Insomnia / Chronic Sleep Disorders

Abstract: In the US, chronic sleep disorders are steadily rising. IMS Health, a research company reports a 140% increase sleeping pill prescriptions in last 10 years. Eastern Medicine, including both Ayurveda and Traditional Chinese Medicine or TCM, view chronic sleep is considered as a symptom of deeper pathogenic conditions. Eastern medicine offers an understanding and remedy to treat the disease at the root level.

“About 42 million sleeping pill prescriptions were filled last year, according to the research company IMS Health, up nearly 60 percent since 2000.”—The New York Times, February 7, 2006. “An estimated 60 million sleeping pill prescriptions were filled last year in the U.S. According to IMS Health, a health care services company, this number grew from 47 million in 2006.” – consumer-drug-report.com March 27, 2012 – (http://www.consumer-drug-report.com/miscellaneous/new-study-reveals-sleeping-pill-risks-270312115230) – In brief, 25 million prescriptions in year 2000, 42 million in 2005, 47 million in 2006, and 60 million in 2011, i.e. 140% increase in last 10 years.

Sleep is a key ingredient for a healthy and joyful life. Good sleep acts as a rejuvenator of mind and regenerator of body, enabling us to have an optimum functional performance during our waking hours. Even powerful medicine is hardly of any use if this fundamental ingredient of life is missing.

Insomnia word cloud concept

With chronic Insomnia, sleeping difficulties occur at least three nights per week for more than three months. Chronic sleep impairment leads to one or more of the following symptoms:

Poor attention or concentration
Fatigue or daytime sleepiness
Impaired performance (errors, accidents)
Reduced energy or motivation
Behavioral problems (i.e., hyperactivity, impulsiveness, aggression)
Malaise (feeling unwell)
Headache, upset stomach, and chronic pain complaints

Sleep is important because it supports the generation of essence (called Ojas in Ayurveda or Jing in TCM). Essence is one the three treasures (other two being Prana or Qi in TCM and Tejas or Shen in TCM) that integrates body, mind, and spirit into an optimally functioning individual. Interaction of shen/tejas and jing/ojas/essence produces the “light” of consciousness observed in twinkle of a clear eye. Jing or Essence is the refined substance that is derived from digestion and assimilation of food. It governs the growth and development processes of the body and enhances the immune system. “Dependent on sleep is happiness and misery, corpulence and leanness, strength and weakness, potency and impotency, intellect and non-intellect, life and death”, says Sage Charka, the father of modern Ayurveda.1

Understanding Sleep

According to Classical Chinese Medicine, sleep is a result of harmonious coordination between yang (wei qi or defensive qi) and yin (ying qi or nutritive qi). In the Yellow Emperor’s Inner Canon (Huang Di Nei Jing Ling Shu), the chapter 18 says, wei qi circulates twenty five times in the yin meridians during the night and twenty five times in the yang meridians during the day, that is to say, wei qi circulates fifty times in twenty four hours. As a result, when it arrives at the yang (meridians), it “awakens”, and when it arrives at the yin (meridians), it “goes to sleep”2.

On the other hand, ying qi follows the regular meridian flow and continuously circulates through the body in a daily cycle. According to the Yellow Emperor’s Inner Canon (Huang Di Nei Jing Su Wen),  the ying qi’s pathway is –  lung meridian – large intestine meridian – stomach meridian – spleen meridian – heart meridian – small meridian – bladder meridian – kidney meridian – pericardium meridian – san jiao meridian – gallbladder meridian – liver meridian – Governor Vessel – Conception Vessel. Both ying and wei qi share the same origin and the movements of these two types of qi work in a coordinated manner to maintain a harmonious balance, including sleep-wake cycle.

Sleep is a result of harmony between the yin (ying qi) and the yang (wei qi) which then allows anchoring of shen in the heart. When the yang and yin interaction is out of balance and weakening of the ying qi encroaches on wei qi circulation at night then it become the cause of restlessness of shen or shen floating upwards instead of resting in the heart and this results in sleep-disorders.

In the Indian tradition of Ayurveda and Tantra, sleep is considered as one of the state of consciousness (the other two being wakefulness and dream state.) Prashnopanishad3 says that the state of sleep is the result of awareness withdrawing from the senses. The Brihadaranyaka Upanishad4 (classic text of Yoga and Ayurveda), says that the heart is the centre of the 72,000 nadis or subtle channels, and the place into which the senses are withdrawn during sleep.  In other words, if our awareness is not able to withdraw to the heart center then the quality of sleep is adversely affected.  According to Ayurveda the two primary reasons for sleep-disorder are unbalanced vata (inner-wind) and habitually improper life-style. Charak Samhita, says, “Fear, anxiety, anger, smoking, exercise, blood-letting, fasting, uncomfortable bed…these very factors may be taken as causes of insomnia, along with overwork, old age, vatika (inner-wind) disorders and aggravation of vata (inner-wind-pattern) itself.”5

Treatment

Both TCM and Ayurveda focus on understanding the pattern behind sleep disorders. Most excess patterns are due to heat or phlegm causing agitation of the yang or inner-wind resulting in restlessness of the shen. In Ayurveda it is defined as restless sense-consciousness not able to withdraw to the heart center at night. Acupuncture, herbal medicine, and manual therapies can treat the excess conditions to restore the balance of yin and yang.

Chronic sleep disorders are usually deficiency patterns where insufficiency of yin fails to anchor shen in the heart and sense-consciousness remain active at night (unable to withdraw to the heart center.) Chronic sleep disorders are superficial symptoms of underlying deeper imbalances.  Although, acupuncture, herbal medicine, and manual therapies are helpful however, person needs to address deeper imbalances by including healthy life style, proper diet, emotional balance, meditation, exercise, and management of stress.

In Conclusion

Chronic sleep disorders are a manifestation of underlying deeper imbalances of body-mind energies. Improper life-style, eating habits, stress and behavioral patterns create an imbalance in the inner-environment which eventually results in corresponding sleep disorders.  Although receiving courses of treatment is important however, the last thing one should do is mask the symptoms by simply taking medications. It is equally important to address the deeper imbalances by adopting a healthy life style, proper diet, meditation, exercise, management of stress for emotional balance.

Professor Philippe Froguel, the corresponding author of the research from the Department of Genomic Medicine at Imperial College London, said: “There is already some research to suggest there are links between sleep problems and conditions such as obesity and depression, both of which are associated with diabetes. For example, we know that obese children tend to sleep badly and that people become more obese if they are not having enough sleep. Our new study demonstrates that abnormalities in the circadian rhythm may partly be causing diabetes and high blood sugar levels. We hope it will ultimately provide new options for treating people.” — medicalnewstoday.com, December, 9th 2008.

References:

  1. Charak Samhita Sutrasthana xxi 36-37 tr. PV Sharma Chaukhambha Orientalia 1994.
  2. Chap 18 Ling Shu – Nguyen Van Nghi – N.V.N. Edition, Translated from the French by Edward S. Garbacz, MD With Additional Commentary by Sean Christiaan Marshall, D. Ac. © Jung Tao School of Classical Chinese Medicine – 2002
  3. http://en.wikipedia.org/wiki/Prashna_Upanishad
  4. Brhadaranyaka Upanishad – Textual Sources for the Study of Hinduism,  By Wendy Doniger. Manchester University press. 1988, pg 38 – Google Books: http://tinyurl.com/brihadaranyaka-Upanishad-2-3
  5. Charak Samhita Sutrasthana xxi 55-57 tr. PV Sharma Chaukhambha Orientalia 1994.