November 12, 2015

Chinese herbal medicine for insomnia

When insomnia rears its restless head, it can have many different faces. Traditional Chinese herbal medicine recognizes several different patterns of insomnia, and treats them according to their specificities. Here we walk you through four common types of insomnia and the herbal formulas used to address them. But broadly speaking, Chinese herbal formulas treat treat insomnia by:

  • calming the mind,
  • settling the nervous system,
  • building the resources that the body needs for deep rest and relaxation.

Insomnia due to indigestion

For many people, eating a big meal–especially rich, heavy and spicy foods–too soon before bed can undermine quality of sleep or cause insomnia. Not surprisingly, when the digestive system is very active, the body will be restless and it will be hard to fall asleep. In this case, the best remedy is fairly obvious:

  • try to avoid eating too late
  • make your last meal of the day light and avoid spicy foods.

Get me some Bao He Wan, willya?

But Chinese Medicine also has a traditional herbal formula for insomnia due to indigestion, called Bao He Wan. It is used on an “as needed” rather than an ongoing therapuetic basis:

The Bao He Wan formula:

  • Shan Zha (Crataegi Fructus) – Hawthorn Fruit
  • Shen Qu (Massa Medicata Fermentata) – Medicated Leaven
  • Lai Fu Zi (Raphani Semen) – Radish Seed
  • Chen Pi (Citri Reticulatae Pericarpium) – Aged Citrus Peel
  • Zhi Ban Xia (Pinelliae Rhizoma Preparatum) – Honey Fried Pinellia Rhizome
  • Fu Ling (Poria) – Hoelen
  • Lian Qiao (Forsythiae Fructus) – Forsythia Fruit

Although this formula is composed of digestives (like radish seed and citrus peel), there are a few herbs in here that also help the heart and calm the mind:

  • Shan Zha is a Chinese hawthorn berry which is very beneficial for circulation within the heart.
  • Fu Ling is also a heart tonic (tonic meaning something that imparts energy, strength or vitality) with sedating and tranquilizing effects. In Chinese Medicine, the heart is responsible for the mind and mental agitation, and insomnia is typically attributed to the heart.

Insomnia due to Blood Deficiency

Insomnia due to indigestion usually occurs in isolated incidents and doesn’t tend to be a chronic problem. However, there is a diagnosis pattern that links

  • digestive discomfort,
  • fatigue,
  • poor memory and
  • insomnia.

In this case, the digestive system is deficient. The result is an inability to properly digest food and produce enough healthy blood. In Chinese medicine, quality of the blood is key: memory and mental activity is closely linked to the state and quality of the blood. (For example, the more blood and nutrients available, and the better the cerebral circulation, the better the memory.) The quality of the blood is also important for the heart and mind to be able to settle into sleep. With insomnia due to blood deficiency, it may be hard to fall or stay asleep, and the cause is typically due to worry or rumination. From the Chinese herbalist’s perspective, the excessive worry is closely linked to a deficiency in the digestive system, and the traditional remedy to this type of insomnia is a formula called Gui Pi Tang.

The formula for Gui Pi Tang includes:

  • Ren Shen (Panax Ginseng) – Chinese Ginseng Root
  • Huang Qi (Astragali Radix) – Astragalus Root
  • Bai Zhu (Atractylodis macrocephalae Rhizoma) – White Atractylodes Root
  • Zhi Gan Cao (Radix Glycyrrhizae) – Licorice Root
  • Dang Gui (Angelicae Sinensis Radix) – Chinese Angelica Root
  • Long Yan Rou (Longan Arillus) – Longan Fruit
  • Suan Zao Ren (Zizyphi Spinosae Semen) – Sour Jujube Seed
  • Fu Ling (Poria) – Hoelen
  • Yuan Zhi (Polygalae Radix) – Polygala Root
  • Mu Xiang (Aucklandiae Radix) – Costus Root
  • Sheng Jiang (Zingiberis Rhizoma Recens) – Fresh Ginger Root
  • Da Zao (Jujubae Fructus) – Chinese Date

As in the previous formula, Gui Pi Tang contains a few digestives in it such as Sheng Jiang , Zhi Gan Cao, and Mu Xiang. We see Fu Ling again in this formula as it both helps digestion and nourishes the spleen and the heart. Other active ingredients in this formula that specifically calm the mind are Long Yan Rou, Suan Zao Ren, and Yuan Zhi. Blood nourishers in the formula include Long Yan Rou fruit and Suan Zao Ren (the seed of the Chinese red date). These ingredients have been widely used in Chinese herbal formulas to:

  • reduce time necessary to fall asleep,
  • help stay asleep and
  • improve sleep quality.

