COMMON TYPES OF SLEEP DISORDERS AND HOW TO MANAGE THEM
1. What are the common types of sleep disorders and their symptoms?
Traditional Chinese Medicine (TCM) explains insomnia due to the disturbance of Heart and Mind, and is categorized as sleep deprivation or lack of good sleep quality. For mild patients, they suffer from difficulty in falling asleep, or light sleeping, often getting up through the night, or inability to return to sleep after waking up at night. For serious ones, they may not be able to sleep through the night at all.
The balance of Yin and Yang is vital to achieve good sleep. Proper functioning of our Five Organs (Liver, Heart, Spleen, Lungs and Kidneys) aids in the superior circulation of Qi and Blood, providing inner peace to our Heart and Mind, allowing Yang to rest and Yin to work for a nice rested night.
TCM classifies sleep disorders according to the following five syndromes:
(a) 肝火扰心 Insomnia with Syndrome of Liver-Fire disturbing Heart and Mind
Total Inability to Fall Asleep throughout the Night, Many Dreams and/or Nightmares, Restless Legs Syndrome, Quick-Tempered and Irritable, Dizziness and Headache (explosion feeling), Red Eyes, Tinnitus, Constant Feeling of Thirst, Bitterness in Mouth, Constipation, Dark Yellow Urine, Red Tongue (especially on both sides of tongue) with Yellow Tongue Coating, Taut and Rapid Pulse.
(b) 痰热扰心 Insomnia with Syndrome of Internal Disturbance of Phlegm-Heat
Many Dreams and/or Nightmares, Constant Vexation, Restless Legs Syndrome, Chest Discomfort and Tightness or Chest Pain, Abdominal Bloating, Nausea, Belching, Poor or No Appetite, Acid Reflux, Dizziness and Headache (heavy feeling), Slight Red Tongue with Thick Yellow Tongue Coating, Rolling and Rapid Pulse.
(c) 心胆气虚 Insomnia with Syndrome of Qi Deficiency of Heart and Gall Bladder
Many Dreams and/or Nightmares, Night Terrors, Waking Up in Fears or Shocks, Breathlessness, Spontaneous Sweating through the Day, Constant Tiredness and Lethargic, Startles Easily, Timid and Fearful throughout the Day, Palpitations, Pale and Listless, Pale Tongue, Taut and Thin Pulse.
(d) 心脾两虚 Insomnia with Syndrome of Blood Deficiency of Heart and Qi Deficiency of Spleen
Difficulties to Fall Asleep, Many Dreams and/or Nightmares, Wakes Up Easily during Sleep, Palpitations, Forgetfulness, Constant Tiredness and Lethargic, Poor or No Appetite, Weak Body and Limbs, Abdominal Bloating, Loose Stools and Diahorrea, Dizziness, Pale or Yellowish Face, Pale Tongue with Thin Tongue Coating, Weak Pulse.
(e) 心肾不交 Insomnia with Syndrome of Incoordination between Heart and Kidneys
Difficulties to Fall Asleep, Many Dreams, Constant Vexation, Palpitations, Dizziness, Tinnitus, Lower Back Aches, Weak Knees, Hot Flushes, Night Sweats, Feverish Sensation in Chest, Palms and Soles, Dry Throat, Constant Thirst, Wet Dreams or Spermatorrhea, Irregular Menstrual Periods, Red Tongue with Little or No Tongue Coating, Thready Rapid Pulse.
2. What are the most common causes of sleep disorders?
The main cause of sleep disorders is the imbalance of Yin and Yang, either from an excess in Yang or a deficiency in Yin.
Factors such Stress, Busy and Hectic Lifestyle, Emotions, Rich Diet etc can disrupt the body’s Heart, Mind and Spirit which has a direct impact in its inability to sleep well. These factors may also affect the body to have an Excess in Yang, causing disruptions to Yin, and resulting in Yin Deficiency which disrupts the proper functioning of the body’s Organs. Other factors such as Chronic Illnesses, Initial Recovery from other Illnesses, Suffering from Pain, Use of Certain Medications etc may also result in an imbalance of the body’s Yin-and-Yang, which is vital for a good night’s rest.
The general cause for the abovementioned syndromes are:
(a) 肝火扰心 Insomnia with Syndrome of Liver-Fire disturbing Heart and Mind
Emotions such as overjoy, anger, worry, and sorrows may cause Qi Stagnation in the Liver. Prolonged duration of such stagnation results in it to turn into Liver Fire, which in turn moves upwards to disturb the serenity of the Heart and Mind, thereby resulting in insomnia.
(b) 痰热扰心 Insomnia with Syndrome of Internal Disturbance of Phlegm-Heat
Excessive rich and improper diet can harm the well functionality of the Spleen. A weak Spleen may not be able to perform the proper digestion of foods and result in the creation of Phlegm. Prolonged duration of Phlegm-Stagnation turns it into Phlegm-Heat, which in turn disturbs the internal peace of Spleen and Stomach, hence affecting sleep.
