Insomnia
Definition
Western
Insomnia is defined as the perception or complaint of inadequate or poor-quality sleep due to one or more of the following: difficulty in falling asleep; waking up frequently during the night with difficulty returning to sleep; waking up too early in the morning; or waking up feeling unrefreshed.
Traditional Chinese Medicine (TCM)
Insomnia is defined as a disorder such that patients could not acquire normal sleep. Mild conditions include difficulty in falling asleep, poor sleep quality, frequently waking up, and difficulty in falling asleep again once woken up. Severe conditions include sleeplessness or restlessness throughout the night.
Classifications & Symptoms in TCM
Over working of the Liver System
Patients often have dreams or nightmares during their sleep. They are impatient in the day due to lack of rest to recuperate in the night before. Some patients may also feel dizzy, tinnitus, thirsty, bitterness in mouth and pass yellow urine.
Poor Water and Blood Circulation
Patients feel anxious, tired, chest discomforts or upper abdominal distress. Some patients may also feel nausea and bitterness in the mouth cavity. They are easily frightened or have spontaneous perspiration throughout the day.
Weak Heart Functions
Patients have many dreams and can be easily woken up. Some patients may experience heart-throbbing sensation or poor memory. They get tired easily and have poor appetite. Symptoms such as feeling dizzy, experiencing abdominal distention or passing loose stools.
Poor Energy Flow
Patients have discomforts like restlessness, anxiousness, palpitation or sleeplessness. Some patients feel dizzy, tinnitus, or have soreness and weakness in the lower back and knees. They may experence hot flushes, night sweats, dry throat or frequently feeling thirsty.
Causes
Psychological Causes
For many people, insomnia is often the result of emotional disturbances, such as anxiety, stress, or depression, due to heavy workload or worries over financial or relationship problems. This disrupts the normal functions of the internal vital organs, such as the Spleen, Liver and Heart systems.
Physical Causes
People who always work overtime without getting sufficient rest may affect the normal functions of the Spleen system and vital energy which help to transport the food nutrients to the Heart System. When the Heart system is unable to sustain its normal physiological functions, it will cause insomnia. Patients who have suffered from long time illnesses or had just undergone surgeries have not fully recovered, such that they may not be able to acquire normal sleep.
Lifestyle
Poor lifestyle such as having cold drinks, eating excessive foods, consuming too much coffee or tea and smoking are also the common causes for sleep disorders.
Risk Factors
Age
Prevalence of insomnia varies considerably by age and it is the highest in both men and women of working age [1].Moreover, insomnia is a common complaint in older adults too. Insomnia may also be caused by medical illnesses, medication use and changes in homoeostatic regulations of sleep among the elderly.
Hormonal Changes
Menopause is the stage in life when a woman stops having her monthly menstrual cycle. The body stops producing the hormones such as oestrogen and progesterone. Loss of these hormones brings about various symptoms, including hot flushes and uncontrolled sweating. According to the U.S. National Sleep Foundation, approximately 40 percent of menopausal women suffer from sleep problems caused by hot flashes. Similar experience with men when they reach andropausal stage of their life.
Inheritance
People of family history of insomnia may have higher risk of this sleeping disorder [2].
Treatments
1. Lingzhi - 灵芝
|
English/ Common name
|
Ganoderma Mushroom (Lingzhi)
|
|
Latin species
|
Ganoderma lucidum (Leyss. Ex Fr.) Karst.
Ganoderma sinense Zhao, Xu et Zhang
|
|
Park of plant used
|
Whole organism
|
|
Action/s
|
Helps to relieve insomnia [3-5],palpitation and anxiety. Studies showed that it also helps to improve immunity [6] and reduces the incidence of tumours [7-8].
|
|
Precaution/s
|
It is advised to be purchased from established medicine shops.
|
2. Suan Zao Ren - 酸枣仁
|
English/ Common name
|
Suanzaoren
|
|
Latin species
|
Ziziphus jujube Mill. Var. spinosa(Bunge) Hu ex H.F. Chow.
|
|
Park of plant used
|
Seeds
|
|
Action/s
|
Helps to promote quality sleep [9-10] and reduce spontaneous perspiration and night sweats [11].
|
|
Precaution/s
|
Usually used in small quantity. Physician’s guidance is required for medical purposes before usage.
|
3. Bai He - 百合
|
English/ Common name
|
Lilium brownie
|
|
Latin species
|
Lilium brownie F.E. Brown var. viridulium Baker.
