🌙 Deep Sleep, Naturally: Your Path to Insomnia Relief

Insomnia: More Than Just Sleeplessness

Insomnia is more than just “trouble falling asleep.” It is one of the most common sleep disorders, affecting millions of people worldwide. It reflects a deeper imbalance between the body, mind, and spirit. Over time, sleep disruption can affect the cardiovascular, hormonal, and emotional systems—leading to fatigue, anxiety, brain fog, and weakened immunity.

Modern research confirms this ancient observation. Chronic insomnia is now understood as hyperarousal of the central nervous system. Over time, it represents a complex imbalance involving the brain, hormones, immune system, and stress response. Research has shown that chronic insomnia is associated with hyperactivation of the hypothalamic-pituitary-adrenal (HPA) axis, disrupted neurotransmitters such as serotonin, dopamine, and norepinephrine, increased inflammatory cytokines (IL-6, TNF-α), and even gut microbiome dysregulation. These changes elevate cortisol, suppress melatonin, and keep the body in a constant state of alert — even when the mind feels exhausted. These biological changes mirror what Traditional Chinese Medicine (TCM) has long described as “Heart Shen disturbance” and “Yin–Yang disharmony.”

In TCM, insomnia — known as bumei or shimian (不寐 / 失眠) — is seen as a signal of disharmony among the Heart, Spleen, Liver, and Kidney systems. Emotional stress, overthinking, poor diet, or constitutional weakness can weaken the Heart-Shen (spirit) and deplete Blood and Yin, allowing internal Heat, Wind, or Dampness to disturb the mind at night. These imbalances often appear as Liver–Gallbladder disharmony, Heart–Kidney misconnection, or Heart–Spleen deficiency.

Interestingly, these TCM concepts closely parallel physiological patterns. The 2024 review in the Journal of Central South University (PMC10929891) found that the six classical TCM mechanisms of insomnia correspond to measurable neurochemical and inflammatory changes observed in modern research.

By viewing insomnia through both lenses, we can see that stress, emotional strain, and lifestyle habits disrupt the same core balance — whether described as Qi, Shen, or the HPA axis. While conventional treatments often focus on symptom relief, Traditional Chinese Medicine (TCM) offers a holistic approach that addresses the root causes of disrupted sleep by restoring balance in the body’s natural energy, or Qi (氣). TCM aims to calm the mind, nourish the heart, clear heat, and gently guide the body back into its natural rhythm of rest.

🩸 Six TCM Mechanisms of Insomnia

Classical Formulas, Modern Neuroscience, and Acupuncture Integration

In Traditional Chinese Medicine (TCM), insomnia reflects an imbalance in the Heart, Liver, Spleen, Kidney, or Gallbladder systems, disturbing the harmony of Yin–Yang and the spirit (Shen, 神).

Modern studies now show that these classical TCM patterns align closely with changes in neurotransmitters (GABA, serotonin, dopamine, norepinephrine), stress hormones (cortisol), inflammatory cytokines (IL-6, TNF-α), and gut–brain signaling.

Each pattern below includes its key herbal formulas and representative acupuncture points that restore balance between body and mind.

1. Liver Qi Stagnation Transforming into Fire (肝郁化火型失眠)
Clinical signs: Irritability, vivid dreams, waking easily, chest tightness, bitter taste, constipation, red tongue with yellow coating.

Mechanism: Emotional constraint causes Liver Qi to stagnate, which transforms into Fire that disturbs the Heart and Shen.

Neurophysiology: HPA-axis hyperactivation, high IL-6, TNF-α, elevated dopamine and norepinephrine, low serotonin.

Formulas:

Long Dan Xie Gan Tang (龙胆泻肝汤) — clears Liver–Gallbladder Fire.
Key herbs: Long Dan Cao, Huang Qin, Zhi Zi, Sheng Di, Dang Gui.
→ Shown to increase 5-HT and GABA, while lowering DA, NE, and TNF-α.

Dan Zhi Xiao Yao San (丹栀逍遥散) — regulates Liver Qi, nourishes Blood, clears mild heat.
Key herbs: Chai Hu, Bai Shao, Dang Gui, Mu Dan Pi, Zhi Zi, Fu Ling.
→ Upregulates GABA and serotonin, reduces inflammation, stabilizes mood.

Acupuncture points:
LR3 (太冲 Taichong), GB34 (阳陵泉 Yanglingquan), LI4 (合谷 Hegu), HT7 (神门 Shenmen), PC6 (内关 Neiguan), Yintang (印堂 Yintang).
→ Promote Qi flow, reduce sympathetic arousal, and soothe the Shen.

