Insomnia and Chinese herbs

By Kenneth Tan and John Lew

Dysfunctional bedtime will throw you off for the next day, or even the whole week. Don't let insomnia ruin your life. While sleeping pills may be a quick solution, prolonged use may lead to addiction and worsening insomnia conditions. Instead, turn to natural remedies such as herbs to help treat your condition.

“The current technological progress has made it possible for the curative powers of the herbs to be reduced to powders so the traditional preparation of boiling for hours is no longer needed,” say Eu Yan Sang integrative health physician and traditional Chinese medicine practitioner John Lew. “Now, you can either mix it in water or swallow as a capsule.”

The following are six common body syndromes to insomnia and the herbs which will fix it.


PROBLEM 1: You have a highly-strung nervous system and when you sleep, you have a fearfulness of the dark. Palpitation with fear is a common sign, coupled with dreaminess, fearful of disturbances, involuntary sweating and short breath. The tongue is usually pale with taut and thready pulse.

THE CAUSE: Your heart and gallbladder systems are weak. “When the heart-qi is weak, the mind is easily disturbed. And when the gallbladder-qi is weak, the whole person finds most things scary and fearful,” say Lew. Also, deficiency of qi makes breathing to be short and sweating more profound.

THE SOLUTION: To strengthen the heart and gallbladder, first of all, ginseng ( 人参; Ren Shen) boosts the qi of heart and gallbladder systems. Poria (茯苓; Fu Ling), poria sclerotium with hostwood (茯神; Fu Shen) and polygala root (远志; Yuan Zhi) reinforce spleen (strengthen digestion and absorption of food), dissolve phlegm and tranquilize the irritated mind. Grassleaf sweelflag rhizome (石菖蒲; Shi Chang Pu) stabilizes and calms the mind; yet at the same time brings more awareness to the heart. Wild jujuba seed (酸枣仁; Suan Zao Ren), sour in taste, related to the channels of heart and liver, nourishes liver, cools the heart and tranquilizes the mind. Rhizome of anemarrhena (知母; Zhi Mu), bitter in flavor and cold in property, purges heat and gets rid of irritation. Chuanxiong rhizome (川芎; Chuan Xiong), pungent and fragrant in flavor and warm in nature, regulates the blood by promoting the flow of qi. If palpitation and irritation gets severe, add raw dragon’s bone (生龙骨; Sheng Long Gu), raw oyster shell (生牡蛎; Sheng Mu Li) and Cinnabar (朱砂; Zhu Sha: Contains mercuric sulfide, not to be taken in large dosage or for a long time to avoid mercurialism. To be refined into powder with water but not to be decocted in water).

The formula has the effects of nourishing the blood, tranquilizing the mind, inducing sleep and calming down fever.

PROBLEM 2: Despite feeling fatigue around the limbs or the whole body, you cannot sleep well and you feel moody and slightly irritated. Your face shows sallow complexion with poor appetite. The tongue can be pale with thin and whitish coating, and thready and loose pulse.

THE CAUSE: The late hours reduce your liver’s effectiveness in detoxifying blood, depriving your heart and spleen of good blood. “The qi and blood in the heart and spleen systems are lacking, causing palpitation, amnesia; sometimes even night sweat, recurrent mild fever, anorexia,” says Lew. “This body type happens frequently to men and women undergoing menopause.”

THE SOLUTION: In this suggested formula, ginseng (人参; Ren Shen) and astragalus root (黄芪; Huang Qi) serve as principal herbs, have the effects of tonifying qi and invigorating the spleen. White atractylodes rhizome (白术; Bai Shu) and prepared licorice root (炙甘草; Zhi Gan Cao), sweet in flavor and warm in property, assist ginseng and astragalus root in enriching the source of the production of qi and blood by reinforcing the spleen and replenishing qi. Chinese angelica root (当归; Dang Gui) is good at enriching the liver to promote the generation of heart-blood. Poria sclerotium with hostwood (茯神; Fu Shen), longan aril (龙眼; Long Yan) and wild jujuba seed (酸枣仁; Suan Zao Ren), all being sweet and neutral in nature, function in nourishing the heart and tranquilizing the mind. Honey-parched polygala root (蜜炙远志; Mi Zhi Yuan Zhi) relieves mental stress by means of restoring normal coordination between the heart (fire) and kidney (water). Aucklandia root (木香; Mu Xiang) regulates the flow of qi and prevents qi-replenishing herbs and blood tonics from causing stagnation of qi. Fresh ginger (生姜; Sheng Jiang) and jujubae Chinese dates (大枣; Da Zao) tonify the spleen and regulate the stomach (better digestion and absorption), coordinating the effects of other herbs in this suggested prescription.

