoniae Radix rubra) 10g;
• Yuan Zhi (Polygalae Radix) 6g;
• Chang Pu (Acori tatarinowii Rhizoma) 10g;
• Suan Zao Ren (Ziziphi spinosae Semen) 15g.

Total 3 doses.

After 3 doses, this sleep-deprived mom can fall into sleep for about 4 hours, with only few dreams. Since it worked, another several doses continued. Half months later, she came to told that the sleep deprivation was gone and her sleep couldn’t be better now.

Now you can see that sleep-deprived mom is not an accident, it does link to her susceptibility of suffering from static blood due to her special physical structure.

Since I have introduced Mr. Hu Xishu yesterday, I would like to pick one typical sleep disorder treatment case from Mr. Hu Xishu. And from this case, we can learn how to treat sleep disorder and know that why Traditional Chinese medicine works?

Sleep disorder treatment case from Mr. Hu Xishu

First visit of sleep disorder patient

Zhang, F, 65 years old, medical record number 16248.

First visit date: December 13th, 1965.
Chief complaint: Suffering from sleep disorder for many years, and medication these years can do nothing about sleep disorder.

Current syndrome:
1. Sleep disorder for years;
2. Occasionally sleep soundly but with endless interference by dreams;
3. 2 straight days without sleep when sleep disorder deteriorate;
4. Dizziness very often;
5. Dry mouth;
6. Palpitations and upset;
7. Spontaneous perspiration;
8. Red and dry tongue, white coating;
9. Thin, weak and rapid pulse, especially on right hand.

This pattern belongs to Yin blood deficiency, which means that Yang’s hyperactivity causes Yang can not transform into Yin and the balance between Yang and Yin breaks. Based on the above analysis, the solution should be taken to restrain Yang to make Yang harmony with Yin.

The prescription was as follows:

Raw Suan Zao Ren (Ziziphi spinosae Semen) 30g;
Zhi Mu (Anemarrhenae Rhizaoma) 12g;
Fu Ling (Poria) 15g;
Chuan xiong ( Chuanxiong Rhizoma) 9g;
Gan cao (Glycyrrhizae Radix) 6g;
Long gu (Fossilia Ossis Mastodi) 12g;
Mu li (Ostreae Concha) 24g.

Second visit of sleep disorder patient

Second visit: December 17th

Current syndrome after 3 doses taken:
1. Sleep improved slightly.
2. Still upset, palpitations, spontaneous perspiration and dizziness;
3. Outstanding symptom of dry mouth but do not want to drink.

Solution based on the previous prescription:
1. Remove Long gu (Fossilia Ossis Mastodi);
2. Add Dang Gui (Angelicae sinensis Radix) 9g;
3. Add Bai shao (Paeoniae Radix alba) 12g;
4. Add Gui zhi (Cinnamomi Ramulus) 9g;
5. Add Bai zhu (Atractylodis macrocephalae Rhizoma) 9g.

Note: That is equal to combine with Dang gui shao yao san.

Third visit of sleep disorder patient

Third visit date: December 22nd
After 3 doses taken, all symptoms were eliminated. To consolidation the effect, extra 3 doses prescribed.

Sleep disorder treatment analysis

This is a common pattern of Yin blood deficiency, which causes Yang can not transform into Yin, and then sleep disorder occurs. Suan zao ren is an astringent tonification herb. In particular, it can strengthen the nerves and soothe the mind. Suan zao ren is the leading herb to tonify deficiency and soothe the mind for sound sleep. And assisting with Chuan xiong and Gan cao to harmonize blood and solve the emergency; Zhi mu and Fu ling release upset and palpitation; and Long gu and Mu li not only arrest sweating and consolidate essence, but also soothe the mind.

In short, this formula benefits Yin and harmonizes blood, restrain the spirit and soothe the mind to make Yang transform into Yin. So Suan zao ren tang is a commonly used prescription for sleep disorder treatment.

Insomnia treatment with Tea plus Suan zao ren

Each day before 8:00 am, taking 15g green tea to brew with boiling water for two times, and then drink them all. After that, do not drink tea any more the whole day; at the same time, grind fried Suan zao ren (Ziziphi spinosae Semen) into powder, and take 10g with boiled water each night before going to sleep. Drinking them for continuous 3 to 5 days, usually the condition of insomnia would begin to improve.

Tea can revive and refresh. Tea contains bio-active substances of caffeine, which can excite high-level nerve center to cheer spirit, activate thought and eliminate fatigue. So this Chinese herbs work to adjust insomnia conditions of apathetic and drowsy state during the day.

Suan zao ren (Ziziphi spinosae Semen) is the seed of thorny jujube tree, which nourish heart yin, tonify liver blood, soothe spirit, and inhibit the central nervous system. Suan zao ren is one of excellent Chinese herbs on insomnia treatment, which has a good effect on the inhibition process into sleep at night.

As you may notice that, the two Chinese herbs are with totally different attribute, in other words, or against each other. But it is where the magic of Chinese herbs lies in. The combination of these two contradictory Chinese herbs neither impairs their own effects, nor produce side effects. On the contrary, they blend so well with each other and work as a perfect match for insomnia treatment.

Alternate tension with relaxation, excitement and inhibition can result in remarkable effect for insomnia treatment. So it is worth a try for someone who needs insomnia treatment.

Insomnia treatment with Dan shen and rock sugar soup

30g Dan shen (Salviae miltiorrhizae Radix), plus 300ml water boils with the slow fire for 20 minutes, remove the herbs, and then add an appropriate amount of crystal sugar, 2 doses one pot.

Dan shen (Salviae miltiorrhizae Radix) is natured of bitter and slightly cold, promoting blood circulation and soothing the nerves. Dan shen works a tranquilizer effect on the chronic insomnia treatment. What’s more, Dan shen also has improvement on diseases such as coronary heart disease and chronic hepatitis disease.