(c) 心胆气虚 Insomnia with Syndrome of Qi Deficiency of Heart and Gall Bladder
Qi Deficiency of the Heart results in the inability to calm the Mind and Spirit, while Qi Deficiency of the Gall Bladder affects the Spirit causing one to be timid and fearful at all times even during sleep, hence impacting sleep quality.
(d) 心脾两虚 Insomnia with Syndrome of Blood Deficiency of Heart and Qi Deficiency of Spleen
An unhealthy lifestyle or over fatigue may weaken the Spleen and negatively affects the absorption of nutrients in turn making less essence for Qi and Blood production. Chronic illnesses may also result in an overall deficiency in blood. Blood Deficiency of the Heart impacts the normal upholding of a Calm Heart and Mind, thereby affecting sleep.
(e) 心肾不交 Insomnia with Syndrome of Incoordination between Heart and Kidneys
Yin Deficiency of the Kidneys results in the inability to travel upwards to cool down the Heart, hence causing an overheat of the Heart Fire, disturbing the serenity of Heart and Mind, thereby affecting the ability to sleep.
3. How do sleep disorders affect one’s health?
TCM believes that the body’s blood is returned to the Liver when we sleep to replenish nutrients, and to perform repair and detoxification of all our Five important Organs (Liver, Heart, Spleen, Lungs and Kidneys), thereby assisting these Organs to function well.
When an Organ is in imbalance, one may experience one or more related symptoms of the Organ, such as blurred vision due to a weak Liver, palpitations and chest discomforts due to a weak Heart, loss of appetite and bloating due to a weak Spleen, shortness of breath and weakened immunity due to weak Lungs, frequent urination or blood in urine due to weak Kidneys etc.
Prolonged durations of sleep deprivation would also result in imbalances in our body’s various systems, such as weakened immune system, fail in memory system, lessened concentration, changes in hormonal system, lower sex drive, increased risks of cardiovascular diseases such as hypertension and heart diseases, increased risks of cerebrovascular diseases such as stroke, diabetes, weight gains, and mood changes such as anxiety and depression etc.
4. What are common TCM treatments for sleep disorders?
The overall treatment motto for TCM is to Replenish the Deficiencies and Dispels the Excesses, Balancing Yin and Yang for the proper functioning of all the Five Organs.
The general treatment for the abovementioned five syndromes are as follows:
(a) 肝火扰心 Insomnia with Syndrome of Liver-Fire disturbing Heart
Soothing of the Liver and Regulation of emotions to relieve Qi Stagnation in the Liver, dispels Liver Fire, and resumes the serenity of the Heart and Mind.
(b) 痰热扰心 Insomnia with Syndrome of Phlegm-Heat Disturbing Heart and Mind
Improves Spleen functionality and aids digestion and absorption, removes Phlegm and dispels Heat to resumes the serenity of the Heart and Mind.
(c) 心胆气虚 Insomnia with Syndrome of Qi Deficiency of Heart and Gall Bladder
Boosts Qi for the Heart and Gall Bladder and Calms the Mind and Spirit.
(d) 心脾两虚 Insomnia with Syndrome of Blood Deficiency of Heart and Qi Deficiency of Spleen
Boosts Qi for the Spleen, Nourishes Blood for the Heart, and Calms the Heart and Mind.
(e) 心肾不交 Insomnia with Syndrome of Incoordination between Heart and Kidneys
Builds Yin of the Kidneys and Dispels Fire of the Heart, and Resumes the Coordination between the Heart and the Kidneys.
Treatment can be done through methods of customized herbal prescriptions, acupuncture, auricular acupuncture, electroacupuncture and/or cupping.
5a. Can these treatments be used by people of all ages? Yes.
5b. Can these treatments be used by people with existing medical conditions? Yes, with extra caution to the herbal prescriptions, taking into consideration consumption of other medications due to existing medical conditions, and treatments exercised with care.
6. Can you provide us with a few lifestyle tips that may be beneficial for improving sleep quality?
Regulate your emotions, avoid over stimulations resulting in anxiety, worries, sorrows, fears, shocks etc. Maintain a calm and positive attitude towards your sleep disorders. Distress by talking about it with your loved ones when necessary. Exercise regularly and rest well after exercising.
Create a healthy lifestyle routine, go to bed by 11pm, rest on the bed even if you are unable to fall asleep immediately. Wake up the next morning to have your regular meals even if you did not have a good night’s rest. Take short 10-15minutes power naps during the daytime (before 1700hrs) when you need to replenish your energy. Go to bed and get up the same time each day.
Create a conducive sleep environment such as with comfortable lightings, surroundings, humidity and temperature, and comfortable clothings and bed linens.
Avoid heavy dinner or being too hungry at bedtimes. Take light meals during dinners. Avoid drinks such as tea, coffee and reduce alcohol intake before bedtime. Avoid smoking before bedtime. Refrain from using electronic devices right before bedtime.
Maintain a positive outlook on life and seek active medical treatment if need be.
7a. Can other systems of medicine help in treating sleep disorders? Yes.
7b. If yes, what are some of the herbs or remedies (outside of TCM) that can help with this disorder? Magnesium Supplements, Lavender Aromatherapy, Camomile Tea (caffeine free), Peppermint Tea (caffeine free), and Vitamins B12 Supplements are some examples.
