Sleep and recovery! How to sleep better and how to get more of it
July 7th, 2008 by brad whisnantWe have had a good response from the Detoxing and Chinese herbal formula posting. I decided to include another huge complaint about people in general and in recovery; SLEEP! We don’t get enough of it, and when we do sleep we don’t sleep very restfully. See how Chinese herbs can help you sleep and NOT feel “hung over” the next morning.
For people in recovery, sleep is a huge problem. Western sleeping pills typically leave people feeling drowsy the next day, and or people report not feeling like they are achieving natural sleep. Chinese herbs, in particular the formula below, deal with the “typical” type of sleeping disorder of people in recovery. Please remember this formula is a “base” formula that we would start with, and from there modify the herbs to match each person on an individual basis. These herbs can be taken as short or long term therapy depending on the nature of the complaint.
CALM (ES) TM
CLINICAL APPLICATIONS
Stress with poor appetite, headache, tension, insomnia, and similar stress responses
Extreme or severe emotional and psychological disorders such as hysteria, neurosis, schizophrenia, and others
Withdrawal signs and symptoms associated with alcohol, drug and smoking addiction
Insomnia with disturbed sleep and night awakenings
WESTERN THERAPEUTIC ACTIONS
Sedative effect to relieve nervousness and irritability
Anxiolytic function to relieve stress and anxiety
Tranquilizing effect to alleviate severe emotional and psychological disorders
Calming effect to ease withdrawal signs and symptoms associated with alcohol, drug and smoking addiction
Antispasmodic effect to relieve muscle tension and cramping
CHINESE THERAPEUTIC ACTIONS
Spreads Liver qi, purges excess Liver fire
Calms the shen (spirit) and tranquilizes the Heart
DOSAGE
For stress- and anxiety-related disorders, take 3 to 4 capsules three times daily. For severe emotional and psychological disorders, or patients with withdrawal signs and symptoms because of drug or alcohol addiction, the dosage may be increased to 6 to 8 capsules every four to six hours or as needed. Dosage can then be dropped down to 3 to 4 capsules three times daily when symptoms are stabilized.
INGREDIENTS
Bai Zhu (Rhizoma Atractylodis Macrocephalae)
Chai Hu (Radix Bupleuri)
Chuan Xiong (Rhizoma Ligustici Chuanxiong)
Da Huang (Radix et Rhizoma Rhei)
Da Zao (Fructus Jujubae)
Dang Gui (Radicis Angelicae Sinensis)
Fu Ling (Poria)
Gan Cao (Radix Glycyrrhizae)
Gou Teng (Ramulus Uncariae cum Uncis)
Gui Zhi (Ramulus Cinnamomi)
Huang Qin (Radix Scutellariae)
Long Gu (Os Draconis)
Mu Li (Concha Ostreae)
Sheng Jiang (Rhizoma Zingiberis Recens)
Suan Zao Ren (Semen Zizyphi Spinosae)
Xi Yang Shen (Radix Panacis Quinquefolii)
Xie Cao (Radix et Rhizoma Valerianae)
Zhu Ru (Caulis Bambusae in Taenia)
FORMULA EXPLANATION
Calm (ES) is one of the strongest herbal formulas to treat emotional and psychological disorders. In addition to regulating Liver qi and purging Liver fire, it also calms the shen (spirit) and tranquilizes the Heart. Clinically, it is commonly used for patients with severe emotional distress or mild psychological disorders. Furthermore, it can also be used to treat withdrawal signs and symptoms commonly associated with substance addiction.
Long Gu (Os Draconis) and Mu Li (Concha Ostreae) are mineral medicinal substances commonly used to anchor the floating shen (spirit). They have tranquilizing and sedative effects, which can subdue the hyperactivity of Liver fire. Gou Teng (Ramulus Uncariae cum Uncis) treats headache associated with a sudden rise of blood pressure. Huang Qin (Radix Scutellariae) and Da Huang (Radix et Rhizoma Rhei) clear heat and relieve irritability. Chai Hu (Radix Bupleuri) disperses stagnant Liver qi and Dang Gui (Radicis Angelicae Sinensis) nourishes Liver blood. Xi Yang Shen (Radix Panacis Quinquefolii), Bai Zhu (Rhizoma Atractylodis Macrocephalae), Fu Ling (Poria), Sheng Jiang (Rhizoma Zingiberis Recens), and Da Zao (Fructus Jujubae) strengthen and harmonize the middle jiao and prevent the Liver from overacting on the Spleen. Gui Zhi (Ramulus Cinnamomi) and Chuan Xiong (Rhizoma Ligustici Chuanxiong) promote qi and blood circulation. Suan Zao Ren (Semen Zizyphi Spinosae) and Xie Cao (Radix et Rhizoma Valerianae) calm the Heart and nourish the shen (spirit). Gan Cao (Radix Glycyrrhizae) harmonizes all the herbs in the formula and protects the stomach against harshness of the mineral medicinal substances in this formula.
