Deficiency of heart and spleen – often seen in older people, it is easy to fall asleep, but then dreams cause disturbance, and once awakened, it is hard to get back to sleep. During the daytime, they may feel dizzy, low energy, absent-minded, fatigued. Pale complexion and tongue and a weak pulse are indicators. In these cases, the spleen, which acts as a major producer of nutrients within the body, has become overworked and is not nourishing the heart enough. In turn, the heart, which normally houses the Shen (spirit), can’t contain it. Thus, the Shen wanders, causing forgetfulness and restlessness. In these cases, the TCM doctor will work with acupuncture points and herbs to strengthen the spleen and heart and promote an increase in nutrient-rich blood and Qi.

2. Hyperactivity of fire due to yin deficiency – this presentation involves difficulty falling asleep, a sense of having been “up all night.” Patients with this pattern may also experience night sweats, hot sensations in their hands, feet, and chest, heart palpitations, ringing in the ears, and dry mouth. In this case, exhaustion of the kidneys affects the nourishment of the brain, causing the symptoms in the head and sense organs. Kidney weakness also gives rise to more fire energy in the heart and liver. TCM methods are used to cool the fire and strengthen the Yin energy.

3. Liver qi stagnation transforming into fire – difficult to fall asleep, excessive dreaming, accompanied by impatience and irritability, headache, red face, constipation, heavy feeling in chest, frequent sighing, thirst. In some cases, the TCM modality of moxibustion will be used to stimulate the liver qi and improve the quality of sleep.