How did you sleep last night? You are not alone if you have difficulty sleeping. The National Sleep Foundation* says a third of the population suffers from insomnia. Insomnia covers difficulty getting to sleep, difficulty staying asleep, and waking early. Merriam-Webster defines sleep as the natural periodic suspension of consciousness during which the powers of the body are restored. Sounds quite nice. Then there is sleep deprivation, the condition of not having enough sleep. It can be chronic or acute. Chronic sleep deprivation can cause fatigue, daytime sleepiness, clumsiness and weight loss or weight gain. (1) It adversely affects the brain and cognitive function.(2)
TCM and Sleep
Let’s look at sleep through the lens of Traditional Chinese Medicine (TCM). The concepts of Yin and Yang help to understand imbalances. Yin is all that is still, cool and solid. Yang correlates with active, warm and non-substantial. When in balance these energies mutually support each other and health is good. From the standpoint of physical temperature, we can see Yin and Yang at work in the body. If someone has More Yin than Yang there will be too much cold. This person is always wearing more clothes than most people and feels tired. The engine pistons are frozen, this car isn’t going anywhere. On the other hand, if someone has too little Yin as compared to Yang they will feel too warm. There’s no coolant in the engine. This can result in a variety of heat syndromes from hot flashes to night sweats to insomnia. In health Yin and Yang are not separate. Insomnia develops when Yang does not interact with Yin. Without the cool, calm influence of Yin, active, hot Yang disturbs the internal environment making sleep a challenge.
The ability to sleep depends on the state of the Yin and the Blood. These nourish the Heart which is the residence of the Shen (Mind). A Shen with no residence floats at night causing insomnia. Emotions can play a part in causing insomnia. For example, an emotional conflict may leave the Shen becomes too excited to settle. The following formulas settle the Shen and treat the root cause of insomnia. Matching the best formula for the symptoms will result in a good night’s sleep. All formulas are listed by their Pin Yin name when available.
Let’s Get Sleeping
Tian Wang Bu Xing Dan
Emperor of Heaven's Special Pill to Tonify the Heart It is very apt for a sleep formula to have originated from a dream as does Tian Wan Bu Xing Dan. In the physical, this dreamy formula was first used to treat exhaustion from too much thinking. One of its classic indications is for insomnia and exhaustion in people who do a lot of reading.
This is a good insomnia formula when there are outward signs of heat. Symptoms are irritability, anxiety, palpitations, insomnia with restless sleep, difficult concentration, dry stools, red tongue. In addition to feeling warm other outward heat signs include aphthous ulcers, urticaria, and chronic conjunctivitis.
This is a useful formula for patients whose sleeping pills or tranquilizers have ceased to have any effect. (3)
Cautions: Do not consume if you have a digestive weakness with loose stools, feelings of cold and fatigue or phlegm.
Serving Size: Consume according to the label on your product or as recommended by your healthcare practitioner.
Suan Zao Ren
Sour Jujube Decoction Counter to Tian Wan Bu Xing Dan this formula is for use when there are no signs of heat. Primarily made from the seeds of the jujube tree the first record of this formula is from c.220 in the Essentials of the Golden Cabinet. This is a good formula when there are no outward heat signs. As with the previous formula, symptoms include irritability and inability to sleep. The insomnia is further differentiated. Insomnia is with a clear mind and is characterized by both inability to sleep and early waking. Suan Zao Ren helps to regulate sleep. Other possible symptoms are night sweats, dizziness or vertigo, dry throat, and mouth. Other uses for this sleepy formula are elevating the pain of trigeminal neuralgia and migraines.(4)
Suan Zao Ren Tang performed well in research studies. The formula shows good results for menopausal insomniacs and patients with Chronic Hepatitis C. (5)(6)
Cautions: Use with caution if you have loose stools.
Serving Size: Consume according to the label on your product or as recommended by your healthcare practitioner.
Bu Nao Pian
Brain Tonic Pill This is a good formula when the Shen is disturbed from a deficiency of yang and blood, complicated with phlegm. The symptoms which go along with this type of insomnia are poor concentration, memory problems, sinus or lung phlegm, night sweats, agitation, constipation, excessive dreaming, nightmares, anxiety, palpitations, fatigue or mental exhaustion. (7) The tongue body is pale with a thick coating. The coating can be white or yellow. With a foundation of herbs that nourish the blood, calm the Shen, and gently tonify the Yang, Bu Nao Pian is special for clearing the phlegm that can confuse the Shen leading to insomnia.
Serving Size: Consume according to the label on your product or as recommended by your healthcare practitioner.
Caution: Contains Persian Walnut (Juglans regia seed)
Gui Pi Wan
Restore The Spleen Decoction This is for cases when the Shen is disturbed due to a deficiency of qi and blood from Spleen deficiency or digestive weakness. Gui Pi Wan is commonly used for the type of insomnia when it is difficult to fall asleep. Once sleep is achieved it is disturbed by dreams. Other symptoms include forgetfulness, anxiety, palpitations, feverishness, pallor, withdrawal, and low appetite. The tongue is pale with a thin white coating. (8) How did this happen? Obsessive or excessive deliberation injures the Spleen which makes the blood. The blood becomes deficient. The Heart is not nourished by the blood. And it’s the same sad story of the Shen being unable to settle. Although the thought of as a Spleen tonic, of the ten herbs in the formula half have calm Spirit properties, making this an excellent formula for insomnia.
Serving Size: Consume according to the label on your product or as recommended by your healthcare practitioner.
