Insomnia – Shi Mian

Insomnia is the chronic inability to sleep or not being able to achieve deep sleep. Most people who suffer insomnia will be unable to sleep through out the night with ought waking frequently.

The primary organ affecting sleep is the heart in Chinese Medicine Diagnosis.The heart is usually accompanied by a secondary organ which is dysfunctional.

Etiology (causes) of Insomnia:

1. Emotions: All 7 emotions may cause dysfunction–Joy (HT)has most impact on sleep Heart - Joy – shen/spirit doesn’t calm at night - Heart looses control Liver – Anger – can’t store blood – liver turns to fire attacking Heart Stomach - Worry/Sad – Spleen Qi stagnates and can’t and Blood to nourish Heart  

Spleen Deficiency: Caused by diet/poor digestion or over working – can’t produce blood to nourish Heart

Heart and Kidney Disharmony: Causes a disharmony between kidney water and heart fire

Liver Blood Deficiency: Liver can’t store ethereal soul – soul becomes active and eyes will not shut 

Heart and Gall Bladder Qi Deficiency: Impairs heart function – Gall bladder can’t ascend or disperse – timid person

Phlegm Heat in the Liver / Heart: Phlegm heat entraps heart and mind

Disharmony of Stomach Qi: Follows divergent meridian impairing heart

1. Liver stagnation leads to Fire that attacks the Heart/Spirit

2. Phlegm-Heat attacks the Heart/Spirit

3. Spleen deficiency due to attack from the Liver

4. Heart and/or Kidney Yin deficiency causing hyperactive Heart Fire

5. Heart and Spleen deficiency (Qi and blood)

6. Heart and Gallbladder Qi deficiency caused by sudden shock that attacks the spirit

Chinese Medicine Differentiation and Treatment of Insomnia 

Heart and Spleen Deficiency (Qi and Blood) Difficulty falling asleep, excessive dreaming, easily awakened, hard to fall back to sleep, Heart blood deficiency symptoms with Spleen Qi deficiency symptoms Tongue - pale, white coat Pulse - weak, thin

Principle of Treatment: Nourish Heart and Spleen to calm the mind

Acupuncture points – tonify, foot taiyin, hand shaoyin, Bladder 15 and 20, Spleen 6 and Heart 7 - lots of dreams – Bladder 42 (LU spirit point) - poor memory – Bladder 52 (KI spirit point), Du 20 (Moxa and needle)

Herbal Medicine Formula: Gui Pi Tang Liu Jun Zi Tang – more Spleen Qi deficiency symptoms Suan Zao Ren Tang – more Heart Blood deficiency symptoms

Heart Yin Deficiency with Hyperactive Fire Difficult sleeping with irritability, chest dysphoria, yin deficiency symptoms, dry throat, thirsty, mouth sores, cankers Tongue - red, dry coat Pulse - thin, rapid

Principle of Treatment: Nourish Yin, clear Heart fire and calm the mind

Acupuncture points – foot and hand shaoyin, *KI 3 and Pericardium 7, Bladder 15 and Heart 7 - dizziness – Gall bladder 20 - tinnitus – SJ 17, Small Intestine 19 - Kidney deficient signs – Bladder 23, 52

Herbal Medicine Formula: Tian Wang Wu Bu Xin Dan

Heart and Kidney Disharmony Difficult sleeping with dysphoria, reproductive disorders, lower back/knee weakness and pain, Kidney essence deficiency symptoms. Tongue - red tip, scanty coat Pulse - thin rapid

Principle of Treatment: Strengthen Kidney to balance Kidney and Heart to calm mind

Herbal Medicine Formula: Jiao Tai Wan

 Liver Blood Deficiency Difficult sleeping, wakes frequently with great difficulty falling back asleep, excessive dreaming, easily angered, hypochondriac/chest pain/fullness, liver stagnation symptoms Tongue - red sides, white/yellow coat Pulse - wiry, rapid (if heat)

Principle of Treatment: Nourish Liver Blood and sooth Liver to calm the mind

Herbal Medicine Formula: Suan Zao Ren Tang Dan Zhi Xiao Yao San + calming herbs (Liver Heat Turns to fire)

Heart and Gall Bladder Qi Deficiency Difficult sleeping, timid character, always thinking, can’t make decisions, depression, spontaneous sweat, palpitations, short of breath Tongue - pale Pulse - thin, wiry

Principle of Treatment: Nourish Ht and Gall Bladder Qi to calm the mind

Acupuncture points – tonify, foot shaoyang, hand shaoyin, Bladder 15 and 19, Pericardium 7 and Heart 7, Gall bladder 40 - fatigue – Bladder 20, Stomach 36 - tonify more – Bladder 43 (sweats)

 Herbal Medicine Formula: An Shen Ding Zhi Wan + Ren Shen + Fu Ling (to nourish Qi)

Phlegm Heat Difficult sleeping with dizziness, blurred vision, fullness in chest, bitter taste, nauseous, phlegm vomit, belching, overweight Tongue - red, greasy yellow coat Pulse - slippery, rapid Principle of Treatment: Eliminate Phlegm and clear Heat to calm the mind.

Acupuncture points – foot yangming, hand shaoyin, Stomach 44, Spleen 4 and Stomach 40 (Luo points), Heart 7, Pericardium 6 - constipation – Stomach 25, 37 Herbal Medicine Formula: Wen Dan Tang

Stomach Qi Disharmony Difficult sleeping, nauseous, vomit, bloating, irregular bowel movement, abdominal distension/pain, irregular diet Tongue - greasy coat Pulse - slippery Principle of Treatment: Remove Stagnation in Stomach, promote digestion and harmonize Stomach Qi to calm the mind. Herbal Medicine Formula: Bao He Wan + Chen Qi Tang (constipation)

Liver stagnation leads to Fire emotional upset, irritable, trouble getting to sleep, headache, red face and eyes, constipation, T- red with yellow coat, P- wiry rapid

Principle of Treatment – purge Liver Fire, soothe Liver, calm mind

Acupuncture points– sedate, foot jueyin, hand shaoyin, Liver 2 and Gall bladder 43 (ying-spring), Gall bladder 20, Heart 7 - headache, red eyes – taiyang, Large Intestine 5 - tinnitus – SJ 3, 17

Alternative Treatment Methods for Insomnia 

Ear Acupuncture – shenmen, subcortex, sympathetic, HT, SP, Kidney

injection – An Mian (between Gall bladder 20 and SJ 17) with Dang Gui

 7 star – along Du and Bladder Jing, gentle stimulation (do not bleed, only until skin turns pink) meditation, exercise, fresh air, have fun, Qigong, yoga, taiqi