Insomnia
Everyone sometimes sleeps less well. Stress, worry, physical complaints or changes in the daily rhythm may make it difficult to sleep, wake up at night or wake up early. If sleep problems persist, they can increasingly influence energy, concentration, mood and day-to-day functioning.
Insomnia, also known as insomnia, can express itself in different ways. Some people lie awake especially long before they fall asleep, while others easily fall asleep but wake up several times a night. Also a light, restless sleep or many dreams can occur.
Acupuncture and Chinese herbal medicine can be used in various forms of sleep problems. Not only do you sleep poorly, but especially how you sleep badly and what other complaints are present.
Common symptoms
In the case of insomnia, the following symptoms may occur:
- difficulty sleeping;
- Wake up regularly during the night;
- difficulty re-sleeping;
- Wake up early;
- light or restless sleep;
- many or lively dreams;
- waking up feeling unrefreshed;
- fatigue and daytime concentration problems;
- irritability or mood changes.
The way sleep is disturbed can give clues about possible causes. For example, difficulty sleeping may be associated with peaking or tension, while repeated waking up may occur for instance in nightly warmth, physical distress or other health problems. TCM sources also distinguish between different forms of insomnia, such as difficulty sleeping, repeated awakening, many dreams and waking up with warmth or palpitations.
Western disorders in which insomnia may occur
Insomnia can be an independent problem, but it can also occur as part of another condition or phase of life. Examples include anxiety and depression symptoms, transitional symptoms, chronic pain, restless legs syndrome, sleep apnea and thyroid disorders. Stress, alcohol, caffeine, stimulants and certain medications can also affect sleep.
Not every disturbed sleep is insomnia. If someone stays awake for example because of pain, itching or breathlessness, the primary cause is elsewhere. Treatment of that complaint can therefore improve sleep.
For prolonged or severe sleep problems, medical examination may be important, for example when there is evidence of sleep apnea or any other underlying condition.
Possible causes
Sleep problems are often caused by multiple factors that affect each other. Stress and worry can make it difficult to unwind, while prolonged sleep deprivation can then make someone more sensitive to stress.
Other possible factors include irregular sleep-wake rhythm, shiftwork, hormonal changes, prolonged overload, physical complaints, alcohol, caffeine and certain medications. Also habits can play a role, such as late eating, intensive sports just before sleep or much stimulating activity in the evening.
A disturbed sleep rhythm can also remain after the original cause has disappeared. For example, the TCM source describes this in shiftwork and parents who have been sleeping poorly for a long time by a young child: the body can become used to the disturbed rhythm.
How can acupuncture help with insomnia?
In acupuncture, the treatment is tailored to the way your sleeping problems are expressed and to the underlying TCM pattern. Therefore, someone who is difficult to sleep due to stress can be treated differently than someone who is exhausted but sleeps lightly or wakes up at night with warmth and night sweats.
Depending on your situation, treatment may be directed at:
- Relax the Shen and support sleep;
- improve Qi's flow through stress and stress;
- Reduce heat in the event of strong turbulence and irritability;
- Dampness and Phlegm reduce when mental heaviness or digestive problems are present;
- Supporting Qi and Blood in case of fatigue and exhaustion;
- Yin feeding at night heat, dryness and night sweats;
- treat physical stress and other complaints affecting sleep.
Treatment may change during the course of treatment if the sleep pattern also changes.
How can Chinese herbal medicine help with insomnia?
Chinese herbs are also tailored to the underlying pattern. Herbs can be used daily and thus provide between acupuncture treatments by supporting.
Depending on the picture of complaints, treatment may be directed at:
- Calm down the Shen and support sleep;
- regulation of stuck Qi when stress and emotional tension interfere with sleep;
- Reduce heat in case of restlessness and feeling hunted;
- Dampness and Phlegm transform when heaviness, mental fog or digestive problems are present;
- Qi and Blood supplement when exhausted and light sleep;
- Nourish Yin when often waking up together with heat and dryness.
Acupuncture and Chinese herbal medicine can be used separately or in combination. Possible interactions are taken into account when selecting herbs.
How does Chinese medicine view insomnia?
Within the traditional Chinese medicine a lot of attention is paid to the way someone sleeps. Difficulty sleeping, often waking up, early awakening, many dreams and waking up with warmth or palpitations can indicate different underlying patterns within TCM.
