In my last Planetary Herbalism column [October], I discussed important TCM formulas for boosting the immune system response via targeting qi and blood deficiency. In this installment, let's address the incredibly important role of sleep for vibrant immunity and overall health.
TCM offers a wide array of clinical options for patients suffering from insomnia, which I have discussed often in this column. This time, let's focus on a key underlying pattern of disharmony that is often neglected; and two formulas that can effectively target this issue to help patients experience deep, restorative sleep.
Liver Depression Qi Stagnation: A Silent Underlying Factor
When encountering the issue of poor sleep quality in the clinic, a diverse landscape of patterns of disharmony can be present. Yet in almost all cases, regardless of the overall pattern presentation, liver depression qi stagnation is a silent underlying factor. This is not hard to understand, as patients suffering from poor-quality sleep become extremely frustrated – no one enjoys suffering from insomnia.
This frustration can add liver depression qi stagnation to any more obvious pattern of disharmony the patient experiences. Therefore, it is critically important to add an herbal formula that targets liver depression qi stagnation in conjunction with the primary formula targeting the overall pattern of disharmony.
Three TCM Formulas That Help Treat Sleep Disturbances
For this short article, let's focus on the use of the TCM formulas Suan Zao Ren Tang, Chai Hu Shu Gan Wan, and Yi Guan Jian in treating sleep disturbances. The famous formula Suan Zao Ren Tang calms the shen, nourishes heart and liver / yin, clears deficient heat, and invigorates blood. These actions make this formula extremely effective for patients suffering from poor sleep due to potential blood / yin deficiency, disturbed shen, deficient heat, and blood stasis.
Suan Zao Ren Tang is a key medicinal because it is an oily seed, which moistens dryness and nourishes blood / yin of both the heart and the liver. These actions are important when keeping the concept of liver depression qi stagnation in mind. Frustration with poor sleep can inhibit the function of the smooth flow of liver qi, and over time causes both heat and dryness. Suan Zao Ren targets both issues efficiently. This makes Suan Zao Ren Tang an effective formula for poor sleep quality due to any life issue that depletes blood / yin, or causes heat or blood stagnation.
If the sleep issue is chronic, it becomes important to factor in the issue of liver depression qi stagnation. Two key formulas I use in conjunction with Suan Zao Ren Tang in patients who fit this pattern are Chai Hu Shu Gan Wan and Yi Guan Jian.
Chai Hu Shu Gan Wan is an expansion of Zhong Zhong-Jing's Si Ni San and has the actions of soothing the liver, coursing the qi, invigorating blood, harmonizing the spleen / liver, and stopping pain. These actions work in close harmony with the actions of Suan Zao Ren Tang.
I often use Chai Hu Shu Gan Wan in harmony with Suan Zao Ren Tang for patients who suffer from chronic sleep issues; as well as chronic digestive issues, chronic emotional challenges, and premenstrual syndrome. This two-formula combination effectively targets many pattern disharmonies, and can easily be combined either in extract or patent medicine form.
If the patient presenting with sleep disturbances shows more severe signs of yin deficiency, I combine Suan Zao Ren Tang with Yi Guan Jian – this formulanourishes liver yin / blood, soothes liver qi, moistens the tendons, and supports kidney yin. If combined with Suan Zao Ren Tang, the patterns of heart / liver / kidney yin deficiency with liver depression qi stagnation are effectively addressed; and potential deficiency heat and blood stasis are also treated. This particular formula combination is extremely effective for patients suffering from long-term insomnia who also suffer from chronic pain and chronic emotional disturbances.
Any long-standing disorder depletes yin reserves of the body, and this leads to more severe disorders and lingering, hard-to-diagnose symptoms. This formula combination is also effective for patterns of insomnia which show significant signs of blood stasis, as the combination unites Dang Gui and Chuan Xiong. This herbal duo is the key two-herb combo for treating blood stasis throughout the body.
Clinical Takeaway
I hope this discussion inspires you to always search for the underlying patterns that may be found in cases of sleep disturbances. Chronic poor sleep can deeply drain the immune reserves and vitality, but TCM formulas have the potential to not only improve sleep quality, but also deeply nourish and regenerate.
Deep, restorative sleep is vitally important for a hearty immune system and a calm, balanced state of mind, so always ask patients about their sleep patterns. A good night's sleep is powerful medicine for both the mind and body; TCM formulas provide tremendous support for patients in need.
As modern medical standardization continues, the field of traditional Chinese medicine has the advantage of comprehensive personalization. For rare or complex cases, deeper consideration of constitution is invaluable. Proper constitutional assessment, especially with first-time clients, can guide desirable and predictable outcomes. This leads to a higher rate of return, and greater trust between you and your patient.
Though the creation of a financially sustainable, health-promoting model feels far away today, we are casting a vision for a full return on health, believing that this compels us to keep one foot firmly rooted in caring for the sick and the other foot firmly founded in maintaining health. Shifting from a fee-for-service model to value-based care using a phased approach is paramount.
Traditional Chinese medicine and the Vedic traditions both offer rich frameworks for understanding human health, emphasizing the balance of physical, mental, and spiritual aspects. The concept of "souls" or spiritual components in TCM, namely Hun, Po, Shen, Yi, and Zhi, bears significant similarities to the yogic concept of koshas. Their similarities and differences provide insights into how these systems contribute to holistic health practices.
