Insomnia refers to the disease marked by the constant inability to have normal sleep, or difficulty in falling sleep, even lying awake all night in severe cases. Insomnia after recovery mostly results from deficiency of yin and body fluids, or asthenia of the heart and spleen, or residual heat intermingled with phlegm disturbing the mind.
Syndrome differentiation and treatment
Asthenia of the heart and spleen
In manifests dream-disturbed sleep, light sleep, palpitation, susceptibility to fright, amnesia, light-headedness, tiredness of limbs, mental fatigue, poor appetite, lustreless complexion, pale tongue with thin fur, thready and week pulse. It is suitable to tonify the heart, strengthen the spleen, nourish blood and tranquilize the mind. The prescription used is the modified Guipi Decoction (Decoction for Invigorating the Spleen and Nourishing the Heart). In the case of the cardiac blood deficiency, add Shudihuang (Radix Rehmanniae Preaparata ), Baishaoyao (Radix Paeoniae Alba ) and Ejiao ( Colla Corii Asini ); in the case of light sleep, add Wuweizi ( Fructus Schisandrae ) , Baiziren (Semen Biotae), Hehuanhua (Flos Albiziae ) , Yejiaoteng ( Caulis et Folium Polygoni Multiflori), Longgu ( Os Draconis and Mull ( Concha Ostreae ) accordingly.
Excessive fire due to yin deficiency
In manifests dysphoria, sleeplessness, palpitation, dizziness, tinnitus, amnesia, soreness of the waist, nocturnal emission, dysphoria with feverish chest, palms and soles, dry mouth, red tongue with a little fur or cracked fur, thready and rapid pulse. It is suitable to nourish yin and remove fire, nourish the heart and tranquilize the mind. The prescription used is the modified Huanglian Ejiao Decoction (Decoction of Rhizoma Coptidis and Colla Corii Asini ), or Zhusha Anshen Bolus (Sedative Bouls of Cinnabaris). In the case of feverish and reddish complexion, vertigo, tinnitus, add Muli (Concha Ostreae), add Guiban (Plastrum Testudinis ) and Cishi ( Magnetitum ).
Residual heat intermingled with phlegm
It manifests sleeplessness, headache, heavy sensation of the head, or light sleep, profuse sputum, chest tightness, aversion to food, eructation, acid regurgitation, nausea, vexation, bitter taste, dizziness, yellowish and greasy fur, slippery and rapid pulse. It is advisable to clear away heat, resolve phlegm, regulate the middle energizer and tranquilize the mind. The prescription used is Huanglian Wendan Decoction (Decoction of Rhizoma Coptidis for Clearing away Gallbladder Heat) with additional Shanzhi (Radix Pittospori). In the case of palpitation and restlessness, add Zhenzhumu (Concha Margaritifera Uista ), Longchi ( Dens Draconis ) and Cishi (Magnetitum); in the case of stagnation of phlegm and food, incoordination between the spleen and stomach, this prescription is used in combination with Banxia Shumi Decoction (Decoction of Rhizoma Pinelliae and Husked Sorghum) with additional Shenqu (Massa Fermentata Medicinalis), Shanzha (Fructus Crataegi) and Laifuzi (Semen Raphani); in the case of residual heat disturbing the heart, use the modified Zhizi Wumei Decoction (Decoction of Fructus Gardeniae and Fructus Mume ).
Rehabilitation methods
Regulating emotions
Insomnia is a psychosomatic disease. Regulating emotions can achieve better therapeutic effects. The doctor may remove the patient's psychogenic stimulation by means of diverting his emotions, clearing up his suspicion, doing as he wishes, pleasing him and suggestion. Besides, the doctor may use hypnotherapy as well.
Recreation therapy
Recreation may regulate the mind, mould the temperament and is the effective therapy for insomnia. For instance, as far as musical therapy is concerned, the doctor can select the gentle and sweet, slow and light music.
Physical training and bathing
The patient may have the endurance training events such as running, ball games and setting-up exercises to radio music according to the differences of the patient's psychological features, musical accomplishment and personality. Besides, the patient may practice Taijiquan. When practicing it, tranquilize and concentrate the mind and seek for tranquility from activity. Practice it once or twice a day, 20 minutes each time. It is better to practice it until the body is tired before bed time.
Adopt the hot spring bath or lukewarm bath once a day, 30 minutes each time. In the case of good constitution, the patient may select the cold water bath as well. The patient with severe insomnia may take an additional bath before bed time.
Acumox and massage
Acumox: Select Shenmen (HT 7), Sanyinjiao (SP 6) and Neiguan (PC 6) in acumox. In the case of asthenia of both the heart and spleen, add Xinshu (BL 15), Pishu (BL 20) and Jueyinshu (BL 14), with the reducing method and additional moxibustion; in the case of excessive fire due to yin deficiency, add Ganshu (BL 18), Jianshi (PC 5), Taichong (LR 3) and Taixi (KI 3), with the uniform reinforcing-reducing method; in the case of residual heat intermingled with phlegm, add Feishu (BL 13), Fenglong (ST 40) and Chize (LU 5), with the uniform reinforcing-reducing method.
Massage: Mter digitally pressing Yintang (EX- HN3) for half a minute, wipe the part from the supercilliary arch to Taiyang (EX - HN 5) to and fro for five to six times; press the part around the orbit, digitally press Ermen (TE 21 ), Tinghui (GB 2) and Yifeng (TE 17), knead the anterior ear and posterior ear for three to four times and wipe the forehead for ten times; digitally press Baihui (GV 20) and knead the head for four to five times, press and grasp Fengchi (GB 20) and the bilateral Jianjing (GB 21) acupoints. In the case of asthenia of the heart and spleen, press and knead Xinshu (BL 15), Weishu (BL 21) and Ganshu (BL 18); in the case of excessive fire due to yin deficiency, horizontally rub Shenshu (BL 23) and Mingmen (GV 4) until the acupoints are completely warm before rubbing the bilateral Yongquan (KI 1) acupoints; in the case of residual heat intermingled with phlegm, press Zhongwan (CV 12), Zusanli (ST 36) and Fenglong (ST 40).
Dietary therapy
In the case of asthenia of the heart and spleen, select Suanzaoren Gruel (Gruel of Semen Ziziphi Spinosae); in the case of excessive fire due to yin deficiency, select Dihuang Zaoren Gruel (Gruel of Radix Rehmanniae and Semen Ziziphi Spinosae); in the case of residual heat intermingled with phlegm, select Baihe Xingren Gruel (Gruel of Bulbus Lilii and Semen Armeniacae Amarum ).