SUPPLEMENTARY FORMULAS
For moderate amounts of stress and anxiety or PMS, use Calm.
For stress and anxiety with insomnia in deficiency patients, use Calm ZZZ.
For insomnia arising from blood deficiency, add Schisandra ZZZ.
For menopausal signs, add Balance (Heat).
For hypertension, add Gentiana Complex or Gastrodia Complex.
For headache, add Corydalin or Migratrol.
For crying spells or depression, add Shine.
For constipation, combine with Gentle Lax (Excess).
If the patient has hyperthyroidism, add Thyrodex.
For ADD/ADHD, add Calm (Jr).
For heartburn or gastric ulcers, add GI Care.
For stress-related irritable bowel syndrome (IBS), add GI Harmony.
For stress-related ulcerative colitis, add GI Care (UC).
For chronic, stubborn insomnia with blood stagnation, add Circulation (SJ).
For excess fire in the body, add Gardenia Complex.
For thirst and dryness, add Nourish (Fluids).
NUTRITION
A diet high in calcium, magnesium, phosphorus, potassium, and vitamins B and E is recommended. These vitamins and minerals are easily depleted by stress.
Encourage the consumption of fruits and vegetables such as apricots, asparagus, avocados, bananas and broccoli. Brown rice, dried fruit, figs, salmon, garlic, green leafy vegetables, soy products, and yogurt are also recommended.
Avoid caffeine (coffee, tea, cola, chocolate), tobacco, alcohol and sugar whenever possible.[1]
LIFESTYLE INSTRUCTIONS
If insomnia is related to work or stress, advised the patients not to work in the bedroom and remove anything that may be a reminder of the office or work. A warm bath or light snack before bedtime may also be helpful.
Regular exercise, adequate rest, and normal sleep patterns are beneficial for stress reduction.
Practice meditation exercises at least twice daily.
Get away from daily routines to do something enjoyable to relieve stress whenever possible.
Noise can be disturbing to mental health and cause stress. Noise greater than 65-decibels can cause psychological disturbance, greater than 90-decibels can cause emotional and vegetative consequences, and greater than 120-decibels can cause nervous system and hearing damages.
CAUTIONS
Patients with a weak digestive system may experience mild gastrointestinal disturbances. In such cases, reduce the dosage or take the herbs with GI Care for nausea, and Gentle Lax (Deficient) for constipation.
Patients who are on anticoagulant or antiplatelet therapies, such as Coumadin (Warfarin), should use this formula with caution as there may be a slightly higher risk of bleeding and bruising.
This formula is contraindicated during pregnancy and nursing.
CLINICAL NOTE
In addition to using Calm (ES), efforts should be made to identify the underlying cause of illness. Both the symptoms and the cause should be treated concurrently to ensure optimal results.
MODERN RESEARCH
Calm (ES) is formulated based on careful research and includes herbs that have sedative, hypnotic and muscle-relaxant effects. Common applications of Calm (ES) include the treatment of stress, anxiety, insomnia, emotional and psychiatric disorders, and addiction.
Xie Cao (Radix et Rhizoma Valerianae) also has a wide range of functions, including but not limited to antispasmodic and sedative/hypnotic properties.[2], [3] In a double-blind crossover study of 128 people, it was found that those who took Xie Cao (Radix et Rhizoma Valerianae) had a significant improvement in sleep quality with less awakenings during the night, and less somnolence the next morning.[4] The clinical effects of Xie Cao (Radix et Rhizoma Valerianae) are thought to be similar to those of short-acting benzodiazepines.[5]
Calm (ES) is formulated based on a traditional herbal formula that is commonly used to treat stress, anxiety and sleep disorders. Furthermore, clinical trials have proven this formula to be effective in treating such disorders as neurosis, schizophrenia, hysteria, epilepsy, and withdrawal signs and symptoms associated with drug, alcohol and smoking cessation.[6],[7],[8]
PHARMACEUTICAL DRUGS & CHINESE MEDICINE: A COMPARATIVE ANALYSIS
Stress and anxiety are two of the most common emotional disorders. Clinical signs and symptoms include recurrent and intrusive thoughts, insomnia, disturbed sleep, illusions, hallucinations, difficulty concentrating, hypervigilance, restlessness, anger, and irritability.
