Introduction
Insomnia refers to inability to have normal sleep, marked by difficulty to sleep, or easiness to wake up, or inability to sleep after waking up, or shallow sleep, keeping awake all night. Insomnia often occurs together with headache, dizziness, palpitation and amnesia. It is usually caused by anxiety, overstrain, emotional upsets, weakness and prolonged duration of illness as well as improper diet that lead to dysfunction of the heart, liver, spleen and kidney as well as insufficiency of blood. Insomnia is mainly seen in neurosis in modern medicine.
Syndrome Differentiation
1. Exuberance of Fire in the Heart and Liver
Dreaminess and easiness to wake up, dysphoria and susceptibility to rage, dizziness, distension or pain in the head, distending pain in the chest, bitter taste in the mouth, thirst, yellow urine and dry feces, red tongue with yellow fur, taut and rapid pulse.
2. Phlegm-heat Disturbing Heart
Dysphoria and insomnia, dizziness and heaviness of the head, fullness, oppression or pain in the chest and epigastrium, or vomiting of thick phlegm, bitter taste and sticky sensation in the mouth, red tongue with yellow and greasy fur, slippery and rapid pulse.
3. Qi Stagnation and Blood Stasis
Prolonged insomnia, mental depression, oppression and pain in the chest, belching, grayish complexion, purplish tongue and unsmooth pulse.
4. Asthenia of Both Heart and Spleen
Difficulty to sleep, dreaminess and easiness to wake up, palpitation and amnesia, spiritual lassitude and fatigue, anorexia, pale complexion, light-colored tongue with thin fur, thin and weak pulse.
5. Disharmony Between Heart and Kidney
Dyphoria and insomnia, dizziness and tinnitus, feverish sensation in the palms, soles and chest, dry mouth with scanty fluid, aching and weakness of loins and knees, or palpitation, amnesia, seminal emission, red tongue, thin and rapid pulse.
Treatment
1. Body Acupuncture
Prescription: Shenmen (HT 7) and Sanyinjiao (SP 6).
Modification: For exuberance of heart and liver fire: Fengchi (GB 20), Jianshi (PC 5), Laogong (PC 8) and Xingjian (LR 2) are added; for phlegm-fire disturbing the heart, Fengchi (GB 20), Neiguan (PC 6), Zusanli (ST 36), Fenglong (ST 40) and Lidui (ST 45) are added; for qi stagnation and blood stasis, Geshu (BL 17), Jueyinshu (BL 14), Neiguan (PC 6) and Taichong (LR 3) are added; for asthenia of both the heart and spleen, Baihui (GV 20), Xinshu (BL 15), Pishu (BL 20) and Zusanli (ST 36) are added; for disharmony between the heart and kidney, Xinshu (BL 15), Shenshu (BL 23) and Taixi (KI 3) are added.
Performance: Each time 3-5 acupoints are selected. For exuberant liver-fire and heart-fire, phlegm-heat attacking the heart, qi stagnation and blood stasis, reducing techniques are used; for asthenia of both the heart and the spleen, reinforcing techniques should be used with moxibustion applied to Back-Shu acupoints; for disharmony between the heart and the kidney, twirling-rotating techniques for reducing purpose are used for needling Shenmen (HT 7), reinforcing techniques are used for needling other acupoints.
2. Ear Acupuncture
Prescription:
Ear Shenmen (TF4), Heart (CO15), Kidney (CO10), Spleen (CO13) and Subcortex (AT4).
Performance:
Each time 2 - 3 points are selected and needled with moderate stimulation and retained for 20 minutes. On Wangbuliuxingzi (Semen Vaccariae) is used for ear-point pressing and pressed 2 - 3 minutes before sleep.