Understanding Insomnia: from Traditional Chinese Medicine to Modern Neurochemistry

Traditional Chinese Medicine Perspective

In traditional Chinese medicine (TCM), insomnia is viewed through the lens of the body’s harmony between yin and yang, the balance of internal organs, the flow of qi and blood, and the tranquility of the mind and spirit. This ancient wisdom sees sleep as a reflection of the body’s interaction with the natural rhythms of day and night: awakening with the rise of the sun and sleeping as it sets. Insomnia, according to TCM, stems from various imbalances such as anxiety, fatigue, disturbances in heart and spleen function, disharmony between yin and yang Qi, and disruptions in the flow of vital energy.

Ancient texts like the “Lingshu Dahuo Theory” and the “Book of Jingyue, Insomnia” delve into the intricate dynamics of sleep and its connection to the state of the spirit. They describe how disturbances in the body’s Qi flow, whether from external pathogens or internal deficiencies, can manifest as insomnia. For example, anxiety and fatigue weaken the spleen and heart, while emotional frustration disrupts the liver, leading to a cascade of imbalances that affect sleep.

In modern times, the fast-paced lifestyle and stressors of contemporary society exacerbate these imbalances. Studies highlight how factors like fatigue, anxiety, and dietary habits contribute to insomnia. This aligns with TCM’s perspective on the interplay between emotional state, organ function, and sleep quality.

Treatment in TCM focuses on restoring balance and harmony to the body’s energy systems. Acupuncture, a cornerstone of TCM therapy, targets specific acupoints to regulate qi flow, nourish blood, and calm the mind. Points like Sishencong and Taiyang address brain regulation and mental tranquility, while combinations of points such as Zusanli, Yinlingquan, and Taichong target spleen, liver, and kidney function to promote overall vitality and sleep quality.

By integrating TCM principles with modern understanding, practitioners aim to address the root causes of insomnia, offering holistic approaches to promote restful sleep and overall well-being.

A Neurotransmitter Perspective

Recent research has emphasized dopamine’s significance in regulating the sleep-wake cycle. Acupuncture has emerged as a treatment for insomnia by reducing dopamine synthesis and improving sleep quality. Specifically, targeting certain acupuncture points has been shown to lower dopamine and norepinephrine levels in insomnia-afflicted rats, thus enhancing their sleep.

Serotonin, another neurotransmitter, is involved in suppressing wakefulness, while increased norepinephrine activity prolongs wakefulness. Lowering norepinephrine levels speeds up serotonin accumulation in the forebrain, helping regulate sleep. Previous studies have indicated that acupuncture, particularly electrical stimulation at specific points, can regulate sleep patterns and alleviate sleep disturbances by possibly modulating serotonin and dopamine levels.

Acupuncture’s effectiveness in treating insomnia may be attributed to its influence on various neurotransmitters such as norepinephrine, melatonin, gamma-aminobutyric acid, and β-endorphin. However, due to the complexity of these interactions, further research using rigorous methodologies is necessary to fully understand the clinical and basic research evidence.


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