In Traditional Chinese Medicine (TCM), insomnia is often associated with an imbalance of Yin and Yang, disharmony of Qi and Blood, and dysfunction of the autonomic nervous system.
According to the classical text Ling Shu and Su Wen, excessive Yang energy makes it difficult to fall asleep, while excessive Yin energy may lead to frequent awakening during the night.
In modern society, insomnia is very common and causes both physical and psychological distress. Studies show that more than 25% of adults in Taiwan have experienced insomnia.
Among them:
- Difficulty falling asleep: 14.6%
- Early morning awakening: 13.9%
- Difficulty maintaining sleep: 13.4%
Individuals with insomnia are three times more likely to experience excessive daytime sleepiness compared to those without insomnia. Even after adjusting for socioeconomic status, education level, and income, insomnia is still significantly associated with poorer mental health outcomes.
In adolescents, insomnia is often related to academic stress, irregular sleep schedules, or disrupted circadian rhythms.
This article explores insomnia from a TCM perspective, its treatment approaches, and non-pharmacological and dietary strategies to improve sleep.
TCM Perspective on Insomnia
Insomnia is commonly related to imbalance of Yin-Yang, Qi and Blood, and autonomic dysfunction. Conditions such as stress, chronic pain, respiratory disorders, anxiety, depression, alcohol, and caffeine intake may all contribute to sleep disturbances.
TCM treatment focuses on restoring balance of Yin and Yang and regulating Qi and Blood.
- For excessive Yang conditions: calming and heat-clearing herbs such as dragon bone (Long Gu), oyster shell (Mu Li), and Coptis (Huang Lian) may be used.
- For frequent awakening due to liver Qi stagnation: herbs such as Corydalis (Yan Hu Suo), Melia (Chuan Lian Zi), and Albizia bark (He Huan Pi) may be applied.
- For elderly patients or stress-related early awakening: deficiencies of Qi, Blood, Yin, and Yang are common. Herbs such as Biota seed (Bai Zi Ren), ginseng (Ren Shen), and angelica root (Dang Gui) may be used.
TCM herbal treatment is generally effective and is not associated with dependency or addiction.
Q: Can Music Help Improve Sleep?
A: Research in 2021 suggests that music has a positive effect on sleep quality. Music helps relaxation, stabilizes mood, reduces anxiety, and may also influence heart rate and blood pressure.
Some studies even suggest that music can be more effective than certain sedative medications in improving sleep quality.
Listening to music for 25–60 minutes daily for 3 days to 5 weeks has been shown to significantly improve sleep quality.
Different types of music affect the brain and cardiovascular system differently. Classical music and meditation music are generally beneficial for relaxation and sleep, while heavy metal and electronic music may increase stress or even affect heart rhythm.
Composers such as Bach and Mozart are often associated with improved quality of life and potentially longevity. However, individual preferences vary, and further research is needed to fully understand how music affects subjective sleep quality.
Q: Can Insomnia Be Improved Without Medication?
A: Non-pharmacological approaches to insomnia
Psychological research in 2021 suggests that regular physical activity (such as brisk walking or cycling) and mind-body exercises combined with breathing techniques can improve subjective sleep quality in adults.
Exercise therapy has been shown to improve:
- Self-reported sleep quality
- Insomnia severity
- Daytime sleepiness
A 2021 exercise journal recommends:
- 60 minutes of exercise per day
- 4–5 times per week
- Continued for 8–12 months
This is particularly effective for primary insomnia, especially in older adults.
Circadian Rhythm and Light Therapy
Circadian rhythm plays a major role in insomnia and can be adjusted through appropriate light exposure:
- “Night owl” type (common in adolescents): wake up earlier and get morning sunlight to shift the rhythm earlier.
- “Early bird” type (common in elderly): exposure to afternoon sunlight can help shift the rhythm later.
