Insomnia Through the Lens of Traditional Chinese Medicine

Why a restless night may be about more than simply “switching off”

Insomnia can show up as difficulty falling asleep, waking repeatedly, waking too early or waking up without feeling refreshed. In Traditional Chinese Medicine (TCM), these experiences are not treated as one identical problem. Instead, the practitioner will look for the broader pattern beneath the disturbed sleep—how the mind, body, emotions, stress, anxiety and digital habits and how they all interact. (Edinger et al., 2021).

Sleep in TCM: Settling the Shen

TCM often associates a healthy sleep with the state one’s Shen—loosely translated as the spirit or mind. When the body is well nourished and its systems are in balance, the transition into sleep is expected to be smooth. When there is deficiency, stagnation, heat or an accumulation such as phlegm or food retention, the Shen may remain unsettled and can wander at night. The result can be a busy mind, vivid dreams, light sleep, frequent waking or a sense of being “tired but wired” (Zhao et al., 2024).

Common TCM Patterns Behind Insomnia

• Heart and Spleen deficiency: Light sleep, difficulty staying asleep, fatigue, poor concentration or a tendency to overthink. This pattern is often described as a lack of nourishment for the Shen.

• Liver qi stagnation turning to heat: Irritability, frustration, tension, headaches or waking with a restless, overheated feeling. Stress may be a prominent trigger.

• Heart and Kidney disharmony: Trouble falling asleep with night sweats, a warm sensation in the palms or soles, ringing in the ears, anxiety or a sense of inner agitation.

• Phlegm-heat disturbing the Heart: Restless sleep, vivid dreams, chest or digestive discomfort, a heavy sensation, nausea or a “foggy” head.

• Food stagnation: Sleep disrupted after late, rich or heavy meals, often with bloating, reflux or abdominal discomfort.

These are some examples of underlying TCM patterns. Two people with the same sleep complaint may receive different treatment plans and herbal formulas because each person’s overall pattern—including tongue and pulse findings, appetite, temperature, menstrual history, stress and energy—is considered (Zhao et al., 2024).

Wind Down the TCM Way

Keep a regular rhythm. Try to go to bed and wake at consistent times. According to TCM going to bed before 11 PM supports the body’s overnight rhythm.
TCM body clock associates 11 PM to 1 AM with the Gallbladder and bile renewal; during this time, the Gallbladder is also believed to support courage and decisiveness, helping you navigate the day ahead more effectively (Xiang Jun, 2020).

While 1 AM to 3 AM is linked with the Liver, its ability to detox the body, support the smooth flow of qi and blood, emotional balance and the body’s natural renewal

1. Make dinner lighter and earlier. Allow time to digest before lying down, particularly if bloating, reflux or restless sleep follows heavy meals.

2. Create a gentle transition. Dim the lights and put away phones, computers and tablets at least an hour before bed to help your mind slow down and unwind. Avoid shows or content that frighten you or leave you feeling anxious or worried.

3. Settle the body first. Try some deep breathing techniques, a warm shower, gentle stretching, meditation, or even listening to relaxing music, The aim is not to force sleep, but to reduce arousal (Yeo et al., 2022).

4. Empty the mind onto paper. Write down tomorrow’s tasks or recurring worries, then leave the list outside the bedroom.

5. Notice stimulants. Caffeine, nicotine and alcohol can all disrupt sleep. Track timing and effects rather than assuming they are harmless (Edinger et al., 2021).

How can TCM help?

A qualified TCM practitioner may use acupuncture, lifestyle guidance, dietary therapy, breathing or movement practices, Chinese herbal medicine. Treatment is usually tailored to the individual pattern rather than offered as a single standard remedy. Recent reviews suggest that acupuncture and other complementary therapies may improve sleep quality, regularity and duration (Lu et al., 2022; Yeo et al., 2022; Zhao et al., 2024). 

Considerations:

Consult your GP if sleep problems persist, affect daytime functioning, or occur with concerning symptoms such as loud snoring, pauses in breathing—which may indicate sleep apnoea—significant mood changes, pain or restless legs. If you are considering acupuncture or Chinese herbal medicine, consult a suitably qualified TCM practitioner and herbal dispenser who is experienced in tailoring formulas to individual needs. Herbal medicines can interact with other medications, may be unsuitable during pregnancy or for certain health conditions (Li et al., 2025; Zhao et al., 2024). This is why it important to tell your TCM practitioner about every medicine and supplement you take, to avoid any adverse effects.

Key Takeaway

From a TCM perspective, insomnia is a signal to look at the whole pattern rather than chase sleep in isolation. A calmer evening rhythm, supportive daily habits and individualised care may help create the conditions in which sleep can return. The goal is not a perfect night on command, but a more settled relationship between daytime activity, nighttime rest and overall wellbeing (Zhao et al., 2024).
So, if insomnia is an ongoing concern or is affecting your daily life, don’t struggle through it or simply put up with it. Contact us to book an appointment and discuss how we can support you.

References

• Edinger, J. D., Arnedt, J. T., Bertisch, S. M., Carney, C. E., Harrington, J. J., Lichstein, K. L., … Martin, J. L. (2021). Behavioral and psychological treatments for chronic insomnia disorder in adults: An American Academy of Sleep Medicine systematic review, meta-analysis, and GRADE assessment. Journal of Clinical Sleep Medicine, 17(2), 263–298. https://doi.org/10.5664/jcsm.8988

• Li, W., Wang, Q., Dang, C., Xiong, Y., & Lu, Y. (2025). Chinese herbal medicine for insomnia: A systematic review and network meta-analysis. Medicine, 104(33), e43789. https://doi.org/10.1097/MD.0000000000043789

• Lu, Y., Zhu, H., Wang, Q., Tian, C., Lai, H., Hou, L., … Ge, L. (2022). Comparative effectiveness of multiple acupuncture therapies for primary insomnia: A systematic review and network meta-analysis of randomized trials. Sleep Medicine, 93, 39–48. https://doi.org/10.1016/j.sleep.2022.03.012

• Xiang Jun. (2020, July 5). TCM basics 101: TCM body clock—Gall Bladder 11pm to 1am. Retrieved from https://www.drxiangjun.com/blog/tcm-body-clock-gall-bladder-11pm-1am

• Yeo, J. J., Lee, J. W., Kim, K. S., & Hyun, M. K. (2022). Effectiveness of acupuncture, mind and body practices, and natural products for insomnia: An overview of systematic reviews. Journal of Pharmacopuncture, 25(3), 186–198. https://doi.org/10.3831/KPI.2022.25.3.186

• Zhao, F.-Y., Spencer, S. J., Kennedy, G. A., Zheng, Z., Conduit, R., Zhang, W.-J., … Ho, Y.-S. (2024). Acupuncture for primary insomnia: Effectiveness, safety, mechanisms and recommendations for clinical practice. Sleep Medicine Reviews, 74, 101892. https://doi.org/10.1016/j.smrv.2023.101892