Everyone has their physiological Achilles heel - that which first acts up when they’re either under nourished, over stressed, or for some of us when it’s just that time of the year when our vulnerabilities expose themselves. One of my greatest challenges in adulthood in this respect has been insomnia, which wouldn’t you know it, is one of the more challenging pathologies to treat with Chinese Medicine (or any medicine) of course. Though that doesn’t mean we have nothing to say about it.
From a “TCM 101” perspective sleep has to do with the body’s blood and yin (as opposed to yang), our cooling, moistening and grounding mechanism, appropriately. One “pattern” of insomnia is when a person has an insufficiency of blood nourishing their heart, which might present with other symptoms such as heart palpitations, forgetfulness, anxiety or even foggy-headedness. Usually “heart blood deficient” people can fall asleep just fine; they have more trouble staying asleep.
Another pattern is an insufficiency of yin, which typically exhibits with trouble falling asleep in the first place. These people are often prone to symptoms of dryness: Dry skin or eyes, dry mouth or nasal passages. Yin deficient people also tend towards manic behavior and/or anxiety. They’re usually relatively thin in physique and super fun to be around while in good spirits – maybe especially difficult while in bad.
Some of the ways we exhaust our yin is over-work, over-stimulation, going to bed too late, stimulants such as caffeine, alcohol and tobacco, excessive TV-watching, excessive sexual activity, and basically anything that is go-go-go, up to and including eating our food too fast. In summary: everything American.
“Yin insufficiency” is probably most common in our country, even more so in New York City where go-go-go is the baseline M.O. and people fear rest. Rest in most New Yorkers minds equals unproductivity, which equals falling behind, which equals occupational lag, which equals failure, then homelessness, illness and death. Surely even accessing this mental continuum has exhausted my own yin at least ever so slightly.
There are other less common “patterns” that can disrupt our sleep:
“Food stagnation” usually comes from eating either too large and/or too late of a dinner. The undigested food left stirring in the gut creates heat in the body that raises its temperature just enough to create just enough discomfort to interrupt our rest.
“Qi stagnation” is another way of saying stress in Chinese Medicine. While stressed neither our energy, nor fluids flow smoothly, and without healthy circulation all mechanisms are susceptible to disruption. This pattern is a classic example of one where we could prescribe herbs to help someone briefly, but ultimately they must learn ways to de-stress themselves.
“Wei Qi disharmony” has to do with the cycle of our body’s immune system, where if its energy is unable to pass through the more particularly deep levels of our physiology, we get disturbed and wake up. This pattern is more rare and complex, also more challenging to explain in lay terms.
There are other patterns and herbal formulas to address these patterns, but in most cases I find peoples’ habits and lifestyle modifications to be most beneficial towards improving sleep. Some of the changes that have helped me most are as follows:
Bedtime is 10pm. If I can do it anyone can. As a struggling artist who worked nights, for years my bedtime was 4am. That was actually when my insomnia began, coincidentally I’m sure. Eventually I pulled my turn-in time back to 2am, then a year later to 1, and slowly but surely I got to where I’m at now: an old man, brushing my teeth at 9:30… and it’s the best I’ve felt in years! Just like 12:00 noon is “high noon,” which means the height of yang energy, 12 midnight is the height of yin. If we are not doing the most yin thing in the world at that time, we run risk of losing it. What is the most yin thing in the world? Unconsciousness in a dark, quiet, relatively cool room. Really we should go one better and be in bed before 11pm, as 11 is the beginning of gallbladder time in Chinese Medicine’s circadian rhythm. 11-1am corresponds to the gallbladder and 1am-3 the liver. 3-5am corresponds to the lungs, which is why this is the time people with nagging coughs tend to wake up and cough hardest. The gallbladder and liver are the organs of the wood element, which if left unnourished is prone to stress and tension. Supposedly a great way to nourish our wood is through appropriate rest.
Believe it or not, there are a few things that Western and Eastern Medicine agree on, and one of them is that we should abstain from consuming calories at night. Ideally we should not consume anything within 3-4 hours of going to sleep, but if that’s not possible we should at least aim for two. Scientific studies show that the metabolism begins weakening after 7pm, which means the more we eat after that time, the more likely it is to sit in our stomachs. I’ve definitely noticed that cutting off my calorie consumption by 8pm at latest has helped. When I crave a fix I simply have sparkling water or tea. If that’s too boring you should maybe try growing up.
Drink your morning coffee, not too late, but not too early either! Supposedly the sweet spot at which to drink our caffeine is between 10-11am, or at least two hours after waking up. Those of us who B-line it to the source of caffeine the second we open our eyes (myself, pre-enlightenment) are over-activating our adrenal glands, thereby taxing our adrenal glands, which we’re going to need to tap into later in the evening to help us wind down (and stay down). In Chinese Medicine our adrenals correspond almost directly with the yin, so one should fairly easily understand why stimulating them the moment we gain consciousness might not be the best idea. Obviously, by the same token, caffeine has a 12-hour half-life, so consuming any of it after noon is never ideal. If you get really tired in the afternoon I’d recommend reexamining what you’re eating for lunch, or taking a 15-minute siesta in the break room. Siesta naps are not commonly practiced in the western world, and that fact alone should convince any intelligent person that they’re probably a really healthy practice.
If none of these help you should try herbs… or acupuncture. Every condition has the potential to negatively snowball in our bodies, and insomnia is probably the most obvious example of this. Without ample rest, forced to still go about our days of rest and responsibilities we’re forced to find the energy somewhere, which is by tapping into our cellular reserves, or in Chinese Medicine, our kidneys/adrenals. This is the equivalent of having a bad left knee and compensating with our right side, until eventually we have a bad left knee and bad right hip. Over time less than an average of seven hours sleep per night will cause illness, thus should be immediately and persistently addressed.