Insomnia
★Overview
Insomnia (bu mei) is difficulty obtaining normal sleep—trouble falling asleep, light or fragmented sleep, early-morning waking with inability to return to sleep, or staying awake all night—often with dizziness, fatigue, palpitations, and poor memory. It results from emotional strain, dietary irregularity, imbalance of work and rest, or chronic deficiency that either deprives the heart spirit of nourishment or disturbs it, involving the heart, liver, spleen, kidney, and insufficiency of yin-blood.
Pattern differentiation (clinical patterns)
Heart-Spleen Dual Deficiency
Dream-disturbed light sleep with easy waking, palpitations, poor memory, dizziness, fatigue, poor appetite, pale complexion, pale tongue with thin coating, fine weak pulse.
Tonify heart and spleen; nourish blood and calm the spirit.
Yin Deficiency with Effulgent Fire
Vexed inability to sleep and trouble falling asleep, restless palpitations, dizziness, tinnitus, poor memory, five-center heat, dry mouth, red tongue with scant coating, fine rapid pulse.
Nourish yin and downbear fire; clear the heart and calm the spirit.
Liver Constraint Transforming Fire
Irritability and anger with insomnia and many dreams, distending dizziness, red eyes, tinnitus, bitter dry mouth, constipation, dark urine, red tongue with yellow coating, wiry rapid pulse.
Soothe the liver and drain heat; settle the heart and calm the spirit.
Connections
Daily care & prevention
Keep a regular schedule with a fixed wake time; exercise by day but avoid vigorous activity within 3 hours of bed. Reduce caffeine, nicotine, alcohol, late heavy meals, and screens before sleep. Try a warm foot soak, calming music, and breathing relaxation. Massage Shenmen (HT7), Neiguan (PC6), Sanyinjiao (SP6), and Baihui (GV20), with a consistent bedtime routine.
When to seek medical care
Seek professional help for insomnia with persistent low mood or loss of interest, thoughts of self-harm, severe daytime impairment, snoring with witnessed apneas, irresistible daytime sleepiness, or long-term dependence on sleeping pills. Medication requires particular caution in pregnancy and older adults.