 
2. Yin Deficiency with Fire Rising (阴虚火旺型失眠)
Clinical signs: Difficulty falling asleep, heat at night, night sweats, dry mouth, palpitations, and tinnitus.

Mechanism: Yin and Blood depletion fails to anchor Yang; deficient Heat agitates the spirit.

Neurophysiology: Oxidative stress and Nrf2/ARE pathway disruption, decreased melatonin, elevated stress markers.

Formulas:

Suan Zao Ren Tang (酸枣仁汤) — nourishes Liver–Heart Blood, calms the spirit.
Key herbs: Suan Zao Ren, Chuan Xiong, Zhi Mu, Fu Ling, Gan Cao.
→ Increases 5-HT and DA, promotes nitric oxide signaling, improves gut microbiota balance.

Tian Wang Bu Xin Dan (天王补心丹) — nourishes Yin, tonifies Blood, harmonizes Heart–Kidney.
Key herbs: Sheng Di Huang, Suan Zao Ren, Bai Zi Ren, Ren Shen, Dan Shen.
→ Restores GABA–glutamate balance, regulates gut–brain axis, boosts melatonin production.

Acupuncture points:
HT7 (神门 Shenmen), SP6 (三阴交 Sanyinjiao), KI3 (太溪 Taixi), Anmian (安眠), DU20 (百会 Baihui).
→ Nourish Yin, calm the Shen, lower cortical excitability.

3. Phlegm–Heat Disturbing the Heart (痰热内扰型失眠)
Clinical signs: Restless sleep, vivid dreams, heaviness, nausea, thick tongue coating, bitter taste, chest oppression.

Mechanism: Improper diet and worry damage the Spleen, producing Phlegm that transforms into Heat, blocking Heart orifices.

Neurophysiology: Overactivation of NF-κB inflammatory pathways and metabolic stress, leading to neurotransmitter imbalance.

Formula:

Huang Lian Wen Dan Tang (黄连温胆汤) — clears Phlegm-Heat, harmonizes Stomach and Gallbladder.
Key herbs: Huang Lian, Ban Xia, Zhu Ru, Chen Pi, Fu Ling, Zhi Shi, Gan Cao.
→ Lowers IL-6, TNF-α, and NF-κB, regulates GABAergic pathways, improves cognitive quieting.

Acupuncture points:
ST40 (丰隆 Fenglong), PC7 (大陵 Daling), ST36 (足三里 Zusanli), GB34 (阳陵泉 Yanglingquan), SP9 (阴陵泉 Yinlingquan).
→ Resolve Phlegm, clear Heat, regulate the Middle Jiao, and calm agitation.

4. Heart–Kidney Disharmony (心肾不交型失眠)
Clinical signs: Difficulty falling asleep, palpitations, hot flashes, dizziness, forgetfulness, or dream-disturbed sleep.

Mechanism: Yin fails to anchor Yang; Heart Fire flares upward while Kidney Water declines.

Neurophysiology: Disturbed HPA axis, disrupted BDNF/CREB pathways, altered gut–brain axis affecting melatonin.

Formulas:

Jiao Tai Wan (交泰丸) — restores communication between Heart and Kidney.
Key herbs: Huang Lian, Rou Gui.
→ Balances 5-HT and 5-HIAA ratio, regulates cortisol and BDNF expression.

Huang Lian E Jiao Tang (黄连阿胶汤) — nourishes Yin, clears Fire, calms Shen.
Key herbs: Huang Lian, Huang Qin, Bai Shao, E Jiao, Egg yolk.
→ Raises brain GABA, lowers norepinephrine and serotonin overdrive.
Kong Sheng Zhen Zhong Dan (孔圣枕中丹) — heavy tranquilizer for chronic agitation.
Key herbs: Long Gu, Gui Jia, Yuan Zhi, Shi Chang Pu.
→ Inhibits apoptosis and neuroinflammation; calms central overexcitation.

Acupuncture points:
KI3 (太溪 Taixi), HT7 (神门 Shenmen), PC6 (内关 Neiguan), BL15 (心俞 Xinshu), BL23 (肾俞 Shenshu), Anmian (安眠).
→ Connect Heart and Kidney, nourish Yin, stabilize the spirit.

5. Heart–Spleen Deficiency (心脾两虚型失眠)
Clinical signs: Fatigue, light sleep, palpitations, poor appetite, pale complexion.

Mechanism: Overthinking and worry damage Qi and Blood; the Heart lacks nourishment, leading to insomnia.

Neurophysiology: Low serotonin and melatonin, HPA overactivity, elevated inflammatory cytokines.