Schizandra Dreams
Schizandra Dreams is a three herb proprietary formula from Health Concerns. It combines Wu Wei Zi from the Chinese Materia Medica with extracts of California Poppy and Valerian. It primarily nourishes the Heart and calms the Shen to treat insomnia. Additional indications are agitation, anxiety, and palpitations. According to Health Concerns, this formula is effective for relieving anxiety during substance withdrawal or emotional disturbance when Western medications are also being used. Wu Wei Zi (Schizandra fruit ) helps to calm the mind and supports the Lungs and Kidneys. It is helpful for waking with breathing difficulties.(9) California Poppy ( Eschascholtzia californica) mimics sleep, the petals of this bright orange flower close at night. Although named poppy, Eschascholtzia californica is not addictive like its cousin, Papaver somniferum. It does, however, bind to the same opioid sites in the brain for calming and pain relief.(10) Hippocrates wrote about Valerian ( Valeriana officinalis ) more than 2,000 years ago. The Greek physician Galen prescribed it for insomnia. More recently a study pitted it against a placebo for sleep. Valerian had a significant effect on poor sleep. Forty-four percent reported perfect sleep and 89% reported improved sleep from the preparation. No side effects were observed(11)
Serving Size: 2 to 3 tablets, 1 hour before sleeping. For extreme cases, take an additional dose at bedtime. May also be taken during the night, if waking up frequently is part of the pattern. Highly sensitive people should start with 1 tablet per day.
Take 1 tablet as needed during the day for anxiety. (Don’t drive or operate heavy machinery.) 90 tablets, 302.5mg, 30 day supply
Contraindications: Pregnancy
*The National Sleep Foundation (NSF) is an independent, non-profit organization dedicated to improving public health and safety by achieving understanding of sleep and sleep disorders, and by supporting education, sleep-related research and advocacy.
Why can’t I find my favorite sleep supplements?
You may have noticed that your favorite sleep supplements are no longer available to purchase. That is because some sleep supplements contain an ingredient called, phenibut or 4-amino-3-phenylbutyric acid HCl. The FDA has made a decision that phenibut or 4-amino-3-phenylbutyric acid HCl in synthetic forms is now being reclassified because it does not meet the definition of a dietary ingredient and cannot be used in dietary supplements.
Some of the popular products that contain phenibut include Kavinace and Kavinace Ultra PM by NeuroScience Inc, Phenitropic, Phenitropic PM and Phenitropic Ultra PM by Biotics Research, and Gabacore by Apex Energetics. These manufacturers intend on reformulating these products and that should take two to four months.
In the meantime, we recommend the following sleep support supplements as alternatives:
Seriphos Sedalin Nardova Zizyphus 18 Melatonin
If you have any questions about this, please do not hesitate to call our clinic to speak to one of our practitioners regarding this.
Resources The Foundations of Chinese Medicine, Giovanni Maciocia, Churchill Livingstone, 1989
A Practical Dictionary of Chinese Medicine, N. Wiseman, second ed. Brookline, Massachusetts: Paradigm Publications, 1998
The Practice of Chinese Medicine, The Treatment of Diseases with Acupuncture and Chinese Herbs, Giovanni Maciocia, Churchill livingstone, 1994
References
1 Short Sleep Duration Is Associated with Reduced Leptin, Elevated Ghrelin, and Increased Body Mass Index, (research article), Shahrad Taheri, Ling Lin, Diane Austin, Terry Young, Emmanuel Mignot, Published: December 7, 2004
2 Neuropsychiatr Dis Treat. 2007 Oct; 3(5): 553–567. Sleep deprivation: Impact on cognitive performance, Paula Alhola and Päivi Polo-Kantola
3 Formulas and Strategies, Portable 2nd edition, Bensky, Scheid, Ellis, Barolet published Eastland Press Inc. page 461
4 Formulas and Strategies, Portable 2nd edition, Bensky, Scheid, Ellis, Barolet published Eastland Press Inc. page 482
5 Evidence Based Complementary Alternative Medicine. 2011; 2011: 673813. Published online 2011 May 10. doi: 10.1155/2011/673813 Suan Zao Ren Tang as an Original Treatment for Sleep Difficulty in Climacteric Women: A Prospective Clinical Observation, Chia-Hao Yeh, Christof K. Arnold, Yen-Hui Chen, and Jung-Nein Lai https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3108138/
6 Zhong Yao Cai. 2007 Nov;30(11):1482-4. [Clinical observation of modified Suan Zao Ren decoction on insomnia of chronic hepatitis B patients].[Article in Chinese], Zhang SJ, Chen ZX, Lin YW, Cheng YH, Liu SL, Wang CJ.
7 Chinese Herbal Patent Formulas, A Practical Guide, Jake Fratkin, Shya Publications, 1986, page 230
8 Formulas and Strategies, Portable 2nd edition, Bensky, Scheid, Ellis, Barolet published Eastland Press Inc. pg 353
9 Chinese Herbal Medicine Materia Medica, Revised Edition, Bensky & Gamble, Eastland Press, 1993, page 377
10 Biochemistry Research International, Volume 2015, Article ID 617620, Research Article Modulatory Effects of Eschscholzia californica Alkaloids on Recombinant GABAA Receptors Milan Fedurco, Jana Gregorová, Kristýna Šebrlová, Jana Kantorová, Ondřej Peš, Roland Baur,3 Erwin Sigel, and Eva Táborská
11 Pharmacol Biochemistry Behav. 1989 Apr;32(4):1065-6. Double blind study of a valerian preparation. Lindahl O., Lindwall L.
