Insomnia - Bu Mei
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Definition
A condition of being unable to get normal sleep: difficult to get into sleep, wake up in the middle of sleep and unable to get back to sleep, wake up too early, wake up frequently and unable to sleep at all.
Causes and Pathological Mechanisms
- Anxiety and pensiveness and overwork cause heart and spleen impairment: yin blood consumption and shortage of nutrient – Shen disturbance and irritability.
- Coordination failure between Yin and Yang: Kidney Yin Deficiency (long term illness and weak Constitution, etc) can not nourish Heart Yang resulting in heart yang exuberance (disharmony between Water and Fire); or extreme Emotions transforms into Fire. Heart Fire flares and fail to coordinate with Kidney Water (disharmony between Water and Fire); Heart Fire disturbs the Shen resulting in insomnia.
- Yin Deficient Fire leads to Liver Yang Rising disturbance: emotional disorders cause Liver Qi Stagnation and transforms into Fire; or Yin Deficiency and Yang Exuberance. Fire disturbs the Shen resulting in insomnia
- Heart Qi Deficiency and Gall Bladder Qi Deficiency: indecision and susceptibility to fright leads to a unstable Shen
- Stomach Qi disorder: Improper Diet and undigested food leads to Heat and Phlegm formation which disturbs the Shen.
Patterns
- Symptoms: Insomnia, quick temper, irritable, loss of appetite, thirst for drink, red eyes and bitter mouth, dark urine and constipation.
- Tongue: Red tongue with yellow coating
- Pulse: Wiry and Rapid
- Treatment strategy: Relieve liver stagnation and clear fire with assistance to tranquillise shen
- Formula: Long Dan Xie Gan Tang
- Acupoints:
- Symptoms: Insomnia, heavy feeling in head, stuffy chest with excessive phlegm, aversion to food, eructation, acid regurgitation, nausea, vexation and bitter mouth and blurred vision.
- Tongue: Yellow and greasy tongue coating
- Pulse: Slippery and Rapid
- Treatment strategy: Resolve phlegm and clear heat, regulate stomach and pacify shen
- Formula: Wen Dan Tang
- Acupoints:
- Symptoms: Insomnia and vexation, palpitation, dizziness, tinnitus, amnesia, lower back and knee aches, oneirogmus (wet dreams), hot feeling at 5 centers and a dry mouth.
- Tongue: Red tongue with little coating
- Pulse: Thready and Rapid
- Treatment strategy: Nourish yin to reduce fire; nourish heart to pacify shen
- Formula: Huang Lian E Jiao Tang
- Acupoints:
Heart Qi Deficiency and Spleen Qi Deficiency
- Symptoms: Insomnia with excessive dreams and waken up easily, palpitation, amnesia, dizziness, tiredness and listlessness, poor appetite and a dull complexion.
- Tongue: Pale tongue with thin coating
- Pulse: Weak and Thready
- Treatment strategy: Tonify heart and spleen to generate qi and blood
- Formula: Gui Pi Tang
- Acupoints:
Heart Qi Deficiency and Gall Bladder Qi Deficiency
- Symptoms: Insomnia or excessive dreams, susceptible to fright and waken up easily, timid, panic easily, palpitation, short of breath, tiredness, clear and excessive urination.
- Tongue: Pale tongue
- Pulse: Wiry and Thready
- Treatment strategy: Improve qi to conquer fright and pacify shen
- Formula: An Shen Ding Zhi Wan
- Acupoints:
References
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