Western Medical Approach: Pharmaceutical drug treatment for stress and anxiety focus primarily on use of sedative and hypnotic drugs, such as Valium (Diazepam) and Ativan (Lorazepam). Though these drugs are very potent and have immediate effect to sedate patients, they do not address the underlying conditions. Furthermore, long-term use of these medications are associated with many side effects, including drowsiness, dizziness, tiredness, blurred vision, changes in sex drive or ability, shuffling walk, persistent, fine tremor or inability to sit still, difficulty breathing or swallowing, severe skin rash, yellowing of the skin or eyes, irregular heartbeat, and addiction. Therefore, these drugs should only be used when necessary, and only for a short period of time.
Traditional Chinese Medicine Approach: Use of herbs is extremely effective to treat stress and anxiety. Herbs regulate mood and emotions, and alleviate stress and anxiety by enhancing the body’s own ability to deal with these external factors. Unlike drugs that have immediate effect to treat stress and anxiety by “sedating the mind and decreasing its responsiveness,” herbs do not have an immediate effect, and require two or more weeks of continuous use to gradually treat these conditions. In contrast, one of the main advantages of herbs is they are safe and natural, and do not have negative side effects like drugs.
Summation: Stress and anxiety are two very common disorders. While drugs and herbs are both effective, they have contrasting differences of benefits and risks. While drugs are more effective for shot-term treatment, herbs are more successful for long-term management. Furthermore, counseling (behavior and psychotherapy) is extremely important toward the understanding of, and complete recovery from, these conditions.
CASE STUDIES
L.L., a 56-year-old female, presented with frustration, anger and sadness over losing her home in the hurricanes. She was unable to move through these emotions. She was also diagnosed with hypertension, high cholesterol, and post-traumatic stress syndrome recently, and refused to take medications. Her blood pressure was 138/78 mmHg and her heart rate was 82 beats per minute. She also suffered from headaches in the temporal region and the vertex. Other symptoms included twitching of the eyes, agitation, red eyes, and a scalloped tongue with thick yellow tongue coating. TCM diagnoses were damp-heat in the Liver and Gallbladder, Kidney yin deficiency, and excess fire and wind rising. She was prescribed the following formulas: Calm (ES) at 1 to 3 capsules, as needed, Cholisma at 4 capsules twice daily, and Gentiana Complex at 5 capsules twice daily. The patient gained control of her emotions immediately after taking Calm (ES). Blood pressure gradually reduced over time to 120/72 mmHg. The practitioner commented that the combination of these formulas are phenomenal.
M.H., West Palm Beach, Florida
A 49-year-old female social worker presented with stress, anxiety, dizziness and irregular menses. The patient reported occasional irritability, hot flashes, night sweats and dysmenorrhea. Dry eyes and muscle cramps were also present. The patient was diagnosed with Kidney and Liver yin deficiency with Liver qi stagnation. With Balance (Heat) and Calm (ES), the patient experienced a reduction of hot flashes and had less irritability, stress, anxiety and dizziness. She also stated that she slept better and her menses were not as painful. The practitioner concluded that Balance (Heat) and Calm (ES) were an excellent combination for the condition.
D.M., Raton, New Mexico
A 44-year-old female police officer presented with chronic headaches located in the occipital/temporal regions. She stated that stress aggravated the problem. There was acute tenderness at the Fengchi (GB 20) area as well as in the cervical spine. She also experienced pain on her zygoma. The practitioner diagnosed the condition as qiand blood stagnation in Gallbladder, Urinary Bladder, and Small Intestine channels in addition to myofascial syndrome, which was stress-induced because of the nature of her job. She was treated with Corydalin, Neck & Shoulder (Acute) and Calm (ES), which were all so effective that they subsequently replaced her medication, Imitrex (Sumatriptan). The practitioner concluded that a critical aspect in the treatment was to assist the patient in coping with stress, which in turn made the herbal treatment more effective.
S.C., La Crescenta., CA
An 18-year-old female presents with vivid visual hallucinations at night, mainly when going alone from her car to the house. The Western diagnosis was paranoia with visual hallucination; the TCM diagnosis was Liver qi stagnation with shen (spirit) disturbance. The practitioner prescribed three capsules of Calm (ES), three times daily for two weeks, and taught the patient to engage in positive visual imagery and mental clarification. After the integrative therapies, the patient reported that her hallucinations and fears had resolved.
C.L., Chino Hills, California
A 40-year-old male presented with severe insomnia, restlessness and hyperactivity. Tongue body appeared red while his pulse felt rapid and wiry. Western assessment of his condition was schizophrenia. TCM diagnosis was Heart fire and Liver fire. Within a week of taking Calm (ES), his sleep time increased from 2 to 3 hours a night to 7 to 8 hours a night. His restlessness and hyperactivity also subsided.
T.G., Albuquerque, New Mexico
M.C., a 53-year-old female, presented with anxiety. She was very anxious and fearful of flying. Otherwise healthy, she had to take her son up north to begin college and had to fly, and came to my office for treatment. Her blood pressure was 120/78 mmHg and her heart rate was 76 beats per minute. TCM diagnosis was Liver fire. Calm (ES) was prescribed at 4 to 6 capsules before the flight. She reported later that she took 4 capsules 1 hour before her flight, and that her anxiety was under control. She was able to fly out more often to see her son as she felt she could handle the flights when she takes Calm (ES).
