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As a Chinese medicine practitioner, sleep is an important element, so I always ask my patients whether or not the person is coming for insomnia. Sleep is one of the vital and basic body functions beside eating and defecating. Sleep is when the body gets the chance to grow and repair. Insufficient or poor quality sleep leads not only to irritability and exhaustion, but also to muscle stiffness, impaired cognitive functions, lower immunity, and other significant health problems.
Clinically, insomnia is inadequate or poor-quality sleep with one or more of the following presentations:
Difficulty falling asleep;
Shallow sleep or dream-disturbed sleep;
Waking up frequently during the night and difficulty returning to sleep;
Waking up too early in the morning;
Unrefreshing sleep.
Insomnia in terms of TCM
The most basic and simple explanation of insomnia in TCM is the Yin and Yang energy imbalance. Yang energy is the active and excited state while Yin energy is the quiet and calm state. Insomnia is when the Yin energy is distributed. The actual mechanism is of course way more sophisticated, so never expect one simple pill, food or exercise could give you solid and sweet sleep immediately. Only with a systemic cognition and behavioral adjustment, together with some assistance of treatment like acupuncture and herbal supplement, can sleep problem be properly managed. The good thing about this integrative approach is that not just sleep will be improved, but your general health as well. [Read more: Your Body as a Garden] [Read more: TCM vs Western Medicine]
“Shen”, which is known as mind in modern language, is also an important concept. Yin and Yang, apart from the active/calm energy mentioned above, could also mean materialistic and non-materialistic energy. TCM believes that our mind (Shen 神, non-materialistic, Yang) is accomodating in our physical body (Xing 形, materialistic, Yin). The ancient Chinese described this as an emperor living in his palace. When the emperor is stable, calm, well supported by his officials with abundant resources, then the country will be prosperous. In terms of our body, “Shen” is our mind and consciousness. It should be stable and calm with the support of our physical strength and stamina.
There is a biological clock guiding our body to perform the optimal function. For example, melatonin, a sleep inducing hormone is secreted at night , while the cortisol and adrenaline secretion is more active in the morning. Melatonin and other similar action energy is the Yin energy while cortisol and adrenaline are the Yang energy.
Reasons for insomnia
The normal sleep physiology/mechanism? in TCM is when “Yang is returning to Yin”. It is like everyone of us returning home after work, so we can rest and manage our own business. Here are a few common reasons for “Shen” being disturbed, we call it “Yang cannot enter the Yin”:
"Disharmony of the stomach leads to insomnia" refers to improper dietary habits;
The deficiency of Yin energy caused by overwork, anxiety, stress;
Poor lifestyle habits leading to over excitement of Yang energy;
Physical health problems and medications destroying our materialistic energies.
When the internal harmony is disturbed, the stability of “Shen” is affected and insomnia will then occur.
Next time we will discuss the pathology of insomnia in details. Sleep tips: TCM approach (2/2)