Insomnia

Insomnia disorders can be categorized as follows:Neurotic Insomnia: Related to neuroses such as anxiety and depression.Psychotic Insomnia: Stemming from emotional disorders, schizophrenia, or other psychiatric conditions.Substance-Induced Insomnia: Caused by drug or alcohol dependency.Organic Insomnia: Due to structural brain disorders.Insomnia in Dementia: Often observed in elderly patients with dementia.Physical Factor-Induced Insomnia: Related to infections, pain, endocrine disorders, etc.Environmental Factor-Induced Insomnia: Triggered by environmental changes or disruptions.Insomnia is not an isolated condition but rather a symptom that arises from underlying causes. The key to treatment lies in accurately identifying and addressing these root causes, a principle shared by both modern Western medicine and traditional Eastern medicine. It's important to avoid the overuse of sleep-inducing medications without proper consideration. Medications for insomnia are typically prescribed based on symptoms such as difficulty falling asleep, staying asleep, or waking up too early. Currently, benzodiazepine derivatives are the most commonly prescribed drugs for insomnia, though other medications may also be used.From the perspective of traditional Korean medicine, sleep disorders, particularly insomnia, are believed to be closely related to the liver's function and the interaction between the liver and the kidneys. The condition of the heart's fire (심화) and liver's fire (간화) must also be carefully assessed to determine the appropriate treatment approach.Relationship Between Etiology and Symptoms:Sudden incidents or minor worries causing insomnia are often attributed to Heart Deficiency (심허).Excessive mental activity or unresolved excitement from the day can result in insomnia due to Heart Fire Hyperactivity (심화왕성).Aging, chronic illnesses, or cold conditions may cause insomnia, often indicating Kidney Yang Deficiency (신양허) or Kidney Yin Deficiency (신음허), depending on severity.Aging, mental exhaustion, physical overwork, post-surgery, or anemia-related insomnia is often linked to Heart Blood Deficiency (심혈허) or Heart and Gallbladder Qi Deficiency (심담기허) and sometimes Spleen and Kidney Deficiency (비신허).Stress and hypertension-related insomnia may be due to Spleen Deficiency (비허) or Heart and Spleen Yang Deficiency (심비양허).Chronic stress and excessive mental strain often cause insomnia due to Liver Qi Stagnation (간기울결), Liver Fire (간화), or the production of Phlegm Dampness (담음).Overeating, chronic gastrointestinal disorders, or inherent stomach weakness can lead to insomnia due to Stomach Qi Deficiency (위기부족).Other pathological factors, such as Qi Stagnation (기의 정체), Phlegm, Phlegm Dampness, or Blood Stasis (혈어), can also contribute to insomnia. Therefore, treating the underlying condition is essential.In conclusion, traditional Korean medicine emphasizes treating the root cause of insomnia, aiming to restore the balance between the body's various systems.Treatment Case 1) 23-year-old maleHe graduated from university in March and started working in April. He said that he was quite mentally exhausted from the training throughout the month. During the holiday in May, he took sufficient rest. However, perhaps due to his irregular lifestyle, after the holiday ended and he started working, he became unable to sleep. Additionally, he experienced difficulty falling asleep, a lack of restful sleep, feelings of depression, chest tightness, loss of appetite, nausea, and tension in the rectus abdominis with fullness in the chest and hypochondriac regions. His tongue appeared reddish, and his pulse was tense. After starting herbal medicine treatment, his appetite and sleep improved just a week after taking the prescribed medication.Treatment Case 2) 45-year-old femaleFor several months, she had been struggling to sleep at night. Usually, it takes her about 2 to 3 hours of lying in bed with the lights off to finally fall asleep. Even when she does sleep, she wakes up every 1 to 2 hours. She had been prescribed sleeping pills but did not want to take them. She also mentioned being very sensitive to cold. Due to her severe insomnia, we started acupuncture twice a week along with herbal medicine treatment. In the first week, there was no significant change, but by the second week, it took less than an hour for her to fall asleep, and the number of times she woke up during the night decreased from 4-5 times to 2 times. After four weeks of treatment, she found it easy to fall asleep, and she no longer woke up during the night.