M.H., West Palm Beach, Florida
A 53-year-old male miner presented with insomnia, depression, stress, anxiety and fatigue. He had difficulty falling asleep, which was aggravated by relentless worrying. Other symptoms included palpitations and occasional dizziness. A choppy pulse and a pale tongue were present, along with a pale complexion. The practitioner diagnosed the condition as Heart and Spleen blood deficiency. After the initial treatment, his sleep improved from 2 to 3 hours per night to 5 to 6 hours per night. The patient was no longer fatigued and felt much calmer. Because of his occupation and the nature of his condition, he was unable to take the western medication since drowsiness was one side effect. The combination of Schisandra ZZZ and Calm (ES) made it possible to manage his condition with no known side effects. The practitioner recommended continuous application of the herbal combination of Schisandra ZZZ and Calm (ES) for his medical condition.
D.M., Raton, New Mexico
A 78-year-old female with a past history of stroke presented with memory loss, insomnia, and nightmares. She was easily frightened and frequently woke up in the middle of the night because of her dreams. Her western medical diagnosis was dementia. TCM diagnosis included qi and blood stagnation, Liver and Kidney yin deficiency, and Heart fire. She was given Calm (ES) and Neuro Plus. After taking the herbs for approximately one month, the patient was able to recall the practitioner’s name for the very first time! In addition, her sleep, mood, complexion, and energy level improved greatly. The patient was much calmer and less irritable. Despite the fact that she still did not know the name of her town or the correct month, there were many improvements in all other areas. The practitioner concluded that the combination of Calm (ES) and Neuro Plus has enhanced the patient’s quality of life.
P.R., Encinitas, California
An 85-year-old retired female presented with excruciating pain in the neck and shoulder that causes difficulty sleeping. Objective findings included limited range of motion of the neck. The tongue had a dirty yellow coat and a red tip. The western diagnosis included psoriatic arthritis, arthritis, fibromyalgia, hiatal hernia, hypertension, depression, chronic constipation, leaky gut syndrome, sciatica and insomnia. The patient was instructed to take Neck & Shoulder (Acute) and Corydalin, 3 capsules of each three times daily in between meals. Calm (ES) was given at night to help sleep. The patient responded that the formulas were effective in reducing the acute pain in the neck and shoulder region. After the acute phase two weeks later, the patient was switched to Gan Mai Da Zao Tang (Licorice, Wheat, and Jujube Decoction) and Shao Yao Gan Cao Tang (Peony and Licorice Decoction), a combination recommended by Dr. Richard Tan that consistently helped patients with fibromyalgia.
J.B., Camarillo, California
B.B., a 51-year-old female, presented with daily, moderate headaches. She suffered from breast tenderness and a headache that worsened before each period. She also had insomnia and would waken and stay awake for an hour, several times a night. She suffered from irritability that may have arisen from her recent quitting of tobacco smoking. Her tongue was purplish red; her pulse was rapid and wiry. The TCM diagnosis was Liver fire and Liver qi stagnation. Jia Wei Xiao Yao San (Augmented Rambling Powder) and Calm (ES) were prescribed at 2 grams each, daily. After taking the herbs, the patient reported the breast soreness was gone. Her headache began to diminish, especially after she was past nicotine detox. Irritability was also greatly reduced. The patient continued taking the herbs for a year, and noticed that if she stopped taking the herbs, the irritability would return but not the headache or sore breasts. She continues with the formulas at 1 gram per day each, and is very impressed with the results.
C.D., Phoenix, Oregon
thank you,
brad whisnant, www.pinpointclinics.com, www.acupuncturevolunteer.com
July 8th, 2008 at 8:45 am
Wow! Great article on natural sleep remedies. Thanks very much for posting it. Much more exposure needs to be given to natural remedies. As a Certified Chemical Dependency Counselor I see prescription drug abuse and addiction quite often, when with proper education it could be eliminated as well as prevented. Thanks again for the post!
July 8th, 2008 at 6:48 pm
This was a great article to read. Lots of great information. I take Trazadone which was used as an anitdepressant years ago. It is not used anymore to treat depression since one of the major side affects is severe drowsiness. However, It is now used along with an antidepressants for people tha have trouble sleeping. I would like try these natural remedies for my sleep disorder. How does it work if you are sleep deprived because of anxiety? Again thanks for the great article. Very helpful and encouraging to those who want to take a different direction than the western therapeutic way.
