I remember when I was 8 years old.  I would literally jump out of bed at 6.30 a.m to catch my favorite cartoons, ‘Mask’ and ‘Voltron’.

That lasted until I reached high school and became a teenager. I then remember being 18 years old and I could sleep for 12-14 hours,and never wake feeling refreshed.  Looking back, I realize that too much sleep and yet never being able to feel refreshed is an early sign of liver and spleen weakness.  As the years went by, in my mid 20’s, I had problems falling asleep, sweating at night, digestive problems and would wake up several times every night.  I was told that was part of the aging process.

According to Chinese medicine chronic sleep disorders are usually caused by “Yin-Yang” imbalance resulting from a weak liver, spleen, heart or kidneys.  Since these organs affect one another, they all have to be taken care of, especially the heart and the liver.  According to Chinese medicine, the liver filters all our blood through the night, especially between 1-3 am.  A weak or congested liver means that it has to struggle through the night. Poor quality sleep or even insomnia may result in more severe cases.

Dream-disturbed sleep: Nightmares normally indicate a disorder of the Gall Bladder meridian. Dreams in which we go over and over the same ground, walking in a maze, reliving aspects of our jobs or our relationships generally are due to a Spleen/Heart imbalance. People with this problem say, “I can’t shut my mind off.”

Difficulty falling asleep: This is usually related to an excess condition of the Liver or Liver and Gall Bladder. People will lie awake, tossing and turning for hours.

Waking up easily: Many people can fall asleep easily, but then they wake up later and find it difficult to go back to sleep again. They may be awake for an hour or so, or may not go back to sleep at all. These people have a deficiency pattern, often a Heart/Spleen deficiency.

Waking up at a specific time every night:

For example, some people regularly wake up at three o’clock in the morning. In Chinese medicine theory, the body’s energy (Chi) circulates through the twelve principal meridians over a 24-hour period. Each meridian relates to an internal organ. If a person wakes or has some unusual symptoms at the same time every day, it is probable that there is an imbalance in the organ system that is “highlighted” at that time of day. Energy peaks in the Liver meridian at 3:00 a.m., which is why people often wake up then. Liver problems can result from unexpressed anger, stress triggering Liver Chi stagnation, and Liver Fire.

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:

	11:00 P.M. to 1:00 A.M. for the gallbladder
	1:00 A.M. to 3:00 A.M. for the liver
	3:00 A.M. to 5:00 A.M. for the lungs
	5:00 A.M. to 7:00 A.M. for the large intestine

It helps to go to bed early for optimum benefits. 9:00 P.M. sleep time is the most preferable.

Other symptoms: When a Chinese medicine practitioner is analyzing a patient’s sleeping problems, he narrows down the possibilities by looking for other symptoms that are characteristic of a particular disorder. For example, people with the Liver Fire pattern get angry easily, and have Heat signs such as a red face, dark yellow urine, and dry bowel movements. People with Spleen/Heart deficiency tend to be forgetful, have poor concentration, feel very fatigued, and are always worrying about something. People with a Kidney/Heart disharmony can have tinnitus , palpitations, weakness in the low back, feel light-headed, and get flushed easily. Chinese medicine practitioners also examine their patients’ tongues and feel the pulse for further indications of which particular pattern is predominant.

Patients battling chronic insomnia can tell you that insufficient or poor quality sleep leads not only to irritability and exhaustion, but also to muscle stiffness, impaired cognitive function, fibromyalgia, and other significant health problems. Commonly, Western medicine will search for a physical or emotional problem causing the sleeplessness, but TCM recognizes that insomnia can stem from a fundamental imbalance of energy, or qi. While sleeping pills and anti-depressants are commonly prescribed for insomnia and other sleep disorders, these prescriptions can become addictive and patients can find it difficult to sleep naturally, without pills or medicine in the future. Patients may find better relief through the natural based treatments of acupuncture and herbal remedies. TCM utilizes a system of pressure points and meridians to track the function and balance of our organs, blood, and energy. It is believed that each organ houses a different aspect of our spirit. For those with insomnia or sleep apnea, the heart and liver are often out of balance, allowing the spirit to wander and disrupt the normal patterns of sleep. More specifically, the gall bladder meridian is often to blame for dream-disturbed sleep, manifesting in the form of nightmares or repetitive dreams. Patients who experience difficulty falling asleep typically have an imbalanced liver, while those who sleep too lightly often need to be treated for a heart and spleen deficiency. When the proper insomnia pattern has been identified, a TCM practitioner can personalize a course of treatment. The most effective course of treatment for insomnia is a combination of acupuncture and a Chinese herbal formula, which should be incorporated into the patient’s diet. The popular herb Suan Zao Ren helps to enrich the blood that flows to the heart and liver while regulating and calming the liver meridian. This is one of the best herbal approaches to treating insomnia due to a liver/heart dysfunction, however, it’s important to remember that a TCM diagnosis is developed specifically for the individual patient. Herbal formulas will often include a variety of herbs depending on that particular patient’s state. The beauty of TCM is that there is no “one solution solves all” formula for everyone, rather, each patient receives an individualized treatment specifically addressing the issues at hand. There are a variety of Chinese herbal formulas that have been shown to help those with insomnia to sleep more deeply and to achieve restful sleep for longer periods of time. Pairing an herbal remedy with regular acupuncture treatments is critical for success. A series of thin needles are used to apply pressure very carefully to specific points along the surface of the skin. Clinical studies have shown that acupuncture helps release extra neurotransmitters into the central nervous system, including serotonin which regulates sleep patterns. As a result, acupuncture can be used to improve the quality of sleep without the sluggish side effects associated with most sleeping pills.
Heart Qi Blood Def- AnShenDingZiWan- Insomnia, agitation, pale tongue, thready weak pulse.

Heart & Kidney Yin Def- Tian Wang Bu Xin Dan + Sheng Mai San
Liver Fire- Long Dan Xie Gan Tang-
Liver Qi Constraint- Jia Wei Xiao Yao San & Wen Dan Tang
Menopausal Related- Gan Mai Da Zao + Er Xian Tang, Zhi Bai Ba Wei
Severe- Jing Gui Suan Zao Ren Tang
Spleen & Heart Def- Gui Pi Tang

Insomnia Categories

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
Tip’s the you can try for a better sleep:
– Get ‘Sleep Cycle’ from the Ap store on you phone to monitor your sleeping patterns: http://www.sleepcycle.com/
– Get your diet and your digestion sorted out. It’s hard for your mind to relax with noisy neighbors downstairs.
– Exercise, but not too close to bed-time.

– Make sure your room is very dark
– Vitamin D in the morning, and Mag, Collagen in the evening will help sleep.
– Don’t drink coffee past 2PM (~10-ish hours before sleep).
– Meditate morning and night, even for 5 minutes – you need to reorganize your brain and shut down the server at the end of the day. A great little 2 minute intro, one of the best I’ve seen, and cute: https://www.youtube.com/watch?v=rqoxYKtEWEc
– Lighting: Don’t look at any white light 1-2 hours before bed (especially your iPhone in bed!), the white light triggers melatonin (sleepy hormone) to switch off and wake you up again- your body thinks it’s day time- amber light is ok. Or wear blue blocker glasses with orange tint if exposed to bright light at night.
– Use F.lux on your computer. Makes the screen orange’ish in the evening. it’s free! https://justgetflux.com/
– Use Amber light LED bulbs at house in the evening.

– Make sure your cool in bed

– Come and see me if all these things don’t work, and i’ll sort you out.