Insomnia is extraordinarily common in Western society, affecting as much as 30% of the population, with 12% having moderate to severe sleep disturbance (Soldatos, 1994).  Sleep disturbances are linked with heart disease, and can predict heart events (Schwartz et. al., 1999).  Psychological problems account for a large amount of sleep disturbances (Soldatos, 1994), and vice-versa.  Insomnia and sleep disturbance is pervasive among the elderly, and though I disagree, is considered to be normal (Gottlieb, 1990).  The total direct cost for insomnia in the United States in 1995 was estimated to be $13.9 billion (Walsh and Engelhardt, 1999).

Prescription medications account for a large amount of sleep disturbances, as insomnia is a side effect of many drugs.  I have meet many patients whose sleep has improved dramatically as a result of simply weaning off unnecessary medications, and replacing them with healthy diet and lifestyle changes.  A woman called me once and told me that she had stopped taking five prescription medications and replaced them with a multi-vitamin and vitamin E.  Most of her symptoms disappeared, and her sleep returned to normal.

It is very difficult for patients to recover from illness unless they get enough good quality sleep.  Insomnia can be caused by many factors, and you must dig deeper to identify the underlying causes if the methods outlined here do not produce results within a few days.  Sleep apnea, for example, should also be ruled out as a cause.  I have also seen many patients recover from insomnia after they cleaned up their diet and lifestyle.

Treatment Tips

•  Any of the herbs found in the nervine group can be of use.  For simple insomnia, I often mix tinctures of valerian root, passionflower and scullcap.  Dr. Duke points out that it is not single elements like valepotriates that cause the effect of valerian, but the synergy of the different parts working together (Duke, 1997).

•  Simple chamomile tea may prove sufficient in mild cases.

• Kava root is a simple traditional remedy for insomnia, as is lemon balm tea (Melissa officinalis)

• Regular exercise can improve sleep, as can liver detoxification routines.

• Nai-shing says that the premier TCM herb for insomnia is sour date seed (Ziziphus spinosa / suan zao ren).  Second is schisandra berries.

• Hypoglycemia is often a hidden cause of insomnia. Treatment of blood sugar imbalances can solve this problem.

•  Insomnia is often caused by circadian cycle disturbances.  In this case, exposure to bright light at appropriate times can help realign the circadian rhythm (Rajput and Bromley, 1999).

• Restless leg syndrome can be a cause of insomnia.  TCM doctors see this as wind resulting from a failure of the blood to nourish the muscles.  They treat it with a combination of dang gui, chaenomelis fruit, white peony root, millettia root, tortoise shell (gui ban) and siler root (fang feng / Ledebouriella species).  Folic acid (35-60 mg per day) has also been found useful for this condition (Botes, 1976).  Lentils contain high levels of this nutrient.

•  Rauwolfia root can be used under the supervision of a qualified herbalist for short-term relief of insomnia as long as you follow appropriate cautions.  I have often added it to tinctures to increase the effects of other calming herbs.

• In patients with depression and insomnia, the blood-brain barrier (BBB), which filters molecules coming into cerebral circulation, seems to block uptake of 5-HTP (5-Hydroxy L-Tryptophan), the precursor chemical for the natural relaxant serotonin (Agren et. al., 1991).  The seed of the African plant Griffonia simplicifolia, now found in health food stores, can be used to correct this and induce sleep because it contains high amounts of 5-HTP in a lipid-soluble form that is better able to cross the BBB.

• As always, Yoga, T'ai Chi and meditation are recommended.