July 9th, 2008 at 1:42 pm
Srfranci,
thanks for the comment. Lets see to answer your questions….
you bring up a good question, “what about sleep and anxiety?”. This is why i love chinese medicine so much. For you, that is how your sleep issue presents itself, therefore we would modify the above formula to make sure it deals with sleep and anxiety. We would use that formula, add in a few anti anxiety herbs, also figure out what is causing your anxiety and then put the formula together. The nice thing, we wouldnt just be dealing with your symptom-olgy (no sleep) the herbs would treat both your “branch” problem (no sleep, and anxiety) and the “root” (why and what is causing the anxiety and non sleep).
Read below, here is one type of formula that we might use since now we are talking about sleep and anxiety….
you can also call me at 503-750-6238, or email me pinpointdoctor@hotmail.com for more info, questions…..
thanks again for the comment
Back to the Cover Page
SCHISANDRA ZZZ ™
CLINICAL APPLICATIONS
Insomnia with difficulty falling and staying asleep
Disturbed sleep with excessive dreams and worries; “worrywarts”
Poor memory with dizziness, weakness, fatigue, and anemia
Fragile mental state with excessive worries, insomnia, disturbed sleep, dizziness, constant fatigue and weakness
Postpartum depression with weakness and anemia
WESTERN THERAPEUTIC ACTIONS
Mild sedative effect to facilitate falling and staying asleep 4,5,6,7,8
Adaptogenic effect to help the patient cope with stress, anxiety and excessive worries 9,10
Muscle-relaxant property to relieve muscle tension and tightness 7
Improves overall quality of sleep 4,5,6
CHINESE THERAPEUTIC ACTIONS
Nourishes the Spleen and the Heart
Tonifies qi and blood
Tranquilizes the shen (spirit)
DOSAGE
Take 4 capsules three times daily with warm water on an empty stomach. For treatment of insomnia and disturbed sleep, take 8 capsules 30 to 60 minutes before bedtime.
INGREDIENTS
Bai Zhu (Rhizoma Atractylodis Macrocephalae)
Da Zao (Fructus Jujubae)
Dang Gui (Radicis Angelicae Sinensis)
Fu Ling (Poria)
Huang Qi (Radix Astragali)
Long Yan Rou (Arillus Longan)
Mu Xiang (Radix Aucklandiae)
Ren Shen (Radix Ginseng)
Sheng Jiang (Rhizoma Zingiberis Recens)
Suan Zao Ren (Semen Zizyphi Spinosae)
Wu Wei Zi (Fructus Schisandrae Chinensis)
Xie Cao (Radix et Rhizoma Valerianae)
Yuan Zhi (Radix Polygalae)
Zhi Gan Cao (Radix Glycyrrhizae Preparata)
FORMULA EXPLANATION
Schisandra ZZZ is formulated to nourish the Spleen and the Heart, tranquilize the shen (spirit), and tonify qi and blood. Clinical applications of Schisandra ZZZ include insomnia, difficulty falling asleep and staying asleep, poor memory, dizziness, weakness, constant fatigue, postpartum depression due to anemia, etc.
Wu Wei Zi (Fructus Schisandrae Chinensis) replenishes the vital energy and has a regulatory effect on the central nervous system (CNS). Ren Shen (Radix Ginseng), Huang Qi (Radix Astragali), Bai Zhu (Rhizoma Atractylodis Macrocephalae) and Fu Ling (Poria) tonify the Spleen qi and enable it to generate blood to nourish the shen (spirit) of the Heart. Dang Gui (Radicis Angelicae Sinensis) and Long Yan Rou (Arillus Longan) tonify blood and calm the shen (spirit). Suan Zao Ren (Semen Zizyphi Spinosae) and Yuan Zhi (Radix Polygalae) are tranquilizing herbs with sedative and hypnotic effects. Xie Cao (Radix et Rhizoma Valerianae) is an herb that has tranquilizing and calming effects. Zhi Gan Cao (Radix Glycyrrhizae Preparata), Sheng Jiang (Rhizoma Zingiberis Recens) and Da Zao (Fructus Jujubae) improve the appetite, harmonize, and strengthen the gastrointestinal tract. Mu Xiang (Radix Aucklandiae) revives the Spleen and dispels stagnation.
SUPPLEMENTARY FORMULAS
For depression, combine with Shine.
For Spleen qi deficiency with loose stool and poor appetite, add GI Tonic.
For Liver qi stagnation manifesting in irritability, restlessness, or PMS, combine with Calm.
For severe insomnia with disturbed shen (spirit) in excess patients, use Calm (ES).
For insomnia due to stress in patients with deficiency, add Calm ZZZ.
For menopausal symptoms, combine with Balance (Heat).
For dysmenorrhea, combine with Mense-Ease.
For hair loss, dry or brittle hair, combine with Polygonum 14.