Finally, Yuan Zhi  is classically used to dispel brain fog and rumination and help the mind settle into sleep. Research on the active constituents of Yuan Zhi has found that it is nature’s helping hand for the stressed among us: a triterpenoid saponin from the roots, named Yuanzhi-1, shows potent antidepressant effects. Another Yuan Zhi constituent, 3,6′-disinapoyl, has been shown to:

  • block stress-induced elevations of plasma cortisol,
  • improved hippocampal-dependent learning and memory,
  • rescue stress-induced deficits in hippocampal neuronal plasticity and neurogenesis.

Insomnia due to Yin Deficiency

Insomnia due to yin deficiency is the classic case of burnout. The yin is the body’s cooling system. The yin, or yin fluids, refer to the protective lining of all body tissues and nerves–it is a measure of the proper hydration of your body tissues. If yin “runs out”, the body overheats, leading to symptoms like afternoon fever, night sweats, and insomnia.

Yin deficiency insomnia: herbs that help you cool down.

The kidneys are the body’s natural reserves of cooling fluids and are depleted after long hours of work and standing for long periods. If those fluids run low, the heat can go unchecked and rise, agitating the heart and the mind. This is a recipe for bad sleep, manifesting primarily as difficulty staying asleep and night sweats. The traditional remedy for yin deficiency-type insomnia is the formula Tian Wang Bu Xin Dan.

The formula for Tian Wang Bu Xin Dan includes:

  • Sheng Di Huang (Rhemanniae Radix) – Rhemannia Root
  • Ren Shen (Panax Ginseng) – Chinese Ginseng Root
  • Tian Men Dong (Asparagi Radix) – Asparagus Tuber
  • Mai Men Dong (Ophiopogonis Radix) – Ophiopogon Tuber
  • Dan Shen (Salviae miltiorrhizae Radix) – Salvia Root
  • Fu Ling (Poria) – Hoelen
  • Dang Gui (Angelicae Sinensis Radix) – Chinese Angelica Root
  • Xuan Shen (Scrophulariae Radix)  – Scrophularia
  • Yuan Zhi (Polygalae Radix) – Polygala Root
  • Wu Wei Zi (Schisandrae Fructus) – Schisandra Fruit
  • Bai Zi Ren (Platycladi Semen) – Biota Seed
  • Suan Zao Ren (Zizyphi Spinosae Semen) – Sour Jujube Seed
  • Jie Geng (Platycodi Radix) – Balloon Flower Root

This formula contains many herbs called yin tonics, such as Sheng Di Huang, Mai Men Dong and Tian Men Dong. These herbs replenish the body’s cooling system and fluids. We also find Xuan Shen, clears what we call ‘deficiency heat’. In other words, it helps quell the internal fire that happens as a result of the cooling system being out of order. We see some herbs from the previous formula such as Suan Zao Ren, which nourishes the blood as well as helps astringe fluids to keep the body hydrated, and Yuan Zhi which works on brain fog, calms the mind and has antidepressant properties.

Finally, Wu Wei Zi offers a host of benefits, as it:

  • is both sweet and nourishing for the blood, and sour to astringe fluids,
  • helps strengthen the kidneys and calm the mind.
  • is a dual direction herb, meaning that it can be used both to stimulate or sedate the central nervous system (CNS).

As a nervous system stimulant, it increases reflex responses and improves mental alertness. In this formula, Chinese herbalists harness its inhibitory effects on the CNS. (Based on evaluations, this CNS inhibition mechanism may be related to an effect on dopaminergic receptors.)