A central concept here is the Shen . The Shen is connected within TCM to the Heart organ system and includes consciousness, mental rest and emotional functioning. For a quiet sleep, the Shen must be able to calm down enough at night.
Also the Hun, which is connected to the Liver within TCM, is relevant. Their is associated with dreams and mental activity during sleep. This helps explain why, for example, many or very vibrant dreams can occur within certain liver patterns.
There are several ways in which this rest can be disturbed according to TCM. Stress, for example, can hinder the movement of Qi, which makes it difficult to switch off body and mind. Heat can cause strong mental and physical restlessness. Phlegm may be associated with a heavy or clouded feeling. On the other hand, shortages of Qi, Blood or Yin can make sure that the Shen is not sufficiently nourished and anchored. The sources therefore make an important distinction between patterns of excess and patterns of deficiency.
The Heart is not isolated. Also the Liver, Spleen, Stomach and Kidneys can play an important role. Especially the connection between the Heart and the Kidneys is relevant in chronic insomnia with nocturnal heat, restlessness and other signs of Yin deficiency.
A recognizable combination of signs and symptoms is called a TCM pattern. Treatment is based on the overall pattern and not just on the complaint insomnia.
The most common patterns are discussed below. Other patterns are possible and multiple patterns can be present at the same time. This allows you to recognize yourself in different patterns. Also, not everyone with the same pattern has all the symptoms mentioned.
What is a TCM organ system?
A TCM organ system describes a group of connected physical and functional processes and is wider than just the anatomical organ with the same name. Read more at TCM basics .
What is a TCM pattern?
A TCM pattern is a recognizable combination of complaints and physical characteristics that indicates which imbalance according to TCM is in the foreground. Read more at TCM basics .
Most common TCM patterns
Liver-Qi-stagnation
Brief explanation
With Liver-Qi stagnation, the body can be difficult to relax after stress or emotional stress. Especially stress, frustration and a constantly active head can disturb sleep. The source describes this as a common pattern in which sleep clearly deteriorates during periods of stress.
Common symptoms
Difficulty sleeping, light or restless sleep, early awakening, much or lively dreams, worrying, irritability, mood swings, sighs, teeth grinding and tense neck and shoulders. Complaints often increase during stressful periods.
Examples of Western disorders
Stress-related insomnia, trouble sleeping in PMS and insomnia in case of sleep-wake rhythm disturbance.
Heart-Blood- and Spleen-Qi-deficiency
Brief explanation
According to TCM, Blood helps give the Shen sufficient rest at night. The Spleen plays a role in the formation of Qi and Blood. Long-term overload, worry, illness or insufficient recovery can therefore lead to a combination of exhaustion and mild, restless sleep. This pattern occurs, according to the source, after prolonged stress and around pregnancy and childbirth.
Common symptoms
Especially difficult to sleep, light sleep, lots of dreams, regular awakening, daytime fatigue, palpitations, peaking, dizziness, concentration and memory problems, low energy, low appetite and sometimes a pale radiant pain.
Examples of Western disorders
Insomnia after prolonged overload or illness, postpartum sleep problems and symptoms associated with fatigue or anaemia.
Heart- and Kidney-Yin-deficiency
Brief explanation
Yin stands within TCM for, among other things, rest, cooling and recovery. When Yin van Heart and Kidneys is insufficient, the Shen can unwind less well and creates relatively more Heat. The result is often a combination of fatigue and inner restlessness.
Common symptoms
Often waking up, restless or shallow sleep, difficulty sleeping again, waking up with restlessness or palpitations, night sweats, warmth in the evening or night, warm hands and feet, dry mouth or throat, thirst, forgetfulness and sometimes dizziness or ringing in the ears.
Examples of Western disorders
Sleep problems around the transition, chronic stress-related insomnia and prolonged insomnia with nocturnal heat and dryness.
Liver-Heat or Liver-Fire
Brief explanation
When Liver-Qi stagnates long or strong, TCM Heat can occur. A stronger image speaks of Liver-Fire. The mental and physical activity is clearly increased, making switching off and sleeping quietly difficult.
Common symptoms
Often waking up, especially in the first half of the night, a hunted or active head, vibrant dreams or nightmares, strong irritability or frustration, tense neck and shoulders, headache, tooth grinding, warmth, thirst, bitter taste and red or irritated eyes.
Examples of Western disorders
Stress-related insomnia, trouble sleeping in PMS or transitory symptoms and insomnia during periods of strong emotional tension.
