I was recently waking up every hour with bizarre dreams of adventures, challenges and monsters. Usually I am a great sleeper and wake up rested and ready to greet the morning with grace and excitement. However, this was different. I felt like I ran a marathon in my sleep and then I had to tackle a full day. I let this go on for awhile before pausing to ask myself, "Why am I not sleeping? What has changed?" The questions resonated in my consciousness as I was reminded that these are the same questions I ask patients who have insomnia and sleep issues.
Traditional Chinese Medicine Approach to Sleep
In Traditional Chinese Medicine (TCM) insomnia comes in various forms with many different root causes. The most common forms are difficulty falling or staying asleep, dream-disturbed sleep, and frequent waking. There are 4 systems that can cause insomnia-- heart/shen, liver, lungs, and spleen.
Heart and Shen
The shen in TCM is translated as 'spirit' or 'mind.' It plays a key role in higher mental functions, including many of the intellectual and spiritual aspects of consciousness. The shen is closely associated with our conscious awareness and is essentially our ability to perceive, interact and communicate with our world. In addition, the shen and the heart share an interdependent relationship. TCM describes the heart housing the shen and when the heart does not have enough yin to nourish the shen, yang becomes hyperactive causing insomnia. A regular sleep cycle is the result of yin and yang harmony. Yang governs the awake state and yin governs sleep.
The liver is responsible for the distribution of qi and blood and its job is to ensure a steady supply of qi to the other organ systems. Failure of qi distribution can lead to obstructions causing various emotional or psychological problems, most notably depression, anger, mood swings and insomnia. Stress can weaken the function of the liver which causes qi stagnation and affects the cardiovascular, digestive, nervous, endocrine and musculoskeletal systems.
The lungs are involved in respiration, immune system and waste elimination. The lungs also help us let go of the old and take in the new similar to the respiration function of taking in oxygen and releasing carbon dioxide. The emotion related to the lungs is sadness or grief. Sometimes grief can impede our ability to sleep soundly.
An imbalance with the spleen can reduce nourishment to the heart causing anxiety, worry, obsessive thinking which can lead to insomnia and nightmares. The spleen performs several fundamental processes that are critical to metabolism. It is also the basis of digestion, harvesting of nutrients and the transformation of the raw materials of food into qi.
Here is a summary of the TCM organs and how they relate to insomnia:
Emotion - Anxiety
Insomnia - Frequent waking up, not falling asleep easily
Emotion - Stress, anger, frustration
Insomnia - Difficult time falling asleep, recurrent dreams, frequent waking around 1-3 am
Emotion - Sadness, grief
Insomnia - Frequent waking around 3-5 am
Emotion - Obsessiveness, worry
Insomnia - Regularly waking up during the night at the same time, easily awakened, nightmares, restless sleep
What can you do to help reduce insomnia?
1. Create a good sleep routine
Make sure that your are going to bed at a scheduled time and are creating a relaxing sleep environment in your bedroom. Evaluate your bedroom because it is easier to fall asleep in a cool and dark room. Invest in a comfortable bed and pillows that adequately support your neck. Keep your bedroom clean and uncluttered. You can learn more about feng shui for the bedroom here.
Start relaxing at least 1-2 hours before bedtime to allow your body to know that you are going to sleep soon. Drink some herbal relaxing tea (chamomile, lavender, etc), diffuse essential oils (lavender, vetiver, chamomile, orange, etc), take a bath with epsom salt, or listen to relaxing music.
2. Reduce stress
If it is stress that is keeping you up, write away your worries before you sleep or keep a pen and pad of paper at your night stand to write anything down that wakes you up. Start a breathing, yoga, meditation or prayer practice to help release your internal anxieties. Get acupuncture to reduce overall stress.
Exercise at the right time of the day can promote good sleep. I would suggest exercising at least 20-30 minutes a day, whether it is yoga, walking, cardio, etc. Moving your body will reduce stress, release endorphins and help balance sleep promoting hormones. Try not to practice strenuous exercise within 1-3 hours of bedtime since it can give you more energy and keep you awake.
Food is medicine and what we eat either promotes health or dis-ease. If you are noticing difficulty sleeping reduce intake of sugar, alcohol, caffeine, iced beverages, processed and greasy foods. What time are you eating dinner at? Try not to eat dinner too close to bedtime, eat at least 2-3 hours before going to sleep. However, if you suffer from hypoglycemia during nighttime you may experience waking up with low blood sugar levels and eating a light snack before bed can help.
Add these sleep-promoting foods into your diet:
Tart cherry juice
Dark leafy greens
5. Get acupuncture
Acupuncture reduces stress and treats the root causes of insomnia. Each person who experiences insomnia will be treated for their unique root pattern according to Traditional Chinese Medicine. Treating insomnia with acupuncture may take several sessions to reach better sleep health. Usually, by the third treatment patients notice improved sleep and stress reduction.
Schedule your acupuncture treatment with Samantha and receive your personal report of findings and recommendations.
Try using these two acupressure points before going to bed. Rub or press points on both wrists for 30 seconds.
6. Herbal and nutritional supplement therapy
There are several supplements and herbal formulas to treat insomnia. I want to share with you the most effective ones in my practice.
Suan Zao Ren Tang - Chinese herbal formula that nourishes the heart and calms the spirit.
Min - Tran - Standard Process formula that contains mineral complexes, consisting of, magnesium, iodine, and calcium to support emotional balance and sleep health.
Kava Forte - Kava has been traditionally used in the Pacific Islands for its relaxing properties. MediHerb formula contains well-sourced and standardized kava root that reduces anxiety and insomnia.
Calm - Magnesium powder that reduces anxiety, insomnia, muscle tension and constipation.
Adrenal Support - Helps the body respond better to stress and reduces adrenal fatigue symptoms.
I would like to at least mention melatonin in treating insomnia. It can be beneficial, but it can lead to morning time drowsiness and other side effects such as depression, headaches, irritability, and stomach upset. I usually do not recommend melatonin because the above options are more effective with less side effects.
7. Reduce screen time before bed
Artificial light can add unwanted stimulation and disrupt our sleep hormone production. Keep electronics out of the bedroom and reduce your exposure to electronic screens. Try using the "night shift" mode on your phone to help with screen light and eye strain.
8. Treat your aches and pains
If you are waking up from pain, stretch before bed and take a natural anti-inflammatory, such as, turmeric or boswellia. Acupuncture and Chinese herbal supplementation can also help reduce pain.
9. Don't stay in bed if you can't sleep
If you are laying in bed awake for at least 15-20 minutes without going back to sleep, get out of bed to read or do a light activity until you are tired again.
10. Get enough sunlight exposure to help with natural circadian rhythms.
In summary, I hope this gives you a better understanding of insomnia and how it is viewed in TCM. One of the reasons why I wanted to write about insomnia is because it is so common and I see it very often in my practice. It is something most of us experience and Chinese Medicine offers us many ways to get a better night sleep.
If you are having sleep issues and would like an expert opinion contact Samantha for a consultation.
If you are interested in Chinese Medicine read "The Web That Has No Weaver" by Dr. Ted Kaptchuk. Dr. Kaptchuk is a Doctor of Chinese Medicine and an Associate Professor at Harvard Medical School.
If you would like to further explore the Chinese Medicine approach to regulating sleep read, "Curing Insomnia Naturally with Chinese Medicine" by Dr. Bob Flaws.