Healthy Sleep and Insomnia: A TCM Point of View

By Andrea Rivera
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     I'm going to talk about sleep and insomnia from the Traditional Chinese Medicine (TCM) point of view. I’m using what I’ve learned from a very successful sleep specialist, Damiana Corca, and the leader of sleep studies in TCM, Hamid Montakab. 

     It wasn’t until I started talking regularly about people’s sleep patterns (via asking detailed health history information before acupuncture sessions and herbal consults), that I realized just how many people don’t experience healthy sleep, or don’t realize that their sleep patterns are troubled and a larger problem than they think. Did you know that insomnia is considered CHRONIC when a person suffers from some type of insomnia for at least three nights a week for over a month? That’s not a very long time. I think that many people continue on with disturbed sleep this often for months, even years, without addressing it.

               So what is healthy sleep? These are a few of the  basics on what TCM considers healthy sleep:

• Falling asleep within 20 minutes, if it takes longer than 30 minutes, this is considered insomnia. Note: on the other hand, if your head hits the pillow and within seconds of laying down or in less than 5 minutes you fall asleep, you could be sleep deprived.
• Waking once and falling back to sleep easily is considered normal. Any trouble going back to sleep, waking twice or more (even to urinate) is too much for people to get back into proper states of sleep. 
• Achieving proper depth of sleep. Sleep that’s not too superficial where you’re easily wakened by the smallest sound. Your sleep is also superficial if you’re experiencing dream disturbed sleep throughout the night.
• Getting 7 to 9 hours of sleep. 6 hours of sleep only works for some people, the ones who can function well and remain healthy have slept 6 hours their whole life. These people are rare. 
• Waking rested with good energy. Your body and mind feel revitalized. You don’t wake too early, or before your desired and intended amount of sleep. 

                                            To contrast, any kind of insomnia may present like this:

• Reduced sleep time due to difficulty falling asleep, frequent waking for various reasons, and early waking.
• Superficial sleep due to mental restlessness, disturbing dreams, snoring, BRUXISM (teeth grinding, which so many people report as a problem), respiratory difficulties, and physical agitation like restless leg syndrome, pruritus (itching), and general discomfort or pain (secondary insomnia). 

     From this we gather that healthy sleep is achieved by reaching the proper depth and length of sleep. 

     In TCM, insomnia is a symptom, not a disease. Certain patterns of disharmony will result in disturbed sleep. Chinese medicine diagnoses the underlying patterns causing insomnia. When sleep issues are present without any obvious environmental cause, TCM can target the body’s imbalances to harmonize energies and create the internal environment necessary to achieve healthy sleep.

     The standard approach to treating insomnia is with medications. Unfortunately, drug therapies present troubling side-effects like dependency. According to Montakab, sleep that is induced by hypnotics is not physiologically normal:

• Benzodiazepines (your hypnotic, sleep-inducing, anti-anxiety, muscle relaxing drugs) and opiates reduce Stage 4 sleep, the increase in total sleep time being due to an increase in Stage 2 sleep. So although you are sleeping, you're not experiencing the normal and necessary length of stages.
• ​Antidepressant drugs cause reduced REM sleep.

*Something else I want to note here is that alcohol is not a good sleep aid. Alcohol initially causes sleepiness but often has a rebound effect later in the night that will seriously disturb sleep quality, whether you wake up or not. 

     Your practitioner can also provide council on achieving proper sleep hygiene and making lifestyle changes geared toward better sleep.  I’ve started treating sleep with almost every patient I see, no matter what their chief complaint is, and have seen it improve other areas of their health simultaneously. Healthy sleep is the cornerstone of healing.