Phlegm-Heat
Brief explanation
In this pattern, Phlegm and Heat combine. According to TCM, Phlegm can hinder mental clarity, while Heat makes the Shen restless. The source establishes a clear relationship with the Spleen and Stomach system and mentions among other things nutrition and food stagnation as possible factors.
Common symptoms
Unsatisfied or interrupted sleep, many dreams, early awakening, inner restlessness, anxiety or palpitations, mental mist, dizziness, chest tightness, nausea, belching, reflux, low appetite or bloating. Sometimes there is also a lot of mucus formation.
Examples of Western disorders
Insomnia associated with reflux, chronic stomach discomfort or obvious digestive problems.
Stomach disharmony and Food stagnation
Brief explanation
The classic TCM idea that Stomach is not in harmony, which causes one to sleep restlessly is clearly coming back into the source. Too much or late eating can keep digestion active and strained at night. This can disturb sleep. Long-term food stagnation can eventually also contribute to Phlegm-Heat.
Common symptoms
Bad sleep after late or heavy eating, feeling full or blocked in the upper abdomen, bloating, tummy messaging, belching, nausea, reflux, bad breath and sometimes constipation or strong smelling stools.
Examples of Western disorders
Sleep problems that are clearly associated with late or heavy eating, reflux or functional indigestion.
Blood stasis
Brief explanation
Blood stasis means within TCM that the movement of Blood is not sufficiently free. The source describes this both after physical or emotional trauma and during prolonged insomnia where other patterns have eventually led to stagnation. It can be especially relevant in persistent sleep symptoms that do not respond adequately to other treatment strategies.
Common symptoms
Hard insomnia, lots of dreams and restlessness, sometimes nocturnal warmth without obvious sweating, headache or other fixed or sharp pain symptoms. During prolonged Blood stasis, dark or purple discolorations can occur.
Examples of Western disorders
Post-traumatic insomnia, difficulty sleeping after head injury and chronic insomnia involving pain or prolonged illness.
Yin-deficiency with Deficiency Heat
Brief explanation
In Yin deficiency, there is insufficient soothing and cooling capacity. As a result, relative or 'Lege' Heat can be created that becomes active at night. Unlike Heart- and Kidney-Yin deficiency, this pattern does not need to arise specifically from the Heart-Nier connection; for example, Liver-Yin may also be involved.
Common symptoms
However, sleep can only wake up after one or two hours, repeat waking up with warmth and restlessness, warm feet causing the blankets to be kicked away, night sweats, dry mouth and throat, thirst, dry skin or eyes and sometimes muscle cramps or restless legs.
Examples of Western disorders
Chronic insomnia with nocturnal heat, transient sleep symptoms and sleep problems after prolonged illness or exhaustion.
Other patterns
The sources also describe several less general patterns, including Heart-Fire, Heart- and Lung-Qi stagnation, Liver-Bloed deficiency, Heart- and Gallbladder-Qi deficiency and remaining Heat after infection. These are relevant for individual treatment but less distinctive than the above patterns for this overview page.
Outlook
How fast insomnia changes depends heavily on the cause, duration of the symptoms and underlying pattern. Recent sleep problems have arisen in which stress or a temporary disturbance of sleep rhythm plays an important role may be different from insomnia that has existed for years.
In chronic insomnia with marked blood or Yin deficiency, the TCM sources usually describe a more gradual recovery, as not only sleep needs to rest but also underlying deficiency needs to be built up. Factors such as transitional symptoms, chronic stress, physical illness, medication or a prolonged disturbed day-night rhythm can also influence the course of treatment.
In the initial phase, once a week treatment is a usual guideline. In case of severe or acute sleep problems temporary treatment can be appropriate two or sometimes three times a week. When sleep becomes more stable, the frequency can usually be reduced. This always depends on the individual situation.
Regular sleep-wake rhythm remains important. The source highlights, among other things, fixed sleep and wake-up times, regular daytime movement, limiting caffeine and other stimulants and avoiding large meals just before sleep.
Contact
Do you suffer from insomnia and do you want to know if acupuncture or Chinese herbal medicine can fit your situation?
During a first consultation we discuss not only your sleep, but also factors such as energy, stress, emotions, digestion and possible physical complaints. On the basis of the overall picture, a treatment plan will be drawn up that matches your situation.
You can make an appointment directly online or contact us for more information.