L. Pumilum DC.
|
|
Park of plant used
|
Bulb (scales)
|
|
Action/s
|
Helps to promote quality sleep [12-13] and relieve coughing [14].
|
|
Precaution/s
|
No significant side effects have been reported.
|
4. Yuan Zhi - 远志
|
English/ Common name
|
Radix Polygalae
|
|
Latin species
|
Polygala tenuifolia Willd.
Polygala sibirica L.
|
|
Park of plant used
|
Roots
|
|
Action/s
|
Helps to promote quality sleep [15-16] and relieve agitation and palpitations [17].
|
|
Precaution/s
|
Use cautiously in ulcers and gastritis conditions.
|
5. Bai Zi Ren - 柏子仁
|
English/ Common name
|
Baizrien
|
|
Latin species
|
Platycla dusorientalis (L.) Franco.
|
|
Park of plant used
|
Kernel of ripe seeds
|
|
Action/s
|
Helps to promote quality sleep [18-19] and relieve constipation [20].
|
|
Precaution/s
|
Should not be used by patients with loose stools or diarrhoea conditions.
|
6. Mai Dong - 麦冬
|
English/ Common name
|
Ophiopogon root
|
|
Latin species
|
Ophiopogon japonicas (Thunb.) Ker-Gawl.
|
|
Park of plant used
|
Root tubers
|
|
Action/s
|
Helps to promote quality sleep [21-22] and aid in the production of body fluids [23].
|
|
Precaution/s
|
No significant side effects have been reported. Consult with a qualified health care provider before consumption.
|
Test & Diagnosis
Polysomnogram
Conducted to determine the length and quality of patients’ sleep [24].
Electroencephalography (EEG)
Defines the recording of electrical activity along the scalp line [25] for the diagnosis of tumours, stroke and other focal brain disorders.
Home Remedies
Lingzhi + Suanzaoren + White fungus + Rock sugar
a) Soak the white fungus in warm water until soft
b) Put all ingredients in a cooking pot and pour enough water to fill half the pot.
c) Bring to boil for 10 minutes. Simmer for a further 30 minutes.
d) Remove from heat. Serve warm.
References
1. Naomi Breslau, Thomas Roth, Leon Rosenthal, Patricia Andreski. Sleep disturbance and psychiatric disorders: A longitudinal epidemiological study of young adults. Biological Psychiatry 1996, 39(6): pp411-418
2. Yves Dauvilliers, Charles Morin, Katerina Cervena, Bertrand Carlander, Jacques Touchon, Alain Besset, Michel Billiard. Family studies in insomnia. Psychosomatic Research 2002: pp457-458
3. S.C. Jone, J.M. Birmingham. Medicinal Benefits of the Mushroom. Advances in applied microbiology 1992 vol37: pp101-132
4. Xue-min Gao, Zhang TY, Zhang JR, Jian-shen Guo, Zheng-hua Yan, Yong-yan Wang. Science of Chinese material medica. 2002: pp457-458
5. Qing-Ping Chu, Li-En Wang, Xiang-Yu Cui, Hong-Zheng Fu, Shu-Qian Lin and Yong-He Zhang. Extract of Ganoderma lucidum potentiates pentobarbital-induced sleep via a GABAergic mechanism. Pharmacology Biochemistry and Behaviour.2007 , 86(4): pp693-698
6. Xue-min Gao, Zhang TY, Zhang JR, Jian-shen Guo, Zheng-hua Yan, Yong-yan Wang. Science of Chinese material medica. 2002: pp457-458.
7. Toshihiro Akihisa, Yuji Nakamura, Masaaki Tagata, Harukuni Tkuda, Ken Yasukawa, Emiko Uchiyama, Takashi Suzuki, Yumiko Kimura. Anti-inflammatory and Anti-tumor-promoting effects of Triterpene Acids and Sterols from the Fungus Ganoderma lucidum. Chemistry & Biodiversity 2007, 4(2): pp224-231.