Insomnia treatment with Bai he honey soup

Bai he (Bulbus Lilii) 100g, plus clean water 500ml, boils with the slow fire, add appropriate sugar after Bai he melts. 2 doses one pot.

Bai he (Bulbus Lilii) is natured of sweet bitter and slightly cold, which can clear heat and soothe the nerves. Bai he can treat symptoms like low fever, restlessness, irritability, insomnia and more dreams. This Chinese herbs can be used for the deficient pattern of insomnia treatment, which caused by remaining heat and physically weak after just recovery from illness, especially for those insomnia patients with medical history of tuberculosis.

Insomnia treatment with Gan Mai Da zao Tang

Wheat 60g
Gan cao (Glycyrrhizae Radix) 20g;
Da zao (Jujubae Fructus) 15g (remove core).

First clean wheat and Da zao with water, boil them with Gan cao down to the decoction, and then remove Gan cao and wheat after all done, 2 doses one pot.

This is a famous formula from Zhang Zhongjing, who was a renowned doctor in the Han Dynasty. All the Chinese herbs are very simple and ordinary, but the efficacy of insomnia treatment is significant.

Causes of insomnia

Insomnia is a kind of sleep disorder, the main symptoms of which is an inability to sleep or chronic sleeplessness. This kind of disturbance of the normal sleep pattern is widely believed closed associated with mood disorders such as anxiety and depression. Therefore, to some extent, many people believes that remedy for insomnia is the remedy for anxiety as well.

It also makes sense from the point of view of Traditional Chinese medicine (TCM). Chinese medicine believes that insomnia is related to several internal organs like heart, liver, spleen, lung and kidney etc. However, the direct cause is the heart and the calmness of the heart spirit. Shen, or spirit, inhabits in the heart. If heart spirit is in peace, people can sleep well. If the heart spirit is disturbed, people will suffer from insomnia.

No matter disorder from heart channel itself, or from liver channel, spleen channel and stomach channel, they all can affect heart spirit, thus cause insomnia. Among all those causes of insomnia, the most common causes are from anxiety, overwork and deficiency of both heart and spleen due to injuries to heart and spleen.

Herbal treatment for insomnia and Suan Zao Ren Tang

In my practice, Suan Zao Ren Tang is a formula I use very often for insomnia treatments. Suan Zao Ren (Sour Jujube Seed) is the kernel of a small red date that grows wild in remote areas of northern China. It is an extremely effective sleep inducer, which is used in many natural sleep remedy formulas to deal with insomnia caused by stress and anxiety in ancient China. Comparing with antidepressants and sedatives, herbal insomnia remedies have no side effect of addiction and light-headed caused by sleeping pills. What’s more, insomnia herbs can regulate your body imbalance to eliminate the conditions from the root.

Suan Zao Ren Tang – Jin gui yao lue

OK, let’s take a look at what herbs are included in this famous natural insomnia formula?

Ingredient
Suan Zao Ren (semen zizyphi spinosae)…15~30g
Fu Ling (sclerotium poriae cocos)…10~20g
Zhi Mu (radix anemarrhenae asphodeloidis)…6~12g
Chuan Xiong (radix lifustici chuanxiong)…6~12g
Gan Cao (radix glycyrrhizae uralensis)…3~6g

Applications
-nourish heart yin, tonify liver blood, calm down spirit
-irritability, insomnia, palpitations, anxiety due to deficiency
-prevents abnormal sweating

Use herbal remedy for insomnia based on TCM theory

Now we have to go back to our questions raised in the first paragraph of this article. As we know that all those natural remedies for insomnia were not invented suddenly. They were found through all those years’ error and trial. The same is true to the theory of Traditional Chinese medicine. Simply, when using herbs for insomnia, the foremost rule is that you have to stick to guide of this theory. Or it seldom works.

As the most famous herbal remedy for insomnia, Suan Zao Ren Tang works well not only for insomnia, but also excessive sleeping symptoms. But once again, please always keep it on mind that these herbal insomnia remedies should be used only based on Traditional Chinese Medicine theory. This herbal remedy can not treat all conditions and symptoms of insomnia. It is not an all-heal medicine at all. This natural cure for insomnia of Suan Zao Ren Tang works only in the scale of diagnosis for deficiency of liver yin, especially signs and symptoms like lean, squamous and dry skin, pale lip and weary easily etc.

Insomnia treatment from Chinese Medicine perspective
As for Traditional Chinese Medicine perspective, insomnia attribute to overuse of five minds, disharmony of work and rest, Weakness of people who have just recovered and the olds, and poor diet.

     (1) Overthinking, disharmony of work and rest 
           Overthinking hurts heart and spleen; Fatigue hurts spleen qi; Rest too much without movement lead to qi stagnation. All those mentioned problems cause spleen dysfunction, lack the source of generating blood and qi, then can not replenish blood for nourish heart, finally insomnia occurs for malnutrition of heart blood.

     (2) People who just recovered and the old who are weak
           Due to poor natural endowment, acquired disorder, or weakness after just recovery or old age, it causes the heart, kidney and spleen deficiency, both blood and qi are short to nourish heart, or Yin deficiency with excessive heat. All those factors would cause restless and insomnia.

     (3) Panic and anger 
          Panic, tension, and excessive worry gradually lead to chronic insomnia for timidity due to deficiency of heart qi. Or latent anger hurts spleen, spleen stagnation transforms into heat, and flare up to disturb the mind, finally also would cause insomnia.

     (4) Poor diet 
          Spicy, fatty, raw and/or cold food and late-night eating lead to phlegm heat, which invade upward. All those factors would cause restless and insomnia.