To tonify the overall bodily constitution, combine with Imperial Tonic.
For forgetfulness, add Enhance Memory.
For coldness of the extremities, add Balance (Cold).
For Kidney yang deficiency, add Kidney Tonic (Yang).
For Kidney yin deficiency, add Kidney Tonic (Yin).
NUTRITION
Increase consumption of foods that contain high levels of tryptophan such as turkey, bananas, figs, dates, yogurt, milk, tuna, and whole grain crackers as they help promote sleep.
Avoid foods that contain tyramine near bedtime. Tyramine increases the release of the brain stimulant norepinephrine. Foods with high content of tyramine include bacon, cheese, chocolate, eggplant, ham, potatoes, sugar, sausage, spinach, and tomatoes.
A glass of warm milk with honey is helpful for mild insomnia.
LIFESTYLE INSTRUCTIONS
Especially at night, patients with insomnia should avoid alcohol, caffeine, and tobacco.
If insomnia is due to overwork, do not to work in the bedroom and remove anything that may be a reminder of the office or work. A warm bath or light snack before bedtime may also be helpful.
Patient should be counseled to not worry about things they cannot control or change.
CLINICAL NOTE
Schisandra ZZZ is excellent to take for a week after each menstrual cycle. It replenishes the blood and qi lost during each period.
CAUTIONS
Patients who are on anticoagulant or antiplatelet therapies, such as Coumadin (Warfarin), should use this formula with caution, as there may be a slightly higher risk of bleeding and bruising.
This herbal formula may cause drowsiness in individuals who are sensitive to herbs. Patients are advised not to drive or operate heavy machinery while taking this herbal formula. Similarly, alcohol is not recommended as it may intensify the effect.
MODERN RESEARCH
Schisandra ZZZ contains herbs having a wide range of clinical functions, including adaptogenic, muscle-relaxant, sedative, tranquilizing, and anti-aging properties.
Wu Wei Zi (Fructus Schisandrae Chinensis) has many functions and clinical applications. In addition to its use as a liver protectant, it has such uses as a general tonic, a nervous system regulator, gastrointestinal therapy, an adaptogen and others. Wu Wei Zi (Fructus Schisandrae Chinensis) possesses pronounced liver-protectant effect by protecting the hepatocyte plasma membrane and preventing the entry of toxic substances.[1] Furthermore, it repairs liver damage by increasing blood flow to the liver and increasing regeneration of liver cells.[2] In addition to its liver-protectant effect, Wu Wei Zi (Fructus Schisandrae Chinensis) stimulates the nervous system to increase reflex responses and improve mental alertness and treat memory loss, helps the body to adapt to stress by balancing body fluids, and improves failing senses..[3]
Xie Cao (Radix et Rhizoma Valerianae) also has a wide range of functions, including but not limited to antispasmodic and sedative/hypnotic properties.[4],[5] In a double-blind crossover study of 128 participants, it was found that those who took Xie Cao (Radix et Rhizoma Valerianae) had a significant improvement in sleep quality with less awakenings and less somnolence the next morning.[6] The clinical effects of Xie Cao (Radix et Rhizoma Valerianae) are thought to be similar to those of short-acting benzodiazepines.[7]
Chinese herbs that promote sleep include Fu Ling (Poria), Suan Zao Ren (Semen Zizyphi Spinosae), Long Yan Rou (Arillus Longan), and Yuan Zhi (Radix Polygalae). Fu Ling (Poria) has sedating and tranquilizing effects. Suan Zao Ren (Semen Zizyphi Spinosae) and Yuan Zhi (Radix Polygalae) have sedative and hypnotic effects. Long Yan Rou (Arillus Longan) has sedative effects.[8] They are commonly used to reduce the time necessary to fall asleep, reduce the number of awakenings at night, and improve the overall quality of sleep.
Common applications of Ren Shen (Radix Ginseng) include a general strengthening effect, adaptogenic effect against stress, and enhancement in mental and physical performance.[9] The general strengthening and adaptogenic effects include a non-specific increase in resistance to the noxious effects of physical, chemical or biological stress.[10]
PHARMACEUTICAL DRUGS & CHINESE MEDICINE: A COMPARATIVE ANALYSIS
Western Medical Approach: Insomnia is defined as difficulty falling and/or staying asleep. While there are many potential causes of insomnia, pharmaceutical treatment focuses primarily on using sedatives and hypnotics for symptomatic treatment. The sleeping pills most frequently used include benzodiazepines such as Halcion (triazolam), Restoril (temazepam), and Dalmane (flurazepam). The main advantages of these drugs are they are extremely potent, and generally induce sedation within 30 to 60 minutes. However, their effect generally lasts for a long period of time, resulting in drowsiness the following morning. Furthermore, if used for a long period of time, they cause tolerance and dependence, making it increasingly difficult to restore normal sleeping patterns. Finally, these drugs are also likely to cause other side effects, such as blurred vision, changes in sex drive or ability, shuffling walk, persistent, fine tremor or inability to sit still, difficulty breathing or swallowing, severe skin rash, yellowing of the skin or eyes, irregular heartbeat, and addiction. Therefore, these drugs should only be used when necessary for short-term treatment of insomnia, and not be relied upon on a long-term basis.
