Insomnia

失眠

Difficulty sleeping or maintaining restful sleep.

Quick Facts

Health Topic	Sleep & Emotional Balance
Also Known As	Trouble sleeping, Cannot sleep, Sleeplessness, Difficulty sleeping, Poor sleep onset or maintenance
Common Symptoms	Difficulty falling asleep, staying asleep, or returning to sleep after waking. Night-time rest feels insufficient, and daytime alertness may drop. Thoughts may race at bedtime, or waking may occur at regular hours of the night.
Related TCM Patterns	Qi Deficiency · Blood Deficiency · Heart Fire · Kidney Yang Deficiency · Qi Stagnation · Yang Deficiency · Yin Deficiency · Phlegm-Dampness
Related Classical Formulas	Sang Piao Xiao San · Gui Zhi Jia Long Gu Mu Li Tang · Chai Hu Jia Long Gu Mu Li Tang · Suan Zao Ren Tang · Dao Chi San · Ren Shen Yang Rong Tang · Tian Wang Bu Xin Dan · Gui Pi Tang · Gan Mai Da Zao Tang · Zhi Zi Chi Tang · Wen Dan Tang · Zhi Gan Cao Tang · An Shen Ding Zhi Wan · Huang Lian E Jiao Tang

Insomnia in Traditional Chinese Medicine

In Traditional Chinese Medicine, insomnia in the current set is associated with Kidney Yang deficiency among other possible patterns. Differentiation looks at whether there is cold limbs and frequent nocturia, or heat signs and restlessness, and whether the sleep problem is mainly onset or maintenance. Classical formulas are matched to the broader pattern rather than to sleeplessness alone. Accompanying signs such as tongue appearance, pulse quality and the presence of heat or cold help distinguish one presentation from another.

TCM Patterns Associated With Insomnia

The same presentation may be understood through more than one pattern. Pattern differentiation weighs the accompanying signs, not the symptom on its own.

Pattern	Common Features	Related Formulas
Qi Deficiency氣虛證Deficiency Patterns	Easy fatigue, shortness of breath on mild effort, a soft or low voice, and spontaneous sweating with light activity. The complexion is often pale, and recovery after exertion is slow. There may be a tendency to catch external pathogens more easily. Tongue pale with a thin white coating; pulse weak or empty.	Ren Shen Yang Rong Tang Gui Pi Tang Gan Mai Da Zao Tang Zhi Gan Cao Tang An Shen Ding Zhi Wan
Blood Deficiency血虛證Deficiency Patterns	A pale or sallow complexion, dry hair or skin, light-headedness on standing, blurred vision, and easy fatigue. In women the menstrual flow is often scanty and pale. Sleep may be light, and the hands and feet can feel numb when tired. Tongue pale and thin; pulse thin and weak.	Suan Zao Ren Tang
Heart Fire心火證Heat Patterns	Restlessness, insomnia with vivid dreams, a red tip of the tongue, and sores on the tongue or mouth in stronger cases. There may be a bitter or dry mouth, dark scanty urine, and a sense of heat in the chest. The person feels agitated rather than merely tired. Tongue red at the tip; pulse rapid, possibly forceful.	Dao Chi San Zhi Zi Chi Tang Huang Lian E Jiao Tang
Kidney Yang Deficiency腎陽虛證Deficiency Patterns	Cold lower back and knees, cold limbs, clear copious urine or frequent nocturia, and reduced sexual drive or premature ejaculation. Energy is low, especially in the morning or in cold weather, and stools may be loose. The face can look pale and slightly puffy. Tongue pale and swollen with a white coating; pulse deep and weak, especially in the chi position.	Sang Piao Xiao San
Qi Stagnation氣滯證Stagnation Patterns	Distension, tightness or a constrained feeling in the chest, flanks or abdomen that comes and goes with emotion or stress. Frequent sighing, a sense that emotions are hard to move, and in women premenstrual breast or lower abdominal discomfort are common. Symptoms often ease after movement, expression or belching. Tongue may be normal or slightly dusky; pulse wiry.	Chai Hu Jia Long Gu Mu Li Tang
Yang Deficiency陽虛證Deficiency Patterns	Aversion to cold, cold limbs, preference for warm drinks and clothing, and low energy that worsens in cold weather. There may be loose stools, clear copious urine, a pale puffy face, and reduced libido or lumbar weakness. The person feels better with warmth and worse with cold exposure. Tongue pale and possibly swollen with a white coating; pulse deep and weak.	Gui Zhi Jia Long Gu Mu Li Tang
Yin Deficiency陰虛證Deficiency Patterns	Dry mouth and throat, night sweats or warm palms and soles, a thin body frame, and restlessness that is worse in the afternoon or at night. Sleep may be light, and there is often a preference for cool drinks. Symptoms feel empty rather than forceful. Tongue red with scant coating; pulse thin and rapid.	Tian Wang Bu Xin Dan
Phlegm-Dampness痰濕證Phlegm Patterns	Copious white or sticky phlegm, a heavy chest or head, and a greasy tongue coating. There may be nausea, poor appetite, and a foggy or heavy mental feeling that worsens in damp weather or after rich food. Coughing brings up phlegm that is hard to clear completely. Tongue pale with a thick greasy white coating; pulse slippery.	Wen Dan Tang