Author: Physician Niklas Seet | January 2021 | Zhongjing TCM
What is insomnia?
Insomnia is a term commonly used to describe the inability to fall asleep. Our human body needs at least seven hours of rest per night in order to maintain the necessary physiological processes in our body to achieve health. However, with the advent of technology along with the technological advances and accessibility of services, there is a significant increase in people who are sleeping much later, resulting in the different severities of insomnia.
What is the TCM understanding of the condition?
In Chinese Medicine, insomnia (不寐) is described as the inadequacy of hours of sleep, along with the depth of sleep, and can also extend to the quality of sleep. In lighter cases, individuals may have difficulty falling asleep, or that the sleep is unsatisfactory, or intermittent sleep and awake cycles, or difficulty falling back asleep after waking up. For more serious cases, some may be unable to sleep the entire night, and this may start to affect daily life, work, learning and even health.
TCM recognises sleep as a balance of Yin and Yang. Yang governs action, while Yin governs calmness. During the day, Yang is strong while Yin is weak, hence we have the energy to stay awake. As the day goes by, Yang starts to wane while Yin becomes stronger. At night, Yin is strong while Yang is weak, allowing Yang to enter Yin, enabling sleep to occur.
However, if Yang is too overwhelming such that Yin cannot restrain it, or that Yin is insufficient to the point that it cannot overcome Yang, that is when there is a disharmony and imbalance of Yin and Yang. This would then result in insomnia, along with other symptoms.
Another factor that can affect sleep is the stomach. In TCM, there is a saying that goes “when the stomach is in disharmony, sleep would not be peaceful”. Singapore is touted as a “food heaven”, as we have an abundant selection of food for our daily meals. At times, we may take our meals very late, or that the choices are too spicy or greasy. These dietary choices can affect the stomach, causing our sleep to be affected.
Insomnia can also be due to other diseases, such as pain disorders and other physical or mental diseases. Thus, it is important to first resolve such conditions, as treating and controlling such conditions properly can alleviate the insomniac condition.
Acupuncture points/massage
Tai Chong LV3
 | It is located on the foot, in the depression between the first and second metatarsal bones. It is used to dissipate and clear heat in the liver. It can also reduce blood pressure. Press this acupoint until a sore sensation is felt, then knead for 1 minute. |
Shen Men HT7
| It is located on the palmar side on the wrist crease, on the side of the little finger (ulnar side), in between the ligaments. It can calm the mind and regulate nerve function. Knead this acupoint for 1 minute. |
San Yin Jiao SP6
| It is located four finger widths up from the highest point of the inner side of the ankle bone, behind the tibia. This acupoint actually falls on the meridian of three organs, the liver, kidney and spleen. Hence it can nourish the spleen and harmonise the stomach, tonify the kidney and liver, as well as regulate Qi and blood flow. It is to be noted that this acupoint should not be used by those who want to or are expecting. Knead this acupoint for 1 minute, or rub till warm. |
Introduced by Prof. Fu Guo Bing (Head of Tuina Dept at Beijing Dong Fang Hospital), a simple self-massage can also be done as we lay in bed every night. The Heart Meridian travels on the inside of the forearms, from the little finger to the elbow.
- We can use the opposite hand to push the heart meridian (推心经) from the inside of the elbow right up to the little finger, alternating between left and right, for roughly 20 to 30 times. (But do not concentrate on the counting)
- Rub the palms slowly together until warm.
- Cover the orbitals of the eyes with the warm palms
- Sweep the scalp and hair, alternating between the left and right for roughly 20 to 30 times.
- Finally, place your hands on top of one another and massage the abdomen.
Tea therapy
Herbal teas can also be used as a means to alleviate insomnia and poor sleep quality for some individuals. Instead of drinking just regular plain water during the day, small quantity of herbs can be steeped in a hot water flask and drank throughout the day.
Some of the commonly used herbs are:
Depending on the constitution of the individual, these herbs can be adjusted in order to better suit the needs.
For example, for an individual who is experiencing higher level of stress, a combination of rose flower buds, chrysanthemum, Mai Dong, peppermint and goji berries can be used. Another individual who may be experiencing stomach discomforts can choose to use rose flower buds, Sha Shen, and longan instead.
A small quantity of each herb is used (1 or 2 pinches) each time when steeping in hot water, and hot water is constantly refilled throughout the day with the same batch of herbs. It is acceptable for the flavour of the tea to get milder as more refills are done. At the end of the day, you can discard the dregs, and prepare a new batch for the next day.
It is advisable to seek a consultation with a certified TCM physician to fully understand your body before choosing to use any herbs.
For people with sleep disorders, it is advisable to participate in some physical activities during the day. This is to increase the physical exertion of the body, so that the body may feel tired during the night. It is to be noted that physical activity should be done within each individual’s means, and injuries should be avoided.
Strenuous activities such as weight lifting or high intensity interval trainings should be avoided at night as these activities can have a counter-effect – instead of feeling physically exhausted, some individuals may feel even more energetic and alert after a workout session!
Yoga can be chosen as a form of physical activity as it can help the individual learn good breathing techniques to relax. The stretching movements can also help reduce muscle tension which can sometimes cause discomfort while lying in bed.
Other things to note
Sometimes, simple lifestyle changes need to be done in order to improve sleep quality. This can be as simple as turning on the blue-light filter or night mode on our mobile devices, reducing the blue light glare which stimulates our brains. Some research has been done which show that light from our electronic devices can sometimes cause sleep disorders.
The choice of the media we are exposing ourselves to can also play an important role. Building on electronic devices, some individuals may choose to destress at night by catching up on some drama or video clips on streaming platforms. Some of these programmes can get quite exciting, causing us to stay awake longer in order to watch the next episode, or that the content may leave us wanting for more and making our minds wonder what may happen next.
Another issue is the conditioning of our brains to our beds. This is an increasing phenomenon as more people start to work from home due to the Covid-19 situation. Some individuals may choose to work in bed throughout the day. In the long run, this may condition the brain that the bed is a place for work, rather than rest.
Do remember that short term choices may be harmless at best, but in the long run, these become difficult to get rid of once they become routine. It is important to identify such unsatisfactory practices early and prevent them from becoming bad habits, and thereby affecting many areas of our daily life, not just sleep.
