Insomnia Relief the TCM Way, or Why do I wake up at the same time every night?

I used to be one of those people who fell asleep easily and slept through the night with sweet dreams and woke up rested and ready to go. These days it takes forever to fall asleep and then I invariably wake up about the same time every night… 3am give or take 5 minutes. Sometimes I fall right back to sleep, other times I am tossing and turning or even just give up and read for an hour.

I’ve cut down on sugar, don’t drink coffee in the afternoons (or any caffeinated drinks), get regular exercise, and have less stress in my life than I used to have. Even so… waking at 3am to make to-do lists is getting old!

TCM theory dictates that the body’s energy, or qi, circulates through 12 meridians, which are linked to internal organs and emotions (see chart below). The heart meridian, for instance, relates to anxiety, the liver meridian to stress and anger, the spleen meridian to worry. Too much of any emotion can affect its correlating meridian, creating a disturbance in shen. “Shen is the energy of our emotional body,” explains Claudette Baker, L.Ac., president emeritus of the American Association of Oriental Medicine. “If it is affected by work or stress, it can keep us from falling asleep, prevent REM sleep, and cause us to wake easily.”

What’s Your Time?

The TCM Meridian Clock can be a great starting point for determining the cause of insomnia. To understand the clock, let’s take a quick look at the TCM Meridian System, sometimes thought of as the electrical wiring (qi or energy flow) of the body. While qi (chi) is not truly actual electrical energy, it is a good analogy for a sometimes difficult to understand concept.

There are 14 major meridians or flows of an energy substance (you may have heard of Qi/Ch’i which sustains life) with 12 of them sitting within the 24 hour clock. All are constantly flowing with energy from your environment and penetrating your body through your skin, central nervous system and organs. These portals on the skin are what acupuncture and acupressure use. Each has a two hour period where they are the primary meridian. Each meridian is linked to particular parts of the body, mechanisms of the body, other meridians, thoughts and emotions, colour, sound, seasons and other spiritual aspects. They’re also partnered together as Yin (receiving energy) and Yang (expressing energy) of an element – Earth, Metal, Water, Wood, and Fire.

Think of it like electrical circuits – when the energy of a meridian is not flowing well due to a block (like stress), you’ll find that you’ll experience a sign or symptom from the meridian(s) involved. This block will also cause an imbalance in the flows between meridians. So when waking up in the night at the same time, or becoming exhausted with 3:30-itis in the afternoon, you can look at the meridian at work and what may be happening with you.

Here’s a list of the basic emotions of each element (the ring below the meridians).
Earth – Empathy, sympathy, balanced giving and receiving
Metal – Grief and loss
Water – Fear and anxiety
Wood – Anger, frustration and resentment
Fire – Love, hate and joy

Connecting the Dots

TCM links each of the body’s meridians to an emotion. Use the following guide to help you figure out the roots of your imbalance. For an accurate diagnosis and treatment, visit a licensed TCM acupuncturist.

Meridian: Heart
Emotions: Anxiety
Insomnia Characteristics: Waking up easily; difficulty falling asleep

Meridian: Liver
Emotions: Anger, stress, frustration
Insomnia Characteristics: Difficulty falling asleep; waking between 1 a.m. and 3 a.m.

Meridian: Lungs
Emotions: Grief
Insomnia Characteristics: Waking between 3 a.m. and 5 a.m.

Meridian: Spleen
Emotions: Worry, obsessiveness.
Insomnia Characteristics: Waking at the same time every night; dream-disturbed sleep.

Chinese Patent Remedies: Non-habit forming and may be taken long term if needed.

Emperor’s Teapills or Emperor’s Heart Formula,  is a famous classical formula for disturbed shen. Of all the formulas for treating insomnia, it may be the one that is most used clinically. Use for disturbed shen causing insomnia, restlessness, palpitation, anxiety, or vivid uncomfortable dreaming. Also useful for poor memory or concentration, clouded mind, or mental fatigue. This formula doesn’t prevent you from waking, but does allow you to fall back to sleep quickly when you do wake up.

Anmien Pien is helpful for disturbed shen causing difficult sleep; insomnia, restlessness, palpitation, anxiety, and vivid uncomfortable dreaming; chronic low-level anxiety.

Shui De An Capsules are useful for insomnia and anxiety, helping you to fall asleep quickly and to sleep soundly; anxiety disorders, panic attacks and depression.

Lung Tan Xie Gan Pill | Long Dan Xie Gan Wan (Clear Liver) is best used in conjunction with Xiao Yao Wan when stress manifests in anger, frustration, and mood swings and you are waking in the 1am-3am liver time.

Xiao Yao Wan is a well known ancient Chinese herbal formula for liver Qi stagnation. Today, it is a commonly used herbal remedy for anxiety, irritability, stress, and depression.