Traditional Chinese Medicine Approach: Insomnia [inability to fall and/or stay asleep] is the direct result of shen (spirit) disturbance. Therefore, the main focus of this formula is to use herbs that calm the shen (spirit) to treat insomnia. Furthermore, lack of sleep over a long period of time contributes to deficiency. Therefore, many tonic herbs are also used to supplement such weakness and deficiencies. It is important to remember that herbs do not “sedate” the patient to treat insomnia. Rather, they calm the shen (spirit) and nourish the deficiency to restore normal waking / sleeping cycles. Therefore, herbs should be taken continuously for at least one week to restore normal waking / sleeping cycles, as they do not work on an “as needed” basis like sleeping pills.
Summation: It is important to re-evaluate the patients periodically. Individuals who continue to have insomnia should be examined for secondary causes, such as pain, anxiety, stress, depression, and withdrawal from drug or alcohol. While drugs and herbs are both effective, insomnia can only be treated successfully on a long-term basis when these secondary causes are removed.
CASE STUDIES
E.E. is a 30-year-old postpartum female who presented difficulty falling and staying asleep, restlessness, overactive mind, difficulty concentrating, fearfulness and anxiousness. The pulse was thin, weak and rapid. The tongue was very red with peeled edges and quivering at the same time. The face, ear and neck were red and flushed. The practitioner diagnosed her with postpartum depression with Heart fire and Spleen and Heart qi and blood deficiencies. Schisandra ZZZ was prescribed at 3 capsules three times daily. Within the first week, the patient noticed reduced anxiety. She was able to fall asleep and the mind was calmer.
S.S., Topanga, California
A tired and exhausted patient presented with general aches and pain in the neck and low back. There was also a history of poor sleep and digestion with no constipation. The practitioner felt the patient had over-worked herself throughout the years and that the condition was due to “wear and tear.” The diagnosis was qi and blood deficiencies with underlying yin and yang deficiencies. Imperial Tonic, Schisandra ZZZ and Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) were given along with acupuncture and massage therapy. The treatment was concluded to be quite effective.
S.C., La Crescenta, California
An 18-year-old patient presented with life-long insomnia. She often needed one hour to fall asleep. Her sleep quality was quite poor, and she remained sluggish throughout the day. The practitioner diagnosed the case as qi and blood deficiency. The patient took 6 capsules of Schisandra ZZZ 30 minutes before bedtime. After 3 weeks of treatment, the patient was able to fall asleep within 15 minutes and awaken with more energy.
M.K., Sherman Oaks, California
D.S., a 45-year-old female, presented with insomnia, mood swings, cramps and fatigue. The tongue was slightly purplish pale with teeth marks. The coating was thin and white. The pulse was deep and wiry. She was diagnosed with Spleen qi deficiency and blood deficiency. Nourish, Calm, Schisandra ZZZ were prescribed. The patient reported her sleep pattern improved, her moods balanced and her energy level increased. She was very happy with the herbs.
B.F., Newport Beach, California
L.A., a 37-year-old female patient presented with insomnia, with difficulty falling and staying asleep. Other symptoms included neck and shoulder stiffness, TMJ pain, heavy menstrual flow, and cramping with blood clots. She complained of marital problems and held the stress and sadness within. She was also seeing a psychotherapist. The blood pressure was 123/86 mmHg and her heart rate was 88 beats per minute. The tongue appeared to be salmon pink in color, moist with numerous fissures from the center to the tip. The tongue was swollen and the tip was red. The pulse was slippery and thin. The TCM diagnosis was Spleen qi and Heart blood deficiencies with Liver qi stagnation. Calm was prescribed. Calm alone eased her tension, but did not help much with her energy. Her sleep improved slightly. The TMJ resolved after eight acupuncture treatments. After two months, Schisandra ZZZ was added. The patient then slept through the night much more soundly. However, she still complained about the neck and shoulder pain.
J.C.O., Whittier, California
H.G., a 55-year-old female, presented with agitation, anxiety, depression, and insomnia, and stated that she was easily angered. Her tongue was purple, with a thin white coating; her pulse was soft and wiry. The Western diagnosis was depressive-anxiety disorder; the TCM diagnosis was Liver fire rising with Liver qi stagnation. Calm ES was prescribed at three capsules, three times daily. Upon follow-up one week later, the patient reported a decrease of anxiety and agitation, but continuing insomnia. Schisandra ZZZ was added to her herbal regimen. One week later, the patient reported the insomnia completely resolved; but said that she experienced somnolence in the morning. She was told to reduce Schisandra ZZZ from three times daily to twice daily, eliminating the morning dose. After the dosage adjustment, the patient reported calm, uninterrupted sleep, and waking feeling energized, without lethargy or grogginess. She continues to take Schisandra ZZZ on an as-needed basis.
