Insomnia has been a problem worldwide since ancient times and today the stresses of modern life—long hours at demanding jobs and lots of screen time, make it even harder to get good quality sleep.
The CDC now says that more than a third of American adults are not getting enough sleep.
Chinese medicine has a long history of treating insomnia and Western medicine doctors are now recognizing that it offers effective treatments.
Manhattan-based Chinese medicine doctor Decheng Chen L.Ac. Ph.D. said he has many patients come to him after behavior therapies and prescription medications for insomnia have not worked.
He recalled one patient, a woman who started having sleep issues when she hit menopause, who came to him after medication prescribed by her psychiatrist didn’t help. Dr. Chen’s treatments ended her hot flashes and night sweats and she was able to quit the pills and sleep well.
Afterward, the psychiatrist sent his wife to Dr. Chen for treatment and now the psychiatrist regularly refers patients to him.
Chinese medicine can also treat cases of insomnia for which Western medicine cannot find a cause.
Dr. Chen, who has written 15 books on Chinese medicine, said this is due to the difference in diagnostics and because Chinese medicine has a very specific understanding of what causes sleeplessness.
When Chinese medicine doctors diagnose an illness they look at things like the color and coating on the tongue and feel the patient’s pulse. The pulse is checked not only for speed but for strength and unusual characteristics such as whether it is thready, slippery, or rolling.
This pulse diagnostic takes years to master but to a trained doctor it tells a great deal about the health of a patient’s internal organs. Likewise, the color, type of coating, and even placement of coating blotches on tongue tell a Chinese medicine doctor specifics about the health of internal organs.
However, this is not to say that Chinese medicine doctors don’t take advantage of Western diagnostics. Dr. Chen said in a previous interview that he will ask patients to get blood work or certain scans if he thinks more information is needed.
Insomnia Treatments and Why They Work
Chinese medicine treatments for insomnia almost always include acupuncture and usually herbal formulas. Dr. Chen said he also gets good results when patients include herbal foot baths before bed.
Sometimes he makes the herbal formulas into tablets for patients who don’t want to drink decoctions. Herbs are usually taken twice a day; once in the morning and once at night. That is counterintuitive for many patients, Dr. Chen said. Patients expect that the herbs will make them drowsy.
But the herbal formulas for insomnia used in Chinese medicine are not sedative like valerian, an herb commonly used in the West to induce sleep. Instead, Chinese herbal formulas treat weaknesses in body systems that inhibit sleep.
“The herbs make you better and better, and when you are better, then you get good sleep,” Dr. Chen said.
In Chinese medicine, there are three main types of insomnia but one primary cause. People who have the first type of insomnia have difficulty falling asleep. People with the second type fall asleep easily but wake in the middle of the night and can’t fall asleep again. People with the third type are tired during the day but can’t sleep at all at night.
The primary cause of all of these types of insomnia is that an important form of energy is not able to stay in the heart. This energy is called shen, which is translated as spirit or spiritual energy.
If you’ve ever met someone who seemed wise and calm, at peace with the world, and beautiful even though they didn’t have particularly attractive features, it was probably their shen shining through. Shen is also the force behind inspiration, positivity, and motor and sensory function.
Shen can be harmed by emotions, usually painful ones, but excessive joy or excitement can also be damaging.
“Sleep is related to shen,” Dr. Chen explained. “Shen lives in the heart, but during the day it is active, at night it should be inactive. If shen stays active at night, a person will not be able to sleep.”
The two most common factors that keep shen from resting according to Chinese medicine are a condition called excessive heat and a condition of deficiency of blood and therefore nutrition in the heart.
The heart is like a house for Shen, Dr. Chen said. He compared it to how a person would feel if their house had no air conditioning during the peak heat of summer—most of us would leave and find a cooler place. Similarly, if your house is deficient in amenities—no food or entertainment, and little furniture—you’d also be inclined to hang out elsewhere.
Alcohol, spicy food, and intense emotional states such as depression can make the environment in the heart inhospitable for shen.
Dr. Chen estimated that excess heat and deficiency in the heart account for around 80 percent of insomnia. Another 20 percent is caused by a condition called heat stagnation. Heat stagnation can result from overeating or from liver stagnation.
Dr. Chen said there is a Chinese saying, which reminds us that if the stomach is not in harmony, we won’t sleep.
Liver stagnation can occur after a fight as the energy of the liver is blocked by anger, resentment, and frustration. It can also be blocked by traumatic events such as the sudden death of a loved one.
To find the specific cause of a patient’s insomnia, a Chinese medicine doctor will ask many questions and do a physical exam. Based on the diagnosis, acupuncture and herbal formulas are used either to decrease heat, increase nourishment in the heart, improve digestion, or unblock stuck energy.
Herbal foot baths are helpful, Dr. Chen said, because they warm the feet, which improves blood circulation. The compounds in the herbs can also enter the bloodstream through the skin.
Treating Body and Spirit
One side effect of regular sleeping pills can be gastrointestinal problems. Thus from the perspective of Chinese medicine, they can exacerbate the root cause of insomnia.
Sometimes Dr. Chen said that stomach issues need to be addressed first because if the patient is not able to absorb enough nutrition, their blood won’t bring adequate nourishment to the heart.
Dr. Chen recalled one patient he treated several years ago, a 30-year-old man who had had insomnia for two years. The man was taking six sleeping pills a day, had nausea, little appetite, and still could not sleep.
Dr. Chen focused first on healing the man’s stomach and gradually, over a period of six months, the treatments allowed him to eat well and nourish himself. Then gradually he was able to sleep normally.
Dr. Chen recently ran into this patient at the supermarket and the man said he is still doing well—able to work and not taking any medication.
The emerging study of biofield science is testing some of the principles of energetic healing that have existed for thousands of years in traditional medicine systems, thus making these principles understandable to the modern Western worldview.
But for now, a reductionist and mechanical view of the human body is still the ruling paradigm. From the perspective of Chinese medicine, this is rather limited.
“Western medicine only sees the body, it doesn’t see the spirit,” Dr. Chen said.
Chinese medicine takes as its starting point that humans have a spiritual dimension, the care of which is very important for good sleep and good health.
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