Sleep & TCM

Jim Karlsson is an acupuncturist and herbalist, and owner of Restful Technologies. He will be contributing to the Artís Health & Wellness blog, focusing on how to treat sleep disorders with Traditional Chinese Medicine. Sleep well!


Good Morning!

I'd like to talk about how Traditional Chinese Medicine (TCM) can help you sleep soundly and regain your vitality.

As Dr. Andrea Young wrote about in a previous post Self-Care Strategy #2: Sleep (which I highly recommend you read before continuing here), poor sleep and daytime fatigue can affect you negatively both physically and mentally. If you want to feel and function optimally, in addition to getting a good restful night’s sleep, you also need to nourish your body with healthy foods, drink enough water, exercise regularly, do some stretching, and establish some form of mindfulness practice.

In TCM, insomnia is categorized broadly into three different types depending on the time of night, and each stage manifest with different symptoms:

First Stage: allows the body to relax and any disturbance during this stage causes difficulty falling asleep.

Second Stage: manifests by too light sleep and difficulty staying asleep.

Third Stage: is characterized by waking up early and inability to fall back asleep.


When sleeping, the main factor is not just the length of sleep, but rather how you feel after waking up. Has sleep been restful for the body and revitalizing for the mind? If you are tired when you wake, this is considered in TCM to be insomnia, even if you slept for 12 hours!

According to TCM theory, insomnia is not a disease but a symptom. Any pattern that produces an excess or deficiency can result in disturbed sleep. Emotions that affect your mood may also disturb sleep or dreams. The following are all considered during your health assessment so that the correct diagnosis can be made.

  • State of the bodily substances

  • State of mind and emotions

  • Movement of energy in the body

A diagnosis is made by asking you questions about your overall state of health, any unusual or uncomfortable symptoms and feelings, a physical exam, and by taking your pulse and examining your tongue. All of these things are important diagnostic tools in TCM.

From a TCM perspective, there are many ways to diagnose and treat insomnia; acupuncture, cupping, herbal formulas and diet modifications are commonly and effectively used.


Acupuncture for Insomnia

The same acupuncture points that can be needled to interact with the central nervous system to reduce pain, also participate in the regulation of sleep-wake cycles.

Acupuncture can induce brainwave patterns associated with relaxation and drowsiness (alpha waves) on its own, but when combined with light electrical stimulation of the needles, it can further help to promote REM sleep. Compared to the use of medications to help induce sleep, which act primarily on the central nervous system, acupuncture is able to help induce sleep by affecting both the central and peripheral nervous systems. Once your muscles are relaxed via the acupuncture effects on the peripheral nervous system, the central nervous system will follow suit.

Acupuncture can be safely combined with conventional medical treatments for insomnia, such as benzodiazepines, helping to reduce their side effects and enhance their beneficial effects.


Herbal Formulas

Chinese herbal formulas are often taken to reinforce acupuncture treatments, help with relaxation, or build strength and vitality. The herbs in a formula work together to achieve a general nourishing or regulating effect to a deficient, imbalanced or hyperactive system, making it shift to a more quiet state in preparation for sleep.

Whereas Western medicine strives to isolate active chemicals, Traditional Chinese Medicine employs whole plants. By using the whole organism of a plant, it delivers an orchestrated system of chemicals evolved to work together: active ingredients, chemicals that balance side effects, and compounds that manage secondary symptoms.

In most cases, herbs are safe to take with pharmaceutical medications and your practitioner should always ask you for a full list of prescribed and over-the-counter pharmaceuticals, supplements, etc. to avoid any possible interactions.


Essential Oils

Studies have indicated that various essential oils, such as lavender, lemon and bergamot can help to relieve stress, anxiety, depression and other mood disorders. Inhalation of essential oils can communicate signals to the olfactory system and stimulate the brain to exert neurotransmitters (e.g. serotonin and dopamine) thereby regulating mood.

Before the acupuncture treatment begins, I like to apply a drop of essential oil to the patient’s forehead and gently massage it in. The soothing aroma will help relax the body and mind, setting the stage for a good night’s sleep after the treatment.


Cupping for Insomnia

The suction and negative pressure provided by cupping can help loosen muscles, encourage blood flow, and calm the nervous system. Cupping is commonly used to relieve back and neck pains, stiff muscles, anxiety, fatigue and headaches. It often provides a pleasant, calming experience that is conducive to sleep.


A Restful Diet

When there is restlessness or agitation causing you to have difficulty falling asleep, you should avoid stimulating foods and drinks such as alcohol, coffee, too much meat, spicy and oily foods.

The primary vitamins and minerals that aid in promoting sleep are: tryptophan, magnesium, calcium, and vitamin B6. They assist the body in produce melatonin, the hormone responsible for regulating sleep/wake cycles.

The following foods are a great source of these vitamins and minerals: dairy, nuts & seeds, poultry, legumes, dark leafy greens, wheat and avocados. If you feel hungry before bed, how about a whole grain wheat toast with avocado, sprinkled with sunflower seeds and topped off with some shredded dandelion greens. I would recommend enjoying it with a glass of almond milk or chamomile tea.


Simple Relaxation Exercise

When you lie down in bed, it takes a while for your mind, body and breathing to settle. For some, a constant focus on these tensions can become a cause for insomnia in itself. In these cases it can be helpful to practice some form of mindful relaxation exercise. In the 3rd century, the Taoist physician Ge Hong proposed a set of exercises to treat insomnia that you can practice at home.

  1. Lie in a supine position with the knees bent. Use the hands to pull the knees towards the chest, breathing normally. Hold the position for one minute, then straighten the legs, relax the arms and bring them to the sides.

  2. Still in a supine position, both arms are stretched up and above the head while inhaling. While exhaling, bring the hands down to the chest and massage yourself from your chest to your abdomen. Then relax the arms and hands and bring them back to the sides. Repeat several times.

  3. Still in the same position, make the hands into fists and place them under your back, one fist on each side of the spine, as high as possible toward the shoulder blades. Take three deep breaths and then move the fists a few inches down and repeat the deep breathing until you reach waist-level. Take five deep breaths here. The fists are then moved to the side of the tailbone and take five more deep breaths.

  4. Turn over, lying face down and place the hands under the belly. Inhale and exhale slowly, pausing after each exhalation. Relax all muscles and let go of all mental and emotional tension. Repeat several times.


The “Sleeping Deer” Posture

If you assume this position when going to bed, it will help to relax your body. In the beginning it may feel uncomfortable, but try to begin your sleep in this posture and don’t worry if you end up sleeping in a different position. Your body will slowly adjust to its needs and naturally assume the most comfortable position by itself.

  1. Lying on the right side, bend the right arm at the elbow, with the palm facing up, in front of the face.

  2. The left arm rests on the left hip, with the hand hanging in front of the abdomen.

  3. The right leg is straight and the left leg is bent, resting on the bed in front of the right thigh.


I hope this gives you a better understanding of some of the ways insomnia is treated with Traditional Chinese Medicine. If you have any questions or would like to schedule an appointment, please visit


Restfully yours!

Jim KarlssonComment