Insomnia

Mild case: difficult to get to sleep and/or shallow sleep.  When wake, have trouble returning to sleep.

Severe case: not sleep at all.

Western medicine

Seen in neurosis, bulimia, stress, and many other disorders.

TCM

Liver stagnation leads to Fire

Main manifestations: Irritability, dream-disturbed sleep, fright and fear accompanied with headache, distending pain in the costal region, bitter taste in the mouth, red face and eyes, constipation, T- red with yellow coat, P- wiry rapid

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.

P/T – purge Liver Fire, soothe Liver, calm mind.  Sedate, foot jueyin, hand shaoyin.

Acupuncture

[LR2 - GB43 - GB20 - HT7]
headache, red eyes – taiyang, LI 5
tinnitus – SJ 3, 17

Note: GB 43 (ying-spring)

Phlegm-Heat attack Heart

Long term irregular diet, irritable chest/heart/abdomen with fullness or bloating, cough yellow sticky Phlegm, dizziness, blurred vision, bitter taste, T- red with yellow greasy coat,

P- slippery rapid

P/T – strengthen Spleen to transform Phlegm, clear Heat, calm mind

Acupuncture

[ST44 - SP4 - ST40 - HT7 - MH6]
constipation: ST25 - ST37

Note: SP4 & ST40 (Luo points)

Yin deficiency causing hyper Fire

Main manifestations: Restlessness, light sleep (shallow), insomnia, dizziness, tinnitus, dry mouth with little saliva, burning sensation of the chest, palms and soles, 5 centre heat sensation, nocturnal emission, poor memory, palpitation, low back pain, dry signs, T- red with scanty coat, P- thin rapid

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.

P/T – nourish Yin, descend Fire.  010 Shaoyin

Acupuncture

[*KI3 - MH7 - BL15 - HT7]
dizziness: GB20
tinnitus: TH17, SI19
Kidney deficient signs: BL23, BL52

Heart and Spleen deficiency (Qi and Blood)

Main manifestations: Difficulty in falling asleep, very light sleep, lots of dreams, dream - disturbed sleep, palpitation, poor memory, lassitude, listlessness, anorexia, sallow complexion, soft stools, T- pale, thin coat, P- thin weak

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.

P/T – nourish Qi and Blood, calm Heart/Spirit, tonify, foot taiyin, hand shaoyin

Acupuncture

[BL15 - BL20 - SP6 - HT7]
lots of dreams: BL 42 (LU spirit point)
poor memory: BL 52 (KI spirit point), Du 20 (moxa and needle)

Heart and Gallbladder Qi deficiency

May get to sleep, but have lots of dreams, wake with anxiety/shock/fear, palpitations, could be paranoia, timid/reserved person, hyperthyroid

P/T – nourish Heart and Gallbladder

[BL15 - BL19 - MH7 - HT7 - GB40]
fatigue: BL20, ST36
tonify more: BL43 (sweats)

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.

Acupuncture

[HT7 - SP6 - anmian - BL21 - ST36].

Alternative treatment methods

auricular – shenmen, subcortex, sympathetic, HT, SP, KI
injection – anmian (between GB20 & TH17) with dang gui
7 star – along Du and Bladder Jing, gentle stimulation (do not bleed, only until skin turns pink)
meditation, exercise, fresh air, have fun, Qigong, yoga, taiqi
Tapping - needling: Tap sishenchong, metameric back shu or huatuojiaji 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.

Notes

HT7 (shenmen), the yuan-source point of the Heart Meridian, calms the heart and soothes the mind. SP6, the crossing point of the Liver, Spleen and Kidney Meridians, regulates the three meridians. Anmian (Extra) is an extra point for insomnia. BL15 and BL 20, the metameric HT and SP shu points, are combined to reinforce the spleen and nourish the heart. SP1, the jing-well point of the Spleen Meridian, is effective for dream-disturbed sleep. BL15 reduces heart fire. [BL23 - KI3] reinforces kidney water. The combination of these points is to harmonize the heart and kidney. [BL18 - BL19 - GB12] subdues the fire of the liver and gallbladder. [BL 21 - ST 36] regulates the stomach and soothe the mind.