Ellen, a healthy forty-five-year-old, came to the clinic several months ago complaining of insomnia, which had plagued her for more than a year. She could fall asleep without any problem, but would routinely wake up between 2 a.m. and 3 a.m. and remain awake until dawn.
After reviewing good sleep hygiene with her, including the need to maintain a regular sleep schedule and get regular exercise, I performed an examination. I found that Ellen had a fast, weak pulse and a red tongue with little or no coating. Her abdomen was very tight, especially around the navel. She told me she usually felt tired in the late afternoon and her energy levels were generally low. She looked tired and tense.
Ellen had already consulted a medical doctor, who had prescribed Valium, a drug that sedates the nervous system and induces sleep. While the Valium helped Ellen sleep eight hours straight, it also left her feeling disoriented in the morning and sluggish until late in the afternoon.
Ellen’s condition is not rare–one of the most common reasons patients come to my clinic is to seek treatment for insomnia. According to a 1995 study by the National Sleep Foundation, about 20 percent of all American adults and 50 percent of Americans aged sixty-five and older experience significant sleep difficulties on any given night. A 1990 study reported in the American Journal of Public Health showed that nearly one-third of the elderly patients studied used conventional medication to help them sleep.
The REM factor
Insomnia is an inability to fall asleep or remain asleep long enough to adequately refresh the body, mind, and spirit. Modern research shows that sound sleep is vital to good health. Of the five stages of sleep, the stage called rapid eye movement (REM) sleep is especially important. Periods of REM sleep occur off and on throughout the night, and their duration increases as the night goes on. During this deepest and most healing sleep stage, dreaming occurs, and some people believe that emotional and psychological conflicts are resolved.
Many factors can interfere with REM sleep, including stress resulting from work or mental strain, physical and emotional tension, erratic bedtime hours, an unhealthy sleeping environment, and certain pharmaceuticals. People whose REM sleep is unfulfilled may become chronically tired, irritable, moody, and depressed. On the other hand, a full night’s sleep contributes to optimal productivity, creativity, focus, and good health.
A combined approach
Practitioners of Western medicine tend to interpret the body according to cellular processes. Practitioners of the ancient system of Traditional Chinese Medicine (TCM), however, tend to interpret the body in terms of how it fits into the cycles of nature. I believe that the two practices complement each other and I used both approaches to understand and treat Ellen’s condition.
While Western medical practitioners often attribute insomnia to a nervous system that has been overstimulated by stress, illness, or chemical imbalance, practitioners of TCM commonly trace sleep disorders to an imbalance in the liver, hormones, and digestive and nervous systems, which they refer to collectively as the kidney system, a storehouse for vital energy.
I diagnosed Ellen’s insomnia as due to a hormone deficiency because of the fatigue, her age, and the weak and fast pulse. In TCM, this syndrome is known as kidney deficiency. In my view, this syndrome is the result of years of overwork, stress, and worry, and a longtime reliance on such stimulants as refined sugar and coffee.
I advised Ellen to avoid red meat and stimulants of all kinds to help give her body a rest. I recommended that she eat steamed or lightly stir-fried vegetables, fish, chicken, and legumes, and restrict her intake of sweets to fresh fruit, yams, and winter squashes to support and strengthen her digestive and hormonal systems. I further suggested that she practice yoga, tai chi, deep breathing, and/or meditation daily to reduce stress.
Finally, I turned to nature’s green healers to bolster Ellen’s changes in diet and exercise, choosing herbs appropriate to her constitution and health. I made a tincture that included calmatives (California poppy, reishi mushroom); hormone tonics (rehmannia, American ginseng); a liver regulator (fringe tree bark); a sleep-inducing herb (catnip); a muscle relaxant (kava-kava); and flavor enhancers (orange essence, stevia) for sweetening. I advised Ellen to take 1 teaspoon of this tincture two to three times daily, including one dose in the evening an hour or two after dinner. Although hops are often taken to promote relaxation and sleep, I chose not to include them because they are alsoan effective diuretic. Similarly, I didn’t include valerian, another excellent sleep aid, because it stimulates the nervous system in some people.
If you have trouble sleeping,
I recommend seeking the advice of an experienced herbalist or natural health-care practitioner, especially one who is trained in TCM or Ayurveda (an ancient healing system of India) for a complete diagnosis and natural health program.
Christopher Hobbs’s case studies are gleaned from his nearly thirty years of studying and practicing herbalism. Hobbs, a fourth-generation botanist and herbalist, is an Herbs for Health Editorial Advisory Board member and licensed acupuncturist.
“Case studies from an herbalist’s notebook” are not intended to replace the advice of a qualified health-care provider.