Insomnia due to Liver Stagnation and Heat

The final pattern of insomnia that we will explore is insomnia due to too much stress. In this situation, there will be a constant exposure to stress, which will then cause agitation in the nervous system, leading to heat in both the liver and the heart. Patients exhibit irritability, anxiety and have difficulty falling asleep.

The way that the body adapts and responds to stress is closely related to the way that qi moves through the body, so high stress would be diagnosed as qi stagnation.

What is qi? Commonly described as life force, but many now believe the ancient Chinese texts were referring to physical blood circulating in the body. Click to learn more.

In Chinese medicine, the Liver is the primary organ that works on the smooth flow of qi throughout the body, so this type of insomnia is identified as a type of liver qi stagnation. Additionally, irritability is often a sign of heat in the liver, or an agitated nervous system. Finally, anxiety is often attributed to heat in the heart and in this case there is excess heat both in the liver and the heart. The classic remedy for this situation is the formula known as Suan Zao Ren Tang.

The Suan Zao Ren Tang formula includes:

  • Suan Zao Ren (Zizyphi Spinosae Semen) – Sour Jujube Seed
  • Fu Ling (Poria) – Hoelen
  • Chuan Xiong (Chuanxiong Rhizoma) – Szechuan Lovage Root
  • Zhi Mu (Anemarrhenae Rhizoma) – Anemarrhena Root
  • Gan Cao (Radix Glycyrrhizae) – Licorice Root

In this formula, Suan Zao Ren is the key ingredient to nourish the Heart and the Liver and give the nervous system more resources to deal with stress and relax into sleep.

Chuan Xiong is traditionally used to invigorate the blood but here plays a key role in pacifying the liver and enhancing cerebral circulation. Zhi Mu is a great herb to clear the heat associated with anxiety and irritability. Fu Ling and Gan Cao are tonic herbs for the Heart.

Chuan Xiong is widely used to regulate blood flow in the body and has an active constituent called Ligustrazine which can:

  • dilate cerebral blood vessels,
  • reduce vascular resistance,
  • significantly increase blood flow to the brain and body, and
  • improve microcirculation

Chuan Xiong and other herbs that invigorate circulation are particularly helpful for patients who have trouble falling asleep because of headaches, muscle tension or jaw tension.

This simple Suan Zao Ren Tang formula also combines well with other relaxation and stress relief herbs, both Eastern and Western.

Want better sleep?

If you are:

  • having trouble falling asleep or staying asleep,
  • not feeling fully rested upon waking,
  • interested in alternatives to pharmaceutical sleep aids, then

… consider Chinese herbal medicine. Our clinic includes a full Chinese herbal pharmacy and our herbalists prepare custom herbal formulations for your particular combination of symptoms and conditions. If you still have questions about Chinese herbal medicine or our herbal consults, you can contact us or set up a complimentary 15-minute consult (in-person or by phone) to get your questions answered.

4 Comments on “Chinese herbal medicine for insomnia

February 26, 2017 at 6:47 pm

I am currently taking Suan Zao Ren Tang. Oddly I purchased this to help me fall asleep. However it helped me a lot with my circulation. My feet and hands are not as cold anymore!! I have trouble falling asleep, once I am asleep its all good. But falling asleep is another story! I take 4 tablets 3 times a day. I hope it works!! 🙁 I like to speak with you about other herbs that I should be taking. I been taking it now for a week, no help with sleep yet.

Nadia Bouhdili
March 1, 2017 at 4:13 pm

Hi Sonia! Sure thing, one of our herbalists would love to speak with you. If you would like to schedule a New Patient Herbal Medicine consult, you can do so here: . For more info on these herbal consults, visit our page here: Hope to hear from you soon!

February 25, 2018 at 7:53 am

How can one get these medicines?
I need Yin deficiency medicine urgently and how much it costs.

Jeremy Riesenfeld, M.Ac., L.Ac.
June 5, 2018 at 4:53 pm

Hi Francis, thanks for contacting us. For best results, I’d find an acupuncturist and get an in-person herb consult so they can customize the herbal formula for you. We do that here at our clinic, or if you’re not in the DC area, I’d look someone up locally.


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