Insomnia

Insomnia has different patterns : difficulty in falling asleep after retiring , early awakening , intermittent waking through the period of attempted sleep , and even inability to sleep all the night .

Insomnia is often accompanied by dizziness , headache , palpitation , poor memory and mental disorders . Etiology and Pathogenesis

Anxiety and overwork damage the heart and spleen .

Blood is exhausted and the mind is disturbed in case of damage of the heart , while qi and blood production becomes poor in case of deficiency of the spleen qi . Blood deficiency is unable to nourish the heart , leading to insomnia . Just as Zhang Jingyue described , Overwork and anxiety cause exhaustion of blood and disturb the mind . As a result , insomnia follows .

Congenital deficiency , indulgent sexual activity , or a prolonged illness damages the kidney yin .

The kidney water fails to ascend smoothly to the heart to check the heart fire , and the heart yang is therefore hyperactive alternatively . A violent emotional fit can induce flaring of the heart fire which fails to descend to the kidney to control the kidney water . The kidney yin is therefore deficient . Deficiency of kidney yin injures the will and excess of the heart fire disturbs the mind . In either case there is a disharmony between the heart and the kidney , and hence insomnia .

Emotional depression causes the Stagnation of qi in the liver .

The stagnant qi of long duration is transformed into fire , which flares up to disturb the mind , and then insomnia occurs .

Irregular food intake damages the spleen and stomach .

The accumulated undigested food produces phlegm heat in the middle jiao , which in turn causes dysfunction of the stomach and insomnia , as stated in Internal Classic that sleep is disturbed if the function of the stomach is in disharmony .

In summary , insomnia is related to dysfunction of the heart , spleen , liver and kidney , although there are many other causative factors . Blood is made from food essence and supplies the heart with nourishment . Blood is stored in the liver and the liver is soothed by the blood . Blood is controlled by the spleen , where production of essence from blood continues . The essence is stored in the kidney . When the kidney essence ascends to the heart and the heart qi descends to the kidney . With harmonious condition between the heart and kidney , the mind is at ease . Whenever there is anxiety , depression , or overwork to damage the heart , spleen , liver or kidney , essence and blood are consumed and mutually affected , resulting in insomnia .

Differentiation

Deficiency of both the heart and spleen

Main manifestations : Difficulty in falling asleep , dream - disturbed sleep , palpitation , poor memory , lassitude , listlessness , anorexia , sallow complexion , pale tongue with a thin coating , thready , weak pulse .

Analysis : When there is impairment of the heart and spleen , blood is insufficient to house the mind , so dream - disturbed sleep , poor memory and palpitation occur . Sallow complexion and pale tongue are manifestations of a poor blood supply which is unable to nourish the upper part of the body . Dysfunction of the spleen and stomach in transportation and transformation causes anorexia . Deficiency of qi and blood leads to qi declining and blood shortage , resulting in lassitude , listlessness , thready and weak pulse .

Disharmony between the heart and kidney :

Main manifestations : Restlessness , insomnia , dizziness , tinnitus , dry mouth with little saliva , burning sensation of the chest , palms and soles , red tongue , thready rapid pulse , or nocturnal emission , poor memory , palpitation , low back pain .

Analysis : Restlessness , poor memory , palpitation , nocturnal emission and low back pain are due to deficiency of the kidney and hyperactivity of the heart Fire . Dry mouth with little saliva , burning sensation of the chest , palms and soles , red tongue and thready rapid pulse are the signs of yin deficiency in the lower jiao with fire flaring up . Dizziness and tinnitus result from the flaring up of the ministerial fire due to deficiency of the kidney yin .

Upward disturbance of the liver fire :

Main manifestations : Irritability , dream - disturbed sleep , fright and fear accompanied with headache , distending pain in the costal region , bitter taste in the mouth and string - taut pulse .

Analysis : The liver fire flares up to disturb the mind , causing dream - disturbed sleep , fright and fear . When the flaring fire of the liver attacks the head , headache occurs . The liver qi in long stagnation is transformed into fire , leading to irritability . The liver fire flares up with upward flow of the bile , producing bitter taste in the mouth . When the fire stagnates in the Liver Meridian , there is distending pain in the costal region . The string - taut pulse is a sign of hyperactivity of the liver .

Dysfunction of the stomach :

Main manifestations : Insomnia , suffocating feeling and distending pain in the epigastric region , belching , or difficult defecation , sticky tongue coating , and rolling pulse .

Analysis : With the dysfunction of the spleen and stomach in transportation and transformation , the food accumulates in the middle jiao , obstructing the passage , and thus giving rise to suffocating feeling and distending pain in the epigastric region and difficulty in defecation . Therefore , sleep is disturbed . The undigested food staying in the middle jiao forms dampness and produces phlegm , so the tongue coating is sticky and the pulse rolling .

Treatment

Method : Points of the Heart Meridian are selected as the main points to calm the heart and soothe the mind . Deficiency of the heart and spleen :

Reinforcing method with moxibustion in combination is applied to strengthen the heart and spleen .

Disharmony between the heart and kidney : Even movement is applied to harmonize the heart and kidney .

Upward disturbance of the liver fire : Reducing is applied to subdue the liver fire .

Dysfunction of the stomach : Reducing is applied to regulate the stomach qi .

Prescription : Shenmen ( H 7 ) , Sanyinjiao ( Sp 6 ) , Anmian ( Extra ) . Supplementary points : Deficiency of the heart and spleen : Pishu ( B 20 ) , Xinshu ( B 15 ) , Yinbai ( Sp I , moxibustion with small moxa cones ) .

Disharmony between the heart and kidney : Xinshu ( B 15 ) , Shenshu ( B 23 ) , Taixi ( K 3 ) .

Upward disturbance of the liver fire : Ganshu ( B 18 ) , Danshu ( B 19 ) , Wangu ( G 12 ) .

Dysfunction of the stomach : Weishu ( B 21 ) , Zusanii ( S 36 ) .

Explanation : Shenmen ( H 7 ) , the Yuan - ( Primary ) point of the Heart Meridian , calms the heart and soothes the mind . Sanyinjiao ( Sp 6 ) , the crossing point of the Liver , Spleen and Kidney Meridians , regulates the three meridians . Anmian ( Extra ) is an extra point for insomnia . Xinshu ( B 15 ) , the Back - ( Shu ) point of the heart , and Pishu ( B 20 ) , the Back - ( Shu ) point of the spleen , are combined to reinforce the spleen and nourish the heart . Yinbai ( Sp 1 ) , the Jing - ( Well ) point of the Spleen Meridian , is effective for dream - disturbed sleep . Xinshu ( B 15 ) reduces heart fire . Shenshu ( B 23 ) and Taixi ( K . 3 ) reinforce kidney water . The combination of these points is to harmonize the heart and kidney . The combination of Ganshu ( B 18 ) , Danshu ( B 19 ) and Wangu ( G 12 ) is to subdue the fire of the liver and gallbladder . The combination of Weishu ( B 21 ) and Zusanii ( S 36 ) is to regulate the stomach and soothe the mind .

Remarks

Tapping - needling : Tap Sishenchong ( Extra ) , Back - ( Shu ) points or Huatuojiaji ( Extra ) slightly from above downward two to three times . Treat once daily or every other day . Ten treatments constitute a course . Next course of treatment begins after an interval of two to three days .