How Traditional Chinese Medicine(TCM) Categorizes Sleep Problems

Insomnia, a prevalent modern ailment, disrupts countless lives by impairing sleep quality and overall well-being. At our clinic, we specialize in addressing this issue through the principles of Traditional Chinese Medicine (TCM), offering holistic and personalized treatments.

In TCM, insomnia is viewed as an imbalance of the body’s internal systems, often linked to disharmony among the heart, liver, spleen, and kidneys. Common patterns include:

1. Difficulty Falling Asleep

If it takes more than 30 minutes to fall asleep after lying down, it’s considered insomnia. This often occurs in people experiencing high stress or excessive overthinking, making it hard to “turn off” their minds. The more they try to relax, the harder it is to fall asleep. TCM describes this as “Yang not entering Yin,” leading to sleep difficulties. Herbal remedies such as Long Gu (Dragon Bone), Mu Li (Oyster Shell), and Zhe Shi (Hematite) combined with Gui Zhi (Cinnamon Twig) and Bai Shao (White Peony Root) can help. Additionally, formulas like Chai Hu Tang (Bupleurum Decoction) may be used to soothe the liver and relieve emotional tension.

2. Light Sleep & Frequent Awakening

Struggle to sleep soundly through the night, waking up at the slightest noise and repeatedly stirring. To promote deep sleep, herbs like Suan Zao Ren (Zizyphus Seed), E Jiao (Donkey-Hide Gelatin), and Sheng Di Huang (Raw Rehmannia) can nourish Yin and calm the spirit. If waking up in the middle of the night is accompanied by night sweats, irritability, and thirst, it may indicate Yin deficiency with internal heat. This can be treated with Huang Lian E Jiao Tang (Coptis and Donkey-Hide Gelatin Decoction) combined with Di Gu Pi (Goji Root Bark), Dan Pi (Moutan Cortex), or Zhi Zi Dou Chi Tang (Gardenia and Fermented Soybean Decoction).

3. Restless Sleep & Excessive Dreaming

Some people feel like they never truly rest because they dream excessively, affecting sleep quality. TCM recommends using herbs that “clear the heart and calm the spirit,” such as Qing Xin Lian Zi Tang (Clear Heart Lotus Seed Decoction), Bai He (Lily Bulb), Fu Shen (Poria with Root), Lian Qiao (Forsythia), and Shan Zhi Zi (Gardenia). If insomnia is due to “Heart and Kidney disharmony,” leading to excessive dreaming alongside frequent nighttime urination, lower back soreness, and weakness, Tian Wang Bu Xin Dan (Emperor’s Heart-Nourishing Pill) may be beneficial.

4. Waking Up But Still Tired

Some people get a full 7–8 hours of sleep but still wake up feeling exhausted. This is often due to “Yang deficiency” or “excess dampness,” leading to low energy, sluggishness, and even daytime drowsiness. TCM suggests using herbs like Huang Qi (Astragalus), Dang Shen (Codonopsis), and Fu Zi (Aconite) to boost Qi, while Fu Ling (Poria) and Ze Xie (Alisma) help drain dampness and restore vitality.