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Five Elements
It is believed that 30-50% of the general population is affected by Insomnia, and about 10% suffers from chronic insomnia.


  • Inability to fall asleep
  • Waking up during the night
  • Sleep restlessly
  • Waking up early in the morning
  • Dream disturbed sleep


Short term:
Change of environment
Affect of Noise/light
Shift work
Effect of drugs

Long term:
Chronic illness

Pathology of insomnia in TCM aspect:
Shen governs sleep. Heart houses the shen. If there is any situation that hinders the shen to return to the heart, the person will not be able to sleep. The hindrances could be excessive of pathogenic pathogens: phlegm, heat or fire; or on the other side, the person could suffer from deficiency of qi, blood& yin.
Aetiology & Pathology of Insomnia:
Excess condition:
Heart fire because of worry
Liver Fire because of anger
Stomach & Heart Fire because of improper diet leading to phlegm heat
External pathogenic attack of Wind heat

Deficiency condition:
Blood deficiency caused by worry which depletes Heart & Spleen
Yin deficiency caused by overworks which depletes heart & Kidney
Qi deficiency caused by timid Gall Bladder which affects Gall Bladder & Heart
Blood deficiency caused by child birth and lack of rest which affects the heart & liver
Deficiency Insomnia Excess
Worry → He & Sp → Blood xu He Fire because of worry
Overwork → He & Kid → Yin xu Liv Fire because of anger
Timid Gall Bladder → HE & GB
→ Qi xu
Phlegm heat because
improper diet → affect ST & HE
Childbirth → HE & Liv → Blood xu Wind heat
Signs & Symptoms (according to patterns)
Heart & Spleen deficiency Heart & Kidney not communicating
  • Difficulty in falling asleep
  • Dream disturbed sleep
  • Palpitation
  • Poor memory
  • Sallow complexion
  • Poor appetite
  • Epigastric distension
  • Poor sleep pattern, restless
  • Dizziness /vertigo
  • Tinnitus
  • Dry mouth with lack of fluid
  • Heat sensation in the palms & soles
  • Poor concentration
  • Palpitation
  • Difficult with memory
  • Seminal emission
  • Lumbar pain
Phlegm heat in the stomach

Liver fire blazing or Liver Yang rising

  • Poor sleep disturbed by dreams
  • Hot sensation in the chest
  • Distended feeling in the epigastrium and abdomen
  • Belching, regurgitation, nausea & vomiting occasionally
  • Occasional constipation
  • Difficulty in falling asleep, restless
  • Dizziness
  • Headache
  • Short temper, anger
  • Eyes could be congested
  • Could have bitterness taste in the mouth

General tips for getting to sleep:

  • See a doctor or a health practitioner
  • Avoid caffeine, alcohol or smoke especially in the evening
  • Avoid full stomach before bed
  • Avoid greasy and spicy food
  • Don’t go to bed hungry
  • A drink of warm milk or a little snack could help
  • A warm bath could sometimes help
  • Avoid naps during the day
  • Get some physical exercise, at least 30 minutes each day, 4-5 hours before bed
  • Avoid excess fluid intake before bed
  • Try to fix bedtime hours, going to bed and getting up at a set time
  • If you can’t sleep by 30 minutes, get up and go to another room to do some relaxing exercise
  • Do not work, read or watch TV in bedroom, bedroom should be decorated as an environment for sleep
  • Sleep in a well ventilated room
    Sleep with no light or very dim light on
    Light music could help with sleep, but if you find it annoying, turn it off
    Avoid reading, watching TV or worry before going to bed
    Set your alarm clock to avoid worrying sleep in
    Don’t go to bed with worries, resolve them before going to bed if possible
    Deep breathing exercise could help, deep breathe in and breathe out slowly


  • Treat according to the root cause.
  • Follow the above tips, seek health profession advice
  • TCM treatment:
  • Acupuncture: Body & auricular
  • Tuina
  • Chinese herbal medicine: commonly used herbal formulas are: Gui Pi Wan, An Shen Ding Zhi Wan, Ban Xia Hou Po Tang, Wen Dan Tang, Tian Wang Bu Xin Wan; seek advice from your practitioner;
  • Diet therapy
  • Exercise therapy
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