Insomnia Causes and Treatment: An age-old way to understand and treat sleeplessness: too much yang or too little yin!
July 24, 2020
Insomniatreatment? Here’s a different way to make sense of all the advice out there, to discover why some tips are better than others and so help yourself sleep well again.
Insomnia Meaning! What DO we mean by Insomnia?
Here are the accepted symptoms of insomnia:
Difficulty falling asleep even if tired
Need for sleeping pills or alcohol to fall asleep
Often waking up during the night
Unable to get back to sleep if wake up during the night
Trouble getting back to sleep when awakened
Sleep is un-refreshing, even exhausting
Waking up too early in the morning
And, associated with these:
Frequent daytime drowsiness, fatigue, or irritability
Difficulty concentrating during the day
What DON’T we mean by Insomnia?
Before we can talk about effective treatment, let’s start with what we don’t mean by insomnia!! If you can’t sleep because of an existing illness or temporary change in circumstances, then probably that needs to be sorted out first.
For example, if you can’t sleep because:
you’re excited about getting up early to start a journey
you have asthma
because your skin itches in bed
of an impending interview (eg fear or excitement)
because you’re ill with a cold or something worse
you’re suffering from jetlag, or an accident, or surgical operation, or pain, or over-exertion,
you can’t get warm
too hot from recent exercise
you’ve taken too many stimulants
Sorry! All those are excellent reasons for your sleeplessness and Chinese Medicine may be able to help them, but they’re NOT the subject of this page.
Why? Because they’re all kinds of ACUTE insomnia, short-term and not chronic.
In some cases it’s your own fault – for example you’ve drunk too much coffee!
In others, once the underlying illness is cured your sleeplessness will go, meaning that your problem is secondary to something else e.g.:
Bi-polar conditions where you veer wildly between two extremes mentally
you have a disease with symptoms that prevent sleep (eg, cough, bladder incontinence)
Chinese Medicine, Sleep Disorders and Insomnia
Willingly or otherwise, you’ve arrived on a page that explains insomnia and sleep disorders from a different point of view – that of Chinese medicine. Chinese medicine began who knows when, but there are written records going back 3000 years, with a world-view, or rather a universe-view, that modern scientists and philosophers have only recently begun to appreciate.
This way of looking at life and health continues to make a huge impression on those who have seen it in action, and it is used by people and in medical practices and large hospitals round the world.
Adaptations of it include what is called Battlefield Acupuncture, developed by the United States Army Medical Corps.
Further down this page you can read how Chinese medicine fits insomnia into its ideas about Yin and Yang.
But if you are interested in research on acupuncture and insomnia, click here.
Tiny Bit of Theory on Sleeplessness
Based on Yin and Yang, if you can’t sleep or find sleeping difficult you
either have too much of the ‘wrong’ kind of energy or
you have not enough of the ‘right’ kind of energy
There. That wasn’t too bad was it? We come back to it further down the page!
Insomnia comes in many forms. Click the links to find out more:
Imagine a hot air balloon, held down by a large bucket containing liquids and fuel. If you like, the balloon represents your mind and the bucket your body. The bucket’s contents represent your reserves of energy and the liquids in your body.
As it’s a hot air balloon, it burns the liquids to heat the air in the balloon to make it rise up.
In Chinese Medicine terms the balloon is Yang (tries to expand and rise) and the bucket and its contents Yin (tries to contract and descend). Click Yin and Yang to read more on this.
This might be after a good night’s sleep, when you emerge in a positive frame of mind and looking forward to the day ahead.
Conversely, when you are tired and want to lie down…
…after you’ve used up the reserves in the tank, the balloon is less hot and sinks downwards.
What Happens if the Bucket is too small?
When the bucket is too small, or doesn’t contain enough counterweight, just the fuel, the balloon ascends too easily because there isn’t enough to hold it down.
If your bucket is too small, possibly you are a small child or an elderly person.
In both cases, your body can’t easily ‘contain’ enough liquid so it can’t outweigh your Yang and Mind energy.
Here even a little heat is enough to raise the balloon. (Babies with small bodies can be hard to settle. Older people have shrunken bodies or depleted liquids that don’t contain enough Yin factors to keep them asleep.)
