Insomnia refers to difficulty falling asleep, waking up frequently during the night, or the inability to sleep soundly. Short-term insomnia may be caused by jet lag and stress, but chronic insomnia is usually associated with underlying psychiatric conditions such as depression, explains Choey. Other conditions include primary sleep disorders like apnoea (cessation of airflow during sleep), physical conditions like malnutrition, or emotional problems like grief.
TCM, however, also looks into the concept of ‘root and branch’. Zhong describes insomnia as the branches of a disease. The root is a dysfunction or imbalance of the fundamental substances (qi, blood, yin, yang, jing, shen), or of the major organ systems (lungs, heart, spleen, liver, kidneys).
Balekundri notes that insomnia also tends to be more common among women than men. This is partly due to the hormonal changes intrinsic to females, such as PMS, menstruation, pregnancy and menopause.
Besides problems like poor concentration and memory, irritability and impaired social interaction, there are different types of insomnia with different symptoms. “For instance, tension insomnia is common among executives who worry about work or business. Fatigue insomnia happens when she gets tired during the day and naps in the early afternoon, then cannot fall asleep at bedtime. A patient who has in-discomfort insomnia often complains of stomach upsets, toothache and arthritis that cause her to wake up during the night. In-and-out insomnia occurs when she only stayed in the first stage of light sleep and woke up frequently throughout the night,” lists Balekundri.
A TCM practitioner will also look out for symptoms that are characteristic of a particular disorder. “For example, people with the Liver Fire pattern get angry easily and show ‘heat’ signs such as a red face, dark yellow urine and dry bowel movements; people with spleen or heart deficiency tend to be forgetful, have poor concentration and appetite, tire easily, and are always worrying about something,” explains Zhong.
Western Medicine: Removing the underlying cause or precipitating factors will usually cure transient or acute insomnia. Sedative drugs may be used, but Choey cautions against long-term use. “Maintaining good sleep habits is essential; regular exercise, avoiding caffeinated beverages and alcohol in the evening, keeping to a regular sleep and awakening schedule, and going to bed with a contented stomach all help,” adds Choey.
Traditional Chinese Medicine: Different types of insomnia point to problems in different parts of the body. For example if you suffer from nightmares that keep you awake, this indicates a gall bladder meridian disorder; difficulty in falling asleep could point to an excess condition of the liver, or liver and gall.
Photo courtesy of Thinkstock. This article first appeared in NATURA magazine issue No.1. Find NATURA at Eu Yan Sang retail outlets, newsstands and major bookstores in Singapore.