Traditional Chinese Medicine Treatment for Insomnia | Calming the Mind for Restful Sleep and Overcoming Insomnia

How to Achieve Quality Sleep?

Recently, a recently retired patient sought medical consultation. She had hoped that with more free time to pursue her interests, including waking naturally each morning, she would finally enjoy restful sleep. She believed that without the pressure of adhering to a strict work schedule and early rising, she would naturally sleep deeply and soundly. However, the reality proved more complex.

This patient had been struggling with insomnia for over ten years. Every night, she would lie awake for several hours before barely managing to fall asleep. She frequently awoke during the night and found it difficult to return to sleep. In the worst cases, she remained awake throughout the night. Such poor sleep quality severely impaired her daytime functioning, preventing her from fully enjoying her retirement.

From a Traditional Chinese Medicine (TCM) perspective, Dr. Zeng Jiamin explains that sound sleep depends on the harmonious balance of yin and yang. Daytime corresponds to yang, representing activity and vitality; nighttime corresponds to yin, representing calmness and tranquility. Sleep occurs during the period when yin is dominant. If yang remains active and fails to rest appropriately, achieving quality sleep becomes difficult.

Based on the patient’s condition, Dr. Zeng prescribed Chinese herbal medicine. Upon follow-up two weeks later, the patient reported significant improvement: she was able to fall asleep within 30 minutes instead of tossing and turning for hours. Although she still occasionally awoke around 2 a.m., she was able to return to sleep until 5 or 6 a.m. Dr. Zeng recommended that, in addition to adhering to medication and follow-ups, the patient adopt lifestyle modifications such as mindfulness exercises before bedtime to help the mind relax and “power down.” One week later, the patient reported further progress, falling asleep within half an hour and sleeping continuously until 7 a.m.

Modern lifestyles no longer follow the natural pattern of rising with the sun and sleeping after sunset. Evening activities often extend late into the night after work and dinner. Without adequate mental rest, individuals may feel fatigued yet struggle to fall asleep. Poor nocturnal sleep leads to diminished daytime energy and reduced performance across tasks. How can one achieve quality sleep? Contemporary discourse often emphasizes sleep quality, a concept long recognized in TCM. Insomnia, or “bu mei” (不寐) in TCM terminology, encompasses not only difficulty falling asleep but also includes frequent dreaming, shallow sleep, waking easily, inability to return to sleep, or even sleepless nights.

According to a 2020 study conducted by the Chinese University of Hong Kong, nearly 70% of the local population experiences insomnia-related issues*. Unfortunately, many are unaware of their condition or lack sufficient understanding of sleep health, resulting in compromised quality of life. The advantage of TCM in treating insomnia lies in its non-addictive nature. By targeting the root cause, replenishing qi and blood, or eliminating pathogenic factors to restore yin-yang balance, patients can achieve restorative sleep naturally.

TCM recognizes insomnia as multifactorial, with no single “sleeping pill” remedy. Treatment is tailored based on differentiation between deficiency and excess syndromes. Deficiency patterns most commonly involve blood deficiency, as well as yin, heart, spleen, or gallbladder deficiencies. These cases typically develop gradually and worsen over time, with treatment focused on tonification and calming the mind. Excess patterns often stem from liver qi stagnation transforming into fire, food retention, or phlegm turbidity, causing sudden onset insomnia. Treatment aims to clear heat, drain fire, and resolve phlegm to eradicate pathogenic influences.

To improve sleep quality, in addition to Chinese herbal treatment, attention should be given to “sleep hygiene,” including:

• Maintaining regular sleep and wake times to establish a consistent biological rhythm

• Creating a comfortable sleep environment with appropriate temperature, darkness, and quiet

• Using bedding that provides adequate but not excessive warmth

• Avoiding heavy meals and caffeinated beverages such as strong tea and coffee before bedtime

• Allocating time before sleep to relax and unwind, refraining from electronic device usage

• Limiting daytime naps to no longer than 30 minutes

* So, C. (2020, March 12). Insomnia strikes as woes add up. The Standard. https://www.thestandard.com.hk/section-news/section/4/217171/Insomnia-strikes-as-woes-add-up