- Severe delayed sleep phase (sleeping at 3–4 AM): gradually shift sleep time earlier by 5 minutes per day, or alternatively delay sleep time by 3 hours daily; the latter may reset sleep timing within 1–2 weeks.
Body Temperature and Sleep
Warm foot baths or hot showers can improve sleep quality.
Core body temperature naturally rises in the morning, peaks in the afternoon, and drops at night during sleep.
A lower core temperature combined with warmer peripheral (hands and feet) temperature before sleep is associated with faster sleep onset.
Therefore, improving peripheral circulation (e.g., foot baths or wearing socks before bedtime) may support better sleep. Socks should ideally be worn about two hours before sleep and removed at bedtime to allow heat dissipation.
Additional Non-Drug Strategies
Other helpful methods include:
- Diaphragmatic breathing to regulate the autonomic nervous system
- Eye masks to reduce light exposure
- White noise for sound masking
- Sleep routines to enhance psychological conditioning
- Avoiding intense exercise before bedtime
- Reducing smartphone and blue light exposure
Q: Is There a Link Between Gut Microbiota and Insomnia?
A: Recent studies show that individuals with insomnia often have reduced gut microbial diversity compared to healthy individuals. They may lack anaerobic bacteria and short-chain fatty acid-producing bacteria.
This suggests that gut microbiota balance may influence sleep quality.
Dietary strategies include fermented foods such as yogurt and probiotics.
From a TCM perspective, herbs such as Crataegi Fructus (Shan Zha) and Massa Medicata Fermentata (Shen Qu) may help improve digestion and support gut health.
Gut Health and Sleep
TCM states: “When the stomach is not harmonious, sleep becomes disturbed.”
Gastroesophageal reflux disease (GERD) is also associated with insomnia, and insomnia may worsen reflux symptoms.
TCM treatment focuses on regulating liver Qi, strengthening the spleen, warming the middle burner, and harmonizing the stomach.
Lifestyle recommendations include:
- Weight management
- Avoiding irritating foods
- Avoiding large fluid intake after meals
- Avoiding late-night eating
- Avoiding screen use during meals
Q: What Foods Help Improve Sleep?
A: Certain foods are associated with better sleep quality:
- Kiwi fruit (contains antioxidants, serotonin precursors, and vitamin B6)
- Calcium-rich foods (milk, small dried fish, tofu)
- Magnesium-rich foods (nuts and seeds)
Q: Are There Dietary Therapies for Insomnia?
A: Herbal dietary prescriptions may help regulate body constitution. Each course typically lasts 2 weeks, repeated for 6–8 weeks. Consultation with a qualified TCM physician is recommended.
Bai He Sheng Di Tang
- Lily bulb 5 qian, Rehmannia 3 qian
- Suitable for: dry mouth, stress, constipation
Gan Mai Da Zao Tang
- Licorice 2 qian, wheat 4 qian, jujube 2 qian
- Suitable for: exam stress, perimenopausal symptoms, emotional instability
Preparation:
- First decoction: 600cc → 200cc (40–50 minutes)
- Second decoction: 600cc → 200cc (40–50 minutes)
- Mix and divide into equal doses
Q: Which Acupoints Help Improve Sleep?
A:
Shenmen (HT7)
- Location: on the wrist crease, at the ulnar side near the little finger
- Effects: calms the mind, treats insomnia, anxiety, palpitations, and memory issues
Zusanli (ST36)
- Location: below the knee, lateral to the tibial crest
- Effects: strengthens digestion, improves energy, regulates gastrointestinal function
Conclusion
Insomnia has multiple causes, and Traditional Chinese Medicine provides various treatment approaches, including herbal medicine, dietary therapy, and acupuncture.
Non-pharmacological methods such as music therapy, light exposure, foot baths, stress reduction, and sleep hygiene are also effective.
Sleep should not be forced. It is a natural process that occurs best in a relaxed state.
A comprehensive and individualized approach combining these methods may help improve sleep quality and overall well-being.