Much the same applies if there aren’t enough liquids. Perhaps:
you have a depleting illness which has reduced your reserves (Yin deficiency);
you don’t eat enough (not regenerating Yin Blood at night);
you do eat enough but you don’t absorb what you need (your body can’t absorb enough to make Blood); this could be because you don’t eat enough of the right foods with the nutrients you need, or because your digestion is poor and can’t absorb the nutrients even when they are good. It could also happen if you overeat, overloading your digestion. This category mostly comes under what is called your Spleen function.
because of a previous condition or illness the bucket still has inflammation which dries out the liquids’ (old Heat – read more under ‘pathogenic remaining factor‘)
What happens when you can’t sleep because the Balloon is too hot?
If your mind is too active, or you’re high on excitement (or drugs), or you’re too hot perhaps from dancing or exercise, then your Yang is too strong for your Yin, at least until the Yang (your Mind and your heat) has cooled down a bit.
This is not uncommon the night before a big event, a journey, a holiday or a party.
Of course, it also covers when you have a fever or when the weather is too hot.
You also see this in people who have become a bit manic. Bipolar individuals can suffer from this.
What Happens when you are sleeping Well?
As mentioned, the balloon is Yang, the bucket is Yin and so are its contents. To get to sleep and to stay sleep, you need enough Yin (an adequately-sized bucket with enough liquid), and reduced Yang (a reducing flame and hence a cooler balloon).
When you are comfortably asleep, Yang rests within Yin: your Mind rests within the body.
Then, in the morning, after a good sleep, your Yang-Mind is reinvigorated from its rest within your Yin-Body, and your Yin-Body energy is refreshed from the presence of your Yang. Up you get, feeling great!
Chinese Medicine has words to describe these ‘balloon’ analogy conditions, and if your insomnia can be recognised as being due, for instance, to ‘excess Yang‘ or ‘deficient Yin‘ then it can probably be treated. These descriptions are syndromes in Chinese medicine which has developed far beyond these basic ideas. It now includes syndromes like Energy (‘Qi‘) deficiency, Liver Blood Deficiency, Heart Blood stasis and Liver Fire to explain different kinds of insomnia and the sleep disorders we experience.
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A Flowchart of Insomnia Symptoms What kind of Insomnia have you got?
If you’re interested in how Chinese Medicine explains insomnia and effective insomnia treatment, down below is a flowchart. It covers the main basic (Chinese Medical) syndromes in insomnia and their distinguishing features.
Below the flowchart you’ll see for each syndrome the probable best insomnia treatment that you can do yourself.
Later, you’ll see what each kind of insomnia treatment is probably good for.
If your problem is in a circle with a blue background then look at the green boxes where the arrows from that circle go and see if you have any symptoms like those described.
Not all the symptoms of that particular syndrome are described in the box (the box is too small!) and you can check out a fuller picture for that syndrome by clicking on the link further down the page.
You may well have more than one syndrome! In that case, a skilled acupuncturist has to decide from your symptoms, case history, your pulse and tongue and possibly other information, which factors are the main ones. He must then choose which syndrome(s) to treat first.
The syndromes shown cover most of the situations, but not all. There are others. For example, you may wonder which insomnia treatment is best for the effects of a remaining pathogenic factor or from the consequences of previous conditions and the treatments you received. What remains is a kind of ‘Heat’ or excess Yang.
Such ‘Heat’ or excess Yang, can appear in a number of ways: thirst, restlessness, unpleasant dreams, tendency to worry (or get stressed) too much, to sleep very lightly and be easily disturbed, and a tendency to inflammation (skin, throat, bladder etc).
This Heat comes at a cost: you may be low on energy and you may get cold easily, because the Heat your body is producing isn’t going into producing energy and warmth. Instead it’s going into inflammation.
Such ‘stray’ Heat or excess Yang depletes your Yin energy, leading to the development of some of the syndromes that are mentioned, like Liver Yin deficiency, or Heart Yin deficiency.
If you’ve suffered insomnia for a long period, almost certainly more than one syndrome will be involved. Go and see an expert! (And please! Give the expert time to treat you – your health may needmore than just one treatment!)
By the way, on other pages here we talk about many of the factors and thinking behind Chinese Medicine’s approach to insomnia, what you can to do help yourself, why they might work, and when they might not.
So … Which Insomnia Treatment to Try Before You See your Doctor?