8. Zhi-bin Lin, Hui-na Zhang. Anti-tumor and immunoregulatory activities of Ganoderma lucidum and its possible mechanisms. Acta Pharmacol Sin 2004, 25(11): pp1387-1395.
9. YK WING. Herbal treatment of insomnia. Hong Kong Medical Journal 2001 Dec, 7(4): pp392-402.
10. Chen CY, Chen YF, Tsai HY. What is the effective component in suanzaoren decoction for curing insomnia? Discovery by virtual screening and molecular dynamic simulation. Journal of Biomolecular Structure & dynamics 2008, 26(1): pp:57-64.
11. Natha Surinsuk, LAc. Spotlight: Suan Zao Ren. Herbal explorations 2009 Sep: pp2-4
12. Xie Yong-Biao, Xu Li-Ping, Liu Po-Zi. Quality of Life of Patient with Primary Insomnia. Chinese Mental Health Journal 2005 Jun.
13. Mao Li-jun, Lu Yan. The clinical observations of 224 cases of insomnia patients treated with Chanyeanshen capsule. Chinese Journal of New drugs 2007 Nov.
14. Z.W. Liu and L. Liu. Chapter 2: cough. Essentials of Chinese Medicines. Springer London 2009 Sep. pp:13-23.
15. Dr.Bernard Auteroche. The treatment of memory disorders by Chinese medicine. Journal Of Chinese medicine 1993 Jan No.41: pp12-16
16. Chen, Maw-shiou Jong, Yu-Chun Chen, Yen-Ying Kung, Tzeng-Ji Chen, Fun-Jou Chen and Shinn-Jang Hwang. Prescriptions of Chinese Herbal Medicnines for Insomnia in Taiwan during 2002. Oxford Journals: Evidence-17based Compl. And Alt Medicine. 2009 Apr. eCAM, doi:1093/ecam/nep018
17. Mo-Chi Cheng, Chia-Ying Li, Han-Chieh Ko, Feng-Nien Ko, Yun-Lian Lin, and Tian-Shung Wu. Antidepressant Principles of the Roots of Plygala tenuifolia. Journal of Natural Products 2006 Sep 69(9): pp1305-1309
18. L.C. Chen, B.R. Wang, Y.C. Chou, J.H. Tien. Drug utilization pattern of Chinese herbal medicines in a general hospital in Taiwan. Pharmacoepidemiology and Drug Safety 2005 Mar, 14(9): pp651-657.
19. David Wang, Charlie Xue, Noel Lim, Woei-Jia Jiang and Jennifer R Jamison. Clinical observation on Chinese herbal medicine in treatment of long-term insomnia. Chinese Journal of Integrative Medicine 2000 Jun, 6(2): pp122-126.
20. Simon A. Becker. The Chinese medical treatment of constipation. Journal of Chinese medicine 2000, 63: pp20-28.
21. Li Liu, Yun Lu, Qing Shao, Yi-YU Cheng, Hai-Bin Qu. Binary chromatographic fingerprinting for quality evaluation of Radix Ophiopogonis by high-performance liquid chromatography coupled with ultraviolet and evaporative light-scattering detectors. Journal of Separation Science 2007 Sep, 30(16): pp2628-2637.
22. Min Yang, Jianghao Sun, Zhiqiang Lu, Guangtong Chen, Shuhong Guan, Xuan Liu, Baohong Jiang, Min Ye and De-An Guo. Phytochemical analysis of traditional Chinese medicine using liquid chromatography coupled with mass spectrometry. Journal of Chromatography A. 2009 Mar, 1216(11): pp2045-2062.
23. Ming Jin, Haijiao Song and Lin Pan. An experiment of the combined treatment of traditional Lei-hou-jiu therapy with Chinese medicine for the lacrimal gland of Sjogren’s syndrome. Journal of Ocular Biology, Diseases and Informatics 2009 Sep, 2(3): pp119-126.
24. Ancoli-Israel S, Kripke DF, Mason W, Messin S. Comparisons of home sleep recordings and polysomnograms in older adults with sleep disorders. Sleep 1991 Sep 4(3): pp283-291
25. A Niedermeyer E, Lopes da Silva F. Basic Principles, Clinical Applications, and Related Fields. Electoencephalography. Publisher: Lippincot Williams and Wilkins 2005.