Every once in a while, we all have trouble sleeping. In Traditional Chinese medicine (TCM) ideas about problems sleeping differ radically from western medicine concepts. TCM helps look at your whole body system to establish the root causes of sleep problems that may affect your or your children. In fact, using TCM strategies to help you sleep will benefit your overall mental and physical well-being. You can move from a sub-healthy state to optimal health!
Common sleep problems for adults and children in TCM not only include insomnia (both difficulty falling asleep and/or staying asleep) but also include: vivid dreams or dream disturbed sleep, or sleeping too much. Night-time bedwetting and night crying or screaming.
This article is the first article in our Sleep Series, a series about sleep that focuses on explanations for different sleep problems from a TCM framework. Following articles will present strategies to help treat the root cause of these problems.
Chinese Medicine Organ Systems and Why Sleep Matters
It's important know how TCM looks at the human body. This will help you understand why and how the strategies you will learn in later articles can help your body heal. The ultimate goal is to help you overcome insomnia, difficulty falling asleep, troubles staying asleep, vivid dreams, or over sleeping. Let’s start your sleep makeover now!
Chinese medicine views the body as a whole system. All parts of the body work together and affect each other, in both negative and positive ways. If one part of the system does not function properly, it affects everything else.
Think of a polluted river. If someone upstream puts toxic waste into a river, all of the water and land near the waste entry point and downstream are affected. The opposite is also true, if the water stays clean, then all of the areas that rely on the water thrive from it being clean.
The interrelationship between parts of the body is a similar concept. The health and or illness of each part affects the others. The Zang-fu organ systems form the core for a TCM understanding of optimal health.
The five Zang organ systems include the Heart, Lung (referred to in the singular in TCM), Spleen, Liver, and Kidney. The six Fu Organ systems include the Small Intestine, Large Intestine, Stomach, Bladder, and Triple Burner or Sanjiao (the middle section of your body taken as a whole). The Zang-Fu organs interact with each other through the flow of Qi and Blood. Close partnerships occur between various Zang and Fu organs, influencing your overall health.
Your internal organs work together to keep you healthy. Problems sleeping can be a symptom that your organ systems are not functioning properly.
When the Zang-Fu organs function properly in relationship to each other, TCM says your body has balance between Yin and Yang (more on this topic in other articles). This concept is a little more complex than just light and dark. For many people new to thinking about TCM, Yin and Yang are harder to fully grasp. For now, just think of your body having an optimal state of health, a balanced state.
When you are out of balance, problems arise. Qi and Blood cannot flow properly and organs miss critical nutrients and energy. Improper diet (from a Chinese medicine mindset), an irregular schedule, lack of proper and healthy movement (also from a Chinese medicine versus western concept of exercise), and stress can all lead to imbalances.
When you cannot sleep, your body suffers from a sub-healthy status. Insomnia and other sleep problems signal that the Zang-Fu organs are out of balance, and that Qi and Blood are not properly flowing through your body. Any and all prolonged sleep problems need treatment to prevent more serious diseases.
Don't sweep problems under the rug!
Some western treatments for difficulty sleeping harm the Zang-Fu organs, making the problem worse instead of helping. Think of it like sweeping the dirt under the rug instead of putting it into the dust bin. They mask the problem but do not clean it up. These treatments add toxins to your system that further stress your body’s ability to complete natural functions. More importantly, they may mask other symptoms that show a deeper issue with your health.
When you cannot sleep, your body is trying to communicate to you that things are going wrong. Each type of sleep problem provides valuable information about specific issues and where the problem originates. Knowing what kind of sleep problem you or your child has can help determine specific treatments and self-care strategies that can help you not only sleep better but prevent diseases further down the road.
Types of sleep problems and their Chinese medicine explanations
Below you will find a list of different sleep problems and some of the root causes.
Insomnia – Difficulty Falling Asleep or Staying Asleep
According to Chinese medicine, insomnia has several different root causes.
Heart Qi and Blood Deficiency. This cause of insomnia often stems from a Spleen deficiency and leads to the failure of Blood to nourish the Heart. Symptoms characterized by this root cause can include dizziness and palpitations.
Heart Fire. Symptoms for excessive Heart fire are tongue sores, dryness of mouth and nose, and burning pain during urination. It may also be characterized by behaviors people in the west label as hyperactivity.
Liver Qi Stagnation. Qi moves Blood, and if Qi stagnates in the Liver, Blood cannot flow as needed to the brain and other organs. Headaches at the temple region, frequently feeling angry and irritable, frequent hiccups, allergy symptoms such as itchy and red eyes, and sometimes feelings of depression are other indicators of stagnated Liver Qi. Waking between 1:00-3:00 AM in the morning, is another possible sign of Liver Qi stagnation.
Liver Blood Deficiency. This problem is often due to dieting or inadequate food intake. Other possible signs of this deficiency include dry eyes, floaters in the eyes, numbness of limbs if still for too long, dizziness, faintness after exertion, poor or blurred vision, and eyes aching from tiredness.