C.L., Chino Hills, California
A 53-year-old male miner presented with insomnia, depression, stress, anxiety and fatigue. He had difficulty falling asleep, which was aggravated by relentless worrying. Other symptoms included palpitations and occasional dizziness. A choppy pulse and a pale tongue were present, along with a pale complexion. The practitioner diagnosed the condition as Heart and Spleen blood deficiency. After the initial treatment, his sleep improved from 2 to 3 hours per night to 5 to 6 hours per night. The patient was no longer fatigued and felt much calmer. Because of his occupation and the nature of his condition, he was unable to take the western medication since drowsiness was one side effect. The combination of Schisandra ZZZ and Calm ES made it possible to manage his condition with no known side effects. The practitioner recommended continuous application of the herbal combination of Schisandra ZZZ and Calm ES for his medical condition.
D.M., Raton, New Mexico
M.P., a 74-year-old female, presented with insomnia. She was prescribed Ambien (Zolpidem) by her medical doctor but could not take it because of an allergy to the medication where her tongue would swell and burn. She was then put on Zyprexa (Olanzapine) and Paxil (Paroxetine). The patient reported she also had an allergic reaction (tongue swelling) to Zyprexa (Olanzapine). The patient, described by the practitioner, was a very anxious, nervous type of person who would hyperventilate when stressed. Her husband also has multiple medical problems and she stated she was worried about him. Her blood pressure was 120/70 mmHg and her heart rate was 70 beats per minute. The TCM diagnosis was Spleen and Heart disharmony with qi and blood deficiencies. Schisandra ZZZ was prescribed at 4 to 6 capsules at night. The patient reported that taking 4 capsules allowed her to sleep for four hours and then she was awake. Dosage was then increased to 6 capsules at night and she reported she was able to sleep five to six hours. The patient is still currently under care and the practitioner is adjusting the dose slowly.
M.H., West Palm Beach, Florida
A 42-year-old female presented with insomnia due to family-related stress. She reported having difficulty falling asleep due to excessive thoughts, thus creating morning fatigue that “feels like a hangover.” The TCM diagnosis was insomnia due to Spleen and Heart qi deficiencies with shen (spirit) disturbance. After she began taking three capsules of Schisandra ZZZ at bedtime, the patient reported much improved sleep without difficulty falling or staying asleep.
C.L., Chino Hills, California
E.P., a 32-year-old female, presented with a 2½-year history of vertigo, associated with insomnia, palpitations, anxiety and nausea. She also suffered from irritable bowel syndrome with alternating diarrhea and constipation. She had an unsteady gait and was unable to drive. For the Western diagnosis of anxiety disorder, the TCM diagnosis was Liver fire. Initially, Calm and Gentiana Complex were prescribed at two capsules each, three times daily, but then the dosage was increased to three capsules of each, three times daily. After three weeks, the signs and symptoms of irritable bowel syndrome were resolved, and Gentiana Complex was discontinued. On the sixth treatment, the patient reported all symptoms improved. However, work-related stress anxiety remained. On the 15th visit, Calm was changed to Schisandra ZZZ to help with her insomnia. After taking this formula for nine days, the patient reported much improvement in her sleeping patterns, from 5 to 6 hours of interrupted sleep to 6 to 7 hours of uninterrupted sleep. The patient was treated with acupuncture five times throughout the course of herbal treatment.
C.L., Chino Hills, California
A 50-year-old female public information specialist who was emotionally labile presented with pain in the shoulder, neck, thoracic, lumbar and foot. Her lumbar discs at L4 and L5 were herniated. In addition to migraines and bouts of constipation, she also complained of anxiety, depression and insomnia, all of which may be attributed to some side effects of taking multiple pharmaceuticals. The practitioner diagnosed her condition as qi and blood stagnation as well as Liver depression. Corydalin and Schisandra ZZZ were given. Corydalin significantly reduced her pain. She was able to lessen the use of oxycontin and Duragesic (Fentanyl) patches significantly. In fact, the dosages of oxycontin and Duragesic (Fentanyl) patches were reduced by as much as 75%. Furthermore, the practitioner observed that Corydalin was also effective to maintain other patients who suffered from occasional pain. The majority of patients (about 90%) who took Corydalin responded favorably, especially since most were experiencing digestive side effects with ibuprofen.
F.G., Sykesville, Maryland