Formula:

Gui Pi Tang (归脾汤) — tonifies Qi and Blood, strengthens Spleen, nourishes Heart.
Key herbs: Ren Shen, Huang Qi, Dang Gui, Long Yan Rou, Suan Zao Ren, Yuan Zhi, Fu Shen.
→ Raises 5-HT, lowers DA and TNF-α, improves cortisol regulation.

Acupuncture points:
ST36 (足三里 Zusanli), SP6 (三阴交 Sanyinjiao), HT7 (神门 Shenmen), BL20 (脾俞 Pishu), BL15 (心俞 Xinshu).
→ Tonify Qi–Blood, calm the Shen, and harmonize Heart–Spleen.

6. Heart–Gallbladder Qi Deficiency (心胆气虚型失眠)
Clinical signs: Easily startled, vivid dreams, timid personality, palpitations, fatigue, spontaneous sweating.

Mechanism: Fear and overstrain deplete Heart and Gallbladder Qi; Shen becomes unsettled.

Neurophysiology: Reduced GABA and serotonin, dysregulated autonomic function.

Formula:

Shi Wei Wen Dan Tang (十味温胆汤) — strengthens Qi, calms the spirit, transforms Phlegm.
Key herbs: Ban Xia, Chen Pi, Fu Ling, Ren Shen, Suan Zao Ren, Wu Wei Zi, Yuan Zhi, Shu Di Huang.
→ Balances neurotransmitter levels, enhances parasympathetic tone, and improves anxiety-linked insomnia.

Acupuncture points:
GB40 (丘墟 Qiuxu), HT7 (神门 Shenmen), PC6 (内关 Neiguan), ST36 (足三里 Zusanli), DU24 (神庭 Shenting).
→ Boost courage and calm the mind by regulating the Gallbladder channel.

In addition to the six main patterns described above, Traditional Chinese Medicine also recognizes other causes of insomnia such as disharmony of the Stomach Qi, excess Heart Fire, and Blood Stasis obstructing the channels.

Classical formulas commonly used to address these patterns include Ban Xia Xie Xin Tang (半夏泻心汤) to harmonize the Stomach and clear internal Heat, An Shen Wan (安神丸) to settle the Heart Fire and calm the Shen, and Zhi Zi Chi Tang (栀子豉汤) to clear Heat and release irritability. These formulas exemplify TCM’s principle of restoring internal harmony so that the mind may again find peaceful rest.

💤 Integrating the Classics with Modern Care

These six insomnia types reveal how one symptom—poor sleep—can arise from six internal patterns.

By combining acupuncture, herbal therapy, and lifestyle regulation, we not only help patients fall asleep, but also restore systemic balance.

Modern neuroscience now validates what ancient physicians observed: regulating Qi and Blood also harmonizes neurotransmitters, stress hormones, and immune pathways—bridging ancient insight and modern sleep science.

🌗 Harmony Between Ancient Wisdom & Modern Science

Both Eastern and Western medicine agree: deep sleep is a sign of systemic harmony.

Through acupuncture and herbal medicine, the goal is not merely to induce sleep but to restore the body’s internal rhythm—quieting the mind, balancing hormones, soothing the nervous system, and nourishing the Heart–Kidney connection.

With consistent care—typically over a 6–10 week treatment phase—patients often notice gradual yet profound improvements: falling asleep more easily, staying asleep through the night, and waking with true restoration. 

Integrating Lifestyle Changes

Alongside acupuncture and herbal medicine, lifestyle changes are an essential part of TCM's approach to treating insomnia. Practitioners may recommend dietary adjustments, stress management techniques, and regular exercise to support overall health and well-being. These changes can help create a more conducive environment for restorative sleep.

Practicing mindfulness and meditation can also be beneficial, as these techniques help calm the mind and reduce anxiety, which are common contributors to insomnia. By incorporating these practices into daily life, individuals can enhance the effectiveness of TCM treatments and improve their sleep quality over time.

A holistic approach that combines acupuncture, herbal medicine, and lifestyle modifications can offer significant relief for those struggling with sleep disorders.

Remember, TCM is not a one-size-fits-all solution, and treatments are tailored to each individual's needs. With patience and consistency, many individuals find that TCM offers a natural and effective way to achieve lasting relief from insomnia.

Reference: https://pmc.ncbi.nlm.nih.gov/articles/PMC10929891/

Katherine Chen, L.Ac., QME, Dipl. OM
Olakino Health Center (康仁中醫), https://olakinohealthcenter.com/

870 Market Street, Ste 1248, San Francisco, CA 94102                                Call or text: 415-371-9176                                                                              Email: [email protected]