Difficulty falling asleep. Restlessness caused by derangement of Stomach Qi. This issue may also be characterized by an empty sensation at the stomach or gastric discomfort after a meal.
Wakefulness – waking in the middle of the night with difficulty falling back to sleep. If you are waking because of the need to urinate, the cause could be deficient Kidney Qi, in addition to the root causes mentioned above.
Having difficulty falling asleep, waking up at particular times of night, or having trouble falling back asleep again, can also indicate deeper health issues. Your organs "rule" in two-hour increments and knowing what organ system is primary when you wake up at night can help you and your doctor better diagnose your symptoms.
Night sweats may wake people at night and cause them to have difficulty falling asleep again, leading to further sleep problems. Even if you sleep through your night sweats, the symptom requires attention and indicates a sub-healthy state.
In TCM, Yin deficiency is the primary root cause of night sweats. Yin deficiency may also be associated with dry skin, dry eyes, tinnitus, hot flashes, anxiety, lower back pain, knee pain, and insomnia, among other symptoms. Overall, Yin deficiency causes Interior Heat syndrome, leading to these various issues (more on this later).
Dream Disturbed Sleep
While in the west, dreams have value and may even be desirable. In TCM they are a symptom of a sub-healthy state, especially if they are vivid and disturb a full night’s sleep. Causes of vivid dreaming and dream disturbed sleep include Heart Fire, Liver Qi Stagnation, and Yin deficiency from overwork. Yin deficiency caused by mental overwork may take longer to remediate, because it takes longer to set in than short-term physical labor overwork. Yin deficiency can cause Blood and Qi stagnation, leading to other sleep problems.
Dream disturbed sleep can also result from Liver Blood Deficiency due to dieting or inadequate food intake. As stated above, dry eyes, floaters in the eyes, numbness of limbs if still for too long, dizziness, faintness after exertion, poor or blurred vision, and eyes aching from tiredness are also characteristics of Liver Blood Defiency.
Hypersomnia – Too Much Sleep
Hypersomnia results from an imbalance of work and rest leading to imbalance in Yin and Yangand weakens the Qi.Damp and Phlegm Accumulation as conceived of in TCM also plays a role, as does a Heart Yang Deficiency and Kidney Yang Deficiency.
Sleep issues in Children
Often, sleep problems for children have the same root causes as the ones you’ve read for the adults, when not caused by a current illness. The most common problems are night crying, restless sleep, or easy waking at night. As with adults, children can suffer from Yin deficiency. In this situation, additional symptoms may be a weak, forceless, dry cough; heat in the palms of the hands and soles of the feet; irritability, flushed red cheeks; dry, red lips; a red tongue with a thin yellow coating.
One additional source is food stagnation. Children’s digestive systems are very sensitive. Because they are not as developed, it is easier for children to have sleep issues as a result. When food stagnation is to blame, the symptoms may also include abdominal pain and distention; pain relieved by diarrhea; sour, foul-smelling stools; bad breath; possible desire to vomit; thick, slimy, or slightly yellow coating on tongue.
Again, due to a child’s developing and constantly changing system, they are more susceptible to various sources of sleep problems. Insomnia or other difficulties sleeping can result from Yin deficiency with Yang hyperactivity, which leads to excessive Heart Fire, as you read about with adults. Sleep problems may then be accompanied by other symptoms such as hyperactivity, decreased ability to concentrate, thin body, red tongue with scanty coating or a pale tongue with a red tip; heart palpitations; agitation; dizziness; ringing in the ears; possible lower back pain; flushed cheeks.
SUMMARY AND ADDITIONAL THOUGHTS
The same sleep problem may have different root causes in the Zang-Fu organs, Yin and Yang balance, or flow of Qi and Blood throughout the body.
Imbalance results from improper diet, improper work/rest schedule, a lack of proper and healthy movement, and stress.
Adults and children can both suffer from sleep problems, but children may have different root causes based on their developmental stage.
Addressing the root causes will help alleviate the sleep problem symptom(s). If the problem has persisted for any length of time, it will also take longer for the body to rebalance. Patience and diligence in curing the root cause will pay off in the long run.
These articles are recommendations and ideas for you to talk about with your TCM doctor. Making sure you have an accurate assessment of the root cause of your or your child’s insomnia or other sleep problem will enable you to bring the body back into balance.
Dr. Juli Kramer received her Ph.D. in Curriculum and Instruction, with a cognate in Counseling Psychology, has her M.A. in Psychology, and her B.A. in History and Political Science. Most of her professional career has been in education. Motivated by the deteriorating health conditions she sees in the United States, which are in direct contrast to the abundant health she saw while living in Shanghai, China, Juli wants to use her skills as an educator to teach people about the life-saving benefits of Chinese medicine.