Too Much, or Not Enough?
The following syndromes have too much of the wrong kind of energy?
If you’ve had insomnia for only a few days, or even just a very few weeks, with no obvious reason for it and you aren’t aware of any change of habits that preceded its onset, you’ll probably resist the idea that making some simple changes to your life and habits will make any difference.
Causes of lack of sleep coming from the past
Perhaps you’re right! But just in case … if you aren’t aware of any possible cause for it, I suggest you get someone else to ask you questions. Ideally they would be qualified – an acupuncturist comes to mind – and able to persist and ask you searching questions about your recent life.
That may uncover something you thought was unimportant at the time such as (but this is not an all-inclusive list, just things patients have told me about themselves over the years, not realising their significance for the start of their insomnia):
a recent holiday when he got sunburned
a cold she caught returning from a holiday
an argument with someone
a physical effort that tired her more than normal
a period of intense work
diarrhoea he got after sitting on hot rocks beside the sea
a gastronomical adventure when she over-ate
a series of parties and raves he attended
worry about someone or something
taking drugs, social or otherwise
an infection he had some months earlier, followed by something similar more recently, reminding him of the original infection
commencement of her menopause
in a state of physical shock due to unusual physical activity like moving house: could not sleep despite exhaustion
From this list or from thinking about the question with someone else, you may uncover something that suggests either too much Yang or not enough Yin.
Actually, that’s not quite the end of it. You could have too much Yin as well and there are several ways this might happen.
Food Retention causing heat is like a compost heap with new-mown grass in it: it sits there and heats up. There the difference ends, because in the compost heap you want it to cook to break down the grass over a period of time so that worms will eat it and produce good earth to put back on the ground. Whereas in your gut, it smoulders away producing burping and other discomforts including insomnia as it wakes you up. So Food Retention is blocked Yin producing too much Yang.
Phlegm in your nose, sinus, throat or chest. There are various kinds of phlegm but the ones that prevent sleep are mainly those caused by Damp, Cold or Heat. For much more on this read my book Yuck! Phlegm! (Despite the lurid cover, it explains the five main types of phlegm and what works best for each type. It’s had good reviews. I hope it’s easy to read.)
First Steps in Using Yin Yang Theory in Treatment for Insomnia
If you grasped the balloon analogy above, you’ll realise that where you sleep should have Yin characteristics.
Insomnia Treatment Guidelines
a comfortable bed – big enough for you and any others to sleep without disturbing one another and for you to stretch without banging your head or your feet on the bed-ends: Yin is big enough.
a comfortable mattress: some people like firm mattresses, others prefer soft mattresses but whichever, your mattress should be flat, not concave, and thick enough to prevent you losing warmth (eg to the ground underneath), but not so insulating that you feel like you’re lying on hot coals; yin is comfortable.
reduced noise: babies can often sleep through a hurricane but adults can’t. Loud or intermittent or varying levels of noise can prevent deep sleep: not too much yang.
Some noises help you get to sleep and may help keep you there, such as the noise of rain on leaves, or of gentle sea waves. Nowadays there are sound-tracks that help your brain sink into meditative brainwave patterns similar to those in deep sleep. However, I don’t recommend these except perhaps during times of crisis. It’s easy to become dependent on them: sounds of yin, like the womb or the sea.
Other Important Factors
air that is neither too hot or too cold, and that is not too dry (dry and hot are Yang). Opinions vary on what is best but definitely a cool (Yin) room is better than a hot room. For some, a warm room that cools gradually is just right. (Open the window when you go to bed?)
an absence of invading beasts, including mosquitoes and bed bugs, that inject their pathogens and irritate your skin; no yang beasties!
darkness: although some people fear darkness, our eyes bring (Yang) light energy into our brains, and at night we want to reduce Yang, so darkness is better. If you need light to calm anxieties while getting to sleep, see if you can arrange a timer to turn it off after say 30 minutes by when you will normally be asleep. Recent research suggests that too much light during sleep induces an increase in BMI and obesity. (Why should this happen? Perhaps because over time the body reacts by creating more Yin-mass in response to the Yang of the light.)
If you are experiencing sleep disorders, before you start taking medication, do consider seeing an acupuncturist!
Copied from above, here’s a list of pages we’ve written about different aspects of insomnia: