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Insomnia- Senior Physician Li Bing Mei

LI BING MEI—Senior Physician




TCM’s Definition of Insomnia
Insomnia, or sleeplessness, varies in severity. In mild cases, the patients may have difficulty falling asleep, staying asleep or falling back to sleep. Some may wake up frequently during the night. In more severe cases, the patients barely sleep at night. On top of that, they often experience headaches, dizziness, fatigue, weakness, palpitation, forgetfulness, anxiety, and excessive dreaming. TCM suggests that insomnia is closely related to the heart, liver, spleen and kidneys. Sleep is normal when all visceral functions are in balance, and Yin Qi and Yang Qi flow freely. If there is an imbalance between Yin and yang, and Yang Qi does not wind down at night, sleep disturbance occurs.


TCM categorizes insomnia into the following types:




Deficiency of both the heart and spleen system

Excessive/vivid dreaming, easily awakened at night

Palpitation, forgetfulness, vertigo, fatigue, reduced appetite, yellow complexion, weakness in the extremities

Inflammation of the liver system

Sleep deprivation, excessive dreaming

Irritability, red eye, bitter taste in the mouth, constipation/hard stool

Inflammation due to phlegm retention

Chest fullness, irritation, sleeplessness

Heaviness in the head, dizziness, belching, acid reflux, complete loss of appetite

Inflammation due to Yin deficiency

Irritation and sleeplessness

Palpitation, fussy, hot flashes in the palms and soles, tinnitus, forgetfulness

Qi deficiency of both the heart and spleen system

Irritation, sleeplessness, excessive dreaming, easily awakened at night

Apprehension, palpitation, easily startled, shortness of breath, hyperhidrosis (excessive sweating), fatigue, weakness


Case Study

Chen, female, 36, accountant. She has a busy job and had been experiencing intermittent insomnia for over a year. She worried about her insomnia before bed, and the more she worried the more difficulty she had to fall asleep. On a bad day, she would be awake the entire night. When that happens, she felt awful the next day with dizziness, fatigue, irritability, chest fullness, reduced appetite, dry mouth, and bitter taste in the mouth. Her tongue was red with thin yellow coating. Her pulses were taut but thin. I started seeing her about a month ago, and diagnosed her with insomnia, the liver inflammatory type. She was prescribed modified JiaWei XiaoYao San and SuanZaoRen Tang, along with acupuncture sessions. By her follow-up visit a week later, her sleep deprivation and other symptoms had all significantly improved. She continued treatments for another 3 weeks, and was essentially cured. Currently, she uses the herbal medications as needed. She has not experienced any relapse, and continues to do well.


TCM is effective in treating insomnia. I believe that the root causes of insomnia are mostly related to one’s mental and psychological health, so communication is crucial. Counseling can be helpful in addressing concerns and relieving stress. Encouragement is also helpful to the patients in gaining confidence when progress is made. It is necessary for them to realize that insomnia is not incurable. Without the mental block, treatments can be more effective. After the condition resolves, follow-up visits are recommended for lasting results and long-term benefits.