Insomnia is a common complaint seen in our practice. 7 out of 10 of our clients suffer from different degrees of insomnia. In TCM, we categorize the cause of insomnia into the following five: Liver fire disturbing Heart Shen, Damp heat disturbing Heart Shen, Heart & Gallbladder Qi deficiency, Heart & Spleen Qi deficiency and Heart & Kidney in disharmony.
In type 1 Liver fire disturbing Heart Shen, clients cannot fall asleep at all, sometimes throughout the night. They are usually highly irritable and explosive. Other symptoms include headache, burning sensation in the eyes, tinnitus, dry mouth, bitter taste in the mouth, constipation, or loose stool with burning sensation in the anus. Tongue image is red with yellow tongue coating, pulse is wiry and fast. This type of clients usually has lots of stress from their work, daily life, or family relations. Stress will cause Liver Qi stagnation. While left untreated for a long time, it can transfer into Liver Fire. The main acupuncture point is to reduce Tai Chong, Xing Jian on the Liver meridian. Main formula should be Long Dan Xie Gan Tang with modifications.
In Type 2 Damp heat disturbing Heart Shen, clients have a hard time fall asleep, or sleep very shallowly. They usually feel pressure on the chest of stomach region. Other symptoms include acid reflux, sour taste in the mouth, feeling heavy in the head and dizziness. Tongue is red with yellow sticky tongue coating, pulse is slippery and fast. Eating too much greasy food, raw, cold food and lack of exercise can lead to dampness accumulation. Over time, dampness will transfer into more sticky phlegm, which may generate heat. The heat will disturb Heart Shen, resulting in insomnia. Treatment principle is to clear the dampness and heat. Main acupuncture point is Feng Long, Zu San Li, Yin Ling Quan. Main herbal formula should be Huang Lian Wen Dan Tang with modifications.
In type 3 Heart & Gallbladder Qi deficiency, clients often nightmares and are very easily startled during sleep. Other symptoms include shortness of breath, fatigue, easily startled, feeling like being chased, and easily nervous or scared. Tongue image is usually pale. Pulse is thin and wiry. Main treatment principle is to strengthen the Qi and calm the Shen. Main acupuncture points include Bai Hui, Yin Tang, Zhong Wan, Guan Yuan. Main formula should be An Shen Ding Zhi Wan with modifications.
In Type 4 Heart & Spleen Qi deficiency, clients usually can fall asleep without any problem, but frequently wake up at night, sometimes stay awake for hours. Other symptoms include forgetfulness, brain fog, fatigue, abdominal bloating, loose stool, dizziness, and pale face. Tongue image is pale with thin tongue coating. Pulse is thin and weak. Main treatment principle is to strengthen the Spleen and Heart Qi, nourish the blood and calm the Shen. Main acupuncture points include Zu San Li, Guan Yuan, Qi Hai, San Yin Jiang, Di Ji, Yin Lin Quan, Zhi Yang. Main formula should be Gui Pi Tang with modifications.
In Type 5 Heart & Kidney in disharmony, clients find it difficult to fall asleep, and wake up frequently, followed by extreme fatigue the next day. Other symptoms include Heart fire overacting, palpitation, dreaming a lot, dizziness, tinnitus, lower back soreness, knee pain and weak, hot sensation in hands and chest, dry mouth, nocturnal emission, irregular menstruation. Tongue image is red with little tongue coating. Pulse is thin and fast. Treatment principle is to nourish Yin and calm down the fire, connecting Heart and Kidney. Main acupuncture points Tai Xi, Fu Liu, Zhao Hai, Nei Guan, Bai Hui. Main formula should be Jia Tai Wan with modifications.
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