Common Symptoms
Difficulty falling asleep, frequent waking during the night, light or unrefreshing sleep, early waking, or vivid dreams. During the day, people may feel fatigue, low energy, poor concentration, irritability, anxiety, or mood swings. Some may also experience headaches, palpitations, muscle tension, or digestive discomfort, especially during periods of high stress.
Possible Causes
TCM View
In TCM, sleep depends on the Shen (神, mind/spirit) being calm and well-nourished, primarily by the Heart, and supported by the Liver, Spleen, and Kidney systems.
When this balance is disrupted, sleep problems occur.
Common patterns include:
- Heart and spleen deficiency (心脾两虚) – A form of Qi and blood deficiency affecting the Heart and Spleen. Often due to overthinking, stress, or chronic fatigue. Leads to poor nourishment of the Shen, causing difficulty falling asleep, light sleep, excessive dreaming, palpitations, low energy, and poor appetite
- Liver heat disturbing the heart (肝火扰心) – Emotional stress leads to Qi stagnation, which may transform into heat or fire. Symptoms include irritability, restlessness, difficulty falling asleep, headaches, and vivid dreams
- Yin deficiency with heat (阴虚火旺) – Lack of cooling Yin leads to internal heat, causing night waking, restlessness, dry mouth, and night sweats
- Phlegm or phlegm-heat disturbance (痰 / 痰热扰心) – Causes mental restlessness, heaviness, chest discomfort, and disturbed sleep
- Kidney deficiency (肾虚) – Affects the body’s ability to anchor the mind, resulting in chronic insomnia or poor-quality sleep
Modern View
From a Western medical perspective, sleep and stress issues are typically understood as the result of one or more underlying factors:
- Stress and anxiety disorders
- Poor sleep hygiene – Irregular sleep and wake times, excessive screen exposure before bed
- Obstructive sleep apnea (OSA) – A physical condition where the airway becomes partially or fully blocked during sleep
- Mental health conditions – Depression and burnout
- Lifestyle factors – Overwork or insufficient physical activity
- Circadian rhythm disruption – Shift work and jet lag
How we treat
TCM
Calming the mind & regulating the nervous system
Acupuncture and auricular therapy to promote relaxation and improve sleep quality
Restoring internal balance
Herbal medicine tailored to individual patterns (e.g. tonifying Qi/blood, nourishing Yin, clearing heat, calming the Shen)
Western medicine
Cognitive Behavioral Therapy for Insomnia (CBT-I)
Address habits that interfere with sleep
Sleep studies and OSA management
Sleep study (polysomnography), with treatment options including CPAP (continuous positive airway pressure) devices
Sleep studies and OSA management
Prescription options such as sedatives, anxiolytics, or targeted antidepressants to regulate sleep patterns and manage underlying contributing factors
Wellness
Stress management & mental wellbeing
Breathing techniques, mindfulness strategies, and lifestyle counselling
Sleep optimisation
Guidance on sleep hygiene, routines, and environmental factors