TCM patterns commonly found in individuals with insomnia are not unique to insomnia. For this reason, it is rather common to find in TCM that different diseases are treated with the same formula or the same set of acupoints, when the underlying pattern is similar.
Classification of Insomnia Using the Traditional Chinese Medicine System: A Systematic Review provides the list of TCM patterns for insomnia.
We have outlined some best Traditional Chinese Medical practices for the Treatment of Insomnia.
Traditional Chinese Herbal Medicine for the Treatment of Insomnia
Chinese medicinal herbs and formulas have been used in the treatment of insomnia for more than 2000 years in China. In recent decades, Chinese herbal medicine has been widely used in the Western countries. Many clinical studies including randomized controlled clinical trials and research on pharmacological action mechanisms of the herbs for treatment of insomnia have been conducted.
Based on the clinical data, several herbs were identified as most frequently used sedative and hypnotic herbs in Chinese herbal medicine including Suanzaoren (Ziziphus spinose ), Fuling (Poria cocos ), and Gancao (Glycyrrhiza uralensis). The underlying pharmacological action mechanisms discovered in the studies on some key herbs used in the treatment of insomnia were evaluated. The major pharmacological action mechanisms shared by most of the sedative herbs are to act through the neurotransmitter gamma-aminobutyric acid (GABA) or via stimulation of GABAAA receptor. Some herbs exert sedative activities via inhibition of 5-hydroxytryptamine 1A receptor. Another mechanism shown by some herbs is to upregulate the expression of orexin-A, leptin, orexin receptor-1, and leptin receptor in the brain, reducing insomnia-induced negative consequences, and thus indirectly help improvement of insomnia.
Clinical studies about the Treatment of Insomnia With Traditional Chinese Herbal Medicine showed a very wide spectrum of herbs that were used in clinical treatment of insomnia. This was due to different syndrome patterns happened with insomnia.
Chinese herbal medicine for insomnia: a systematic review of randomized controlled trials – Gui Pi Tang was the most commonly used standardized formula, while Suan Zao Ren (Ziziphus jujuba) was the most frequently used single herb.
Analysis about the Effectiveness of Chinese herbal medicine for patients with primary insomnia indicated that CHM could significantly improve the symptoms of insomnia than placebo for patients with primary insomnia.
Acupressure for Insomnia
Another form of manipulative therapy is acupressure, which is a non-invasive technique that involves stimulation of meridian or acupoints on the body using finger pressing movements. It can be administered by nursing staff, or by family members of a patient. Acupressure has been studied in a randomized design in institutionalized older adults. This study noted statistically significant improvements in both the Pittsburgh Sleep Quality Index (primary outcome measure) and number of nocturnal awakenings in the acupressure group relative to the two placebo arms (sham acupressure and conversation). This group has also studied acupressure in end-stage renal patients using a similar design, and also observed evidence of statistically significant improvements in self-reported sleep quality, sleep latency and sleep efficiency. Another study has replicated these findings.
Auricular Therapy for Insomnia
Auricular Therapy is a form of acupressure which involves applying pressure to acupoints either via the fingertips, medicinal seeds, or magnets. A 3 week randomized, single-blind placebo-controlled study using wrist-activity monitoring to provide an objective assessment of sleep parameters between magnetic auricular acupressure and two controls. They observed statistically significant improvements in sleep latency, and sleep efficiency, with an overall increase of approximately 35 min in the total sleep time.
Adverse effects were not discussed in their manuscript; however, auricular therapy is generally considered safe. A six month follow-up of this cohort was also conducted and found that insomnia symptoms remained ameliorated in the treatment group relative to the control groups.
Acupuncture for Insomnia Treatment
Acupuncture is commonly used in treating insomnia in China, and clinical studies have shown that acupuncture may have a beneficial effect on insomnia compared with Western medication.
The mechanism of acupuncture treatment for the treatment of insomnia regulates yin and yang to reinforce health and eliminate the pathogens, thus improving sleep. In modern medicine, acupuncture can increase the content of γ-amino butyric acid, and then enhance sleep quality.
Acupuncture for Treatment of Insomnia: A Systematic Review of Randomized Controlled Trials concluded that Acupuncture plus medications showed better effect than medications alone on total sleep duration. Similarly, acupuncture plus herbs was significantly better than herbs alone on increase of sleep rates. There were no serious adverse effects with related to acupuncture treatment in the included trials.