The formula is effective for promoting digestion and absorption, strengthening metabolism, consolidating the mind, regulating excitement.

PROBLEM 3: Hyperactivity and prone to emotional swings and irritability when under stress, with possible signs of depression. Insomnia occurs with possible back and joint pain. Palpitation, nocturnal emission, dry stools can be observed. Tongue impression is reddened with little or no fur accompanied by thready and rapid pulse.

THE CAUSE: Your body is lacking fluid, particularly yin and blood, causing an upsurge of internal heat. “This internal heat turns into heart-fire of the deficiency type. The person isn't really having excessive heat,” comments Lew. “This constant mild heart-fire irritates the mind and causes all the corresponding symptoms.”

THE SOLUTION: Dried rhizome of rehmannia (生地黄; Sheng Di Huang) is used in larger or double dosage to nourish yin and blood, tonify the kidney and the heart. Together with figwort root (玄参; Xuan Shen), not only do they nourish yin, they also clear pathogenic fire to have the deficiency-fire suppressed and the mind tranquilized. Herbs such as red sage root (丹参; Dan Shen), Chinese angelica root (当归; Dang Gui), ginseng (人参; Ren Shen) and poria (茯苓; Fu Ling) invigorate qi, enrich the blood and tranquilize the mind. Arborvitae seed (柏子仁; Bai Zi Ren), wild jujuba seed (酸枣仁; Suan Zao Ren) and polygala root (远志; Yuan Zhi) reinforce the heart and the spleen to calm the mind. Lucid asparagus root (天冬; Tian Dong) and ophiopogon root (麦冬; Mai Dong), sweet in taste and cold in nature, produce an moistening effect to clear deficiency-fire. Schisandra fruit (五味子; Wu Wei Zi) astringes qi and promotes the production of the body fluid to avoid the dissipation of the heart-qi. Magnolia vine fruit (桔梗; Jie Geng) carries all the ingredients in the formula upward. Cinnabar (朱砂; Zhu Sha) tranquilizes the mind. If nocturnal emission takes place, add cassia bark (肉桂; Rou Gui) to redirect the fire back to kidney-yang.

The above suggested formula gets the yin and blood nourished, the fire of the deficiency type reduced, and thus the mind tranquilized at the same time. It induces sleep without causing drowsiness and achieve the effects of enriching the yin and blood.

PROBLEM 4: Besides sleeplessness, the tip of your tongue is very red or takes on a yellowish hue. Your urine is also very yellow in color and has a very strong odor. You may also have severe palpitation, heart-burn sensation in the chest and lots of dreams.

THE CAUSE: There is too much heat in your heart. When this ‘fire’ is very strong, you will be very easily irritated. “Heart system is where the mind and consciousness reside. When the heart feels heat, the mind will sure feel much irritated,” says Lew. “The heart channel and the small intestine channels are directly linked. That's why the yellowish urine condensed from the heaty small intestine.”

THE SOLUTION: Cinnabar (朱砂; Zhu Sha) clears away heart-fire, relives floating the yang energy that floats on top of the heat and tranquilizes the mind. Coptis root (黄连; Huang Lian), which is very bitter and cooling in nature, clears away heart-fire and relives restlessness. These two herbs play leading roles in the whole formula. Chinese angelica root (当归; Dang Gui) and dried rhizome of rehmannia (生地黄; Sheng Di Huang) nourish yin and enrich blood. Rehmannia root can also replenish the kidney-yin so that it flows upward to help clear away flaring heart-fire. Prepared licorice root (炙甘草; Zhi Gan Cao) tonifies the spleen and regulates the stomach (better digestion and absorption as the above-mentioned herbs can be demanding for spleen and stomach functions). Licorice root also coordinates the actions of all other herbs. If the chest is tight and with numbness, add bamboo shavings (竹茹; Zhu Ru) to clear away stagnated fire in the chest. If constipation is severe with very yellowish and condensed urine, add rhubarb (大黄; Da Huang) and bamboo leaves (Zhu Ye; 竹叶) to guide the fire downward, and to purge the heat.

