The Eastern View of Insomnia Focuses On The Person

Matters of the mind related to the most ephemeral part of our being are often linked to sleep problems

Sleep is a balm to the mind and spirit. It is our time to restore our mind and heal our body so if you aren't getting enough of it, you should investigate. (Sergey Mironov/Shutterstock)

The odds of being sleep deprived, defined as getting less than six hours of sleep a night for adults, has increased significantly in the past 30 years. An estimated 50 million to 70 million Americans suffer from sleep-related problems, and apparently, those numbers are on the rise.

The ever-increasing demands of our hectic lifestyles, a blurring of the lines between work and home life, and increased stress and anxiety from various factors contribute to our difficulties getting restful, rejuvenating sleep. According to the American Sleep Apnea Association, adults between 18 and 64 need seven to nine hours of sleep a night, and adults over 65 need between seven and eight hours.

Most of us understand that there is a direct correlation between sleeping well, functioning well, and feeling well. How awful do you feel the day after staying up all night with a sick child or staying up too late to finish a project that’s due the next day? Barely functional and miserable to boot, likely.

The detrimental effects of inadequate sleep are well known. Poor sleep affects our level of happiness and overall mood and has negative consequences for the brain. Lack of sleep diminishes vigilance, learning, reaction times, ability to remember things accurately (short-term memory in particular), hand-eye coordination, and alertness.

Not sleeping enough impairs our overall function in literally every aspect, and makes us feel awful, too. But understanding why we’re having trouble sleeping might be the key to getting back to better sleep.

Sleep in Eastern Medicine

Eastern medicine has a slightly different approach to how sleep works and the origins of sleep problems. The Eastern philosophy is based on a holistic view, looking at a person’s physiology in addition to their interactions and experiences when evaluating a situation.

Insomnia describes a group of symptoms associated with disturbed sleep that include difficulty falling asleep or staying asleep, frequent waking, restlessness at night, disrupted sleep cycle, and dream disturbed sleep.

Because so many factors affect sleep, distinguishing the cause is vital to correcting the issue. One way to categorize sleep problems in Chinese medicine is if they are due to external or temporary changes (called transitory insomnia) or if they are due to deeper physical, mental, or emotional issues (true insomnia).

Some of the factors that may contribute to transitory insomnia include:

• external noise
• too much light in the bedroom
• sudden weather changes
• bedroom temperature
• stimulants before bed
• eating late (too close to bedtime)
• emotional upsets, shocks, and traumas
• vigorous exercise, especially before bed
• shift work (disrupts circadian rhythms)

The good news is that we can correct most of these factors and restore normal sleep patterns. Other things to consider are if your sleep is being disrupted by physical symptoms like pain, itching, asthma, breathing problems, or side effects from certain medications. Although these most certainly disrupt sleep, they are not considered insomnia. In Eastern medicine, the cause of insomnia is key.

So what is true insomnia, and what causes it? To understand insomnia and its causes in the Eastern model, we must first talk about the shen.

The shen is difficult to explain, especially to a Western audience from a culture with a different point of view. If we consider that many Eastern philosophies have a metaphysical component—something that exists outside of human sensory perception—then perhaps we can begin our discussion there. Most of us have probably heard of qi (pronounced chee), the Eastern concept of energy or life force that animates all living things. Qi is similar to the Japanese “ki“ and the ”prana“ of India. Qi is intrinsic in all living things and is created, in part, from the food we eat and the air we breathe.

There is a spectrum of metaphysical substances in Chinese medicine from material to immaterial. Jing, the most material, is responsible for birth, growth and reproduction and is given to us from each of our parents, next is qi, the energy or life force that powers many biological processes, and shen is the most rarified or ephemeral type. The shen is related to many of consciousness’s intellectual and spiritual aspects and plays an essential role in our higher mental functions. The shen is closely associated with our conscious awareness and how we perceive, interact, and communicate effectively with the world around us.

The heart is intimately connected to the shen, and in Eastern medicine, the shen resides in the heart. Problems with the shen are associated with a disturbance of consciousness on some level, and almost always involve the heart. Factors that especially affect the shen are:

• shock and trauma
• emotional turmoil
• unexpressed emotions
• extreme anger
• heat (internal heat from excess yang energy)
• excessive worry, overthinking, and brooding
• exhaustion, overwork, and not enough rest
• stress
• psychological issues

As you can see, if someone has insomnia, there is often a spiritual or psychological component in the Eastern view. As a practitioner, I always see problems with sleep as a kind of barometer of a person’s spirit. Insomnia can point to emotional or psychological issues deep beneath the surface. The job of the Chinese medicine practitioner is to gently and skillfully unearth the causes and bring them to the surface to be acknowledged and resolved.

In my experience, problems sleeping often come from things that are causing distress, even if the patient is not consciously aware of them. Sleep is often the time when the mind is sorting things out, especially things roiling away in our subconscious.

There are certainly physical factors that can cause insomnia in Eastern medicine, but the shen (spirit) and heart are often involved. We narrow down what is happening and why with thorough questioning and observation of the patient.

The Science of Sleep

An article published by Johns Hopkins neurologist and sleep expert Dr. Mark Wu states that before the 1950s, most people believed that when we slept, both the body and brain were in a dormant state. “But it turns out,” Dr. Wu explains, “that sleep is a period during which the brain is engaged in a number of activities necessary to life—which are closely linked to quality of life.”

Researchers have now discovered several critical functions that take place during sleep. One study suggests the brain clears toxins during sleep that it can’t clear during waking hours. Sleep is also when the brain consolidates memories and wires in the new information it has learned that day. Western scientists readily admit they still have many questions about sleep like why a lack of sleep impairs reasoning, problem-solving, and attention to detail, intellectual functions that reside in the realm of shen.

There is no blanket treatment for insomnia; everyone’s insomnia is different. In the Eastern model, we aren’t treating diseases, we are treating people, and each is unique. That is why Chinese medicine requires such a thorough intake process to understand the patient.

People are beautifully complex organisms. We are affected by our experiences in the world and how we interpret them. In the Eastern model, emphasis is placed on prevention which means tending to every aspect of ourselves in an ongoing process. Tending to our heart and spirits is just as important to our health as eating well, exercising, and getting enough sleep. And if our sleep is being disturbed, it isn’t simply an issue that requires a pill to fix, but rather a signal that something is happening within us or around us that needs to be addressed.