This suggested formula has the effect of cooling and tranquilizing the mind, inducing sleep, regulating heart beat and nourishing the body.

PROBLEM 5: Your sleep is interrupted by a heaviness and stuffiness in your stomach, and acid regurgitation with fetid odor. Loss of appetite, nausea or diarrhea may be observed. And your tongue is coated in a greasy, thick yellowish substance. The pulse can be slippery.

THE CAUSE: There is too much food stagnation as a result of a late dinner and lousy supper. Sleeping on a full stomach interrupts natural slumber. “Improper diet and bad timing is the main cause of retention of indigested food,” says Lew, “this is especially true for those who tend to eat oily, greasy food.”

THE SOLUTION: In this suggested formula, hawthorn fruit (山楂; Shan Zha) is used to remove all kinds of food stagnancy. It's especially good at removing greasy food stagnancy. Medicated leaven (神曲; Shen Qu) is effective for promoting digestion and strengthening the spleen (the digestion and absorption). It's especially good at removing stagnated food related to alcoholic drinking. Radish seed (萝卜子; Luo Bo Zi) keeps the adverse qi downward and promotes digestion, great for food stagnancy due to grain food. Pinellia tuber (半夏; Ban Xia) and Tangerine peel (陈皮; Chen Pi) have the effect of removing stomach phlegms and arresting nauseous vomiting. Poria (茯苓; Fu Ling) strengthens the spleen and induces diuresis which in turn arrests diarrhea or loose stool. Forsythia fruit (连翘; Lian Qiao) clears away heat and scatters stagnancy.

This formula of herbs promotes digestion, helps proper movement of stomach and intestines, arrests vomiting, subdues inflammation. It gets rid of food stagnation that contributes to insomnia.

PROBLEM 6: A flushed face and plenty of heat phlegm in the body which irritates the throat and causes stomach wind. This heat phlegm takes on a green or yellowish color and your emotional condition is quite irritated causing fitful sleep. The tongue is red and the fur yellowish and greasy. Fast slippery pulse is observed.

THE CAUSE: Heat phlegm, which is an accumulation of eating too much spicy, fried and heaty food, is to blame for this. “And it's the combination of emotional irritation, gastric discomfort, palpitation and even bitter taste in mouth that cause you to have insomnia,” says Lew.

THE SOLUTION: Pinellia tuber (半夏; Ban Xia) lowers adverse flow of qi energy to regulate the stomach. It also eliminates dampness to resolve phlegm. Bamboo shavings (竹茹; Zhu Ru) clears away heat and resolves phlegm to relieve vertigo and heavy head. Tangerine peel (陈皮; Chen Pi) regulates qi energy flow and removes phlegm. We can use coptis root (黄连; Huang Lian), which is very cooling in nature, to reduce heat-phlegm. We can also use capejasmine fruit (栀子; Zhi Zi), which helps to purge liver and gallbladder fire and clear damp-heat, to further cool the emotion. For severe palpitation and over-alertness, add Nacre (珍珠母; Zhen Zhu Mu) and Cinnabar (朱砂; Zhu Sha) to calm the mind. If the phlegm is persistently heaty and of the excess type, use prepared arisaema (胆南星; Dan Nan Xing) and scutellaria root (黄芩; Huang Qin). The bitter taste and cold nature of these two herbs is stronger in clearing heat and resolving dampness.

The above prescription has the effect of heat-clearing, phlegm-eliminating, heat cough and asthma relieving. It's suitable for the syndrome of stagnation of phlegm and heat in the upper parts of the body, namely the heart and lung systems.


Tips (Overall):
1) For most cases, standard suggested range of daily dosage for each herbs can be referred to when prescribing the herbs.
2) You can boil the herbs in traditional ways or by opting for condensed extracted powder of each herbs which can be taken orally without boiling.
3) Cases presented are typical or representatives of obvious body types. Most of the people belong to combination of two or three body types, depending on degree of severity. And there are other body types mixed with other diseases. Please consult a physician of TCM for proper diagnosis of body syndromes (types) and other diseases.

PS:
1) This solution of Insomnia appears in MIND & BODY_The Roots to Snooze, on page 76 and page 77 of Men's Health magazine, January 2009, Malaysia.