Treating Insomnia with Chinese Medicine

290 Pages·2022·16.478 MB·English

by  Yoann Birling

Treating Insomnia
with Chinese Medicine
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TREATING
INSOMNIA with
CHINESE MEDICINE
A Synthesis of Clinical Experience
YOANN BIRLING
Foreword by Jane Lyttleton
First published in Great Britain in 2022 by Singing Dragon
An imprint of Jessica Kingsley Publishers
An imprint of Hodder & Stoughton Ltd
An Hachette Company
1
Copyright © Yoann Birling 2022
Foreword Copyright © Jane Lyttleton 2022
The right of Yoann Birling to be identified as the Author of the Work has been
asserted by him in accordance with the Copyright, Designs and Patents Act 1988.
Front cover image source: Shutterstock® and Deposit Photos. The cover image
is for illustrative purposes only, and any person featuring is a model.
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the prior written permission of the publisher, nor be otherwise circulated
in any form of binding or cover other than that in which it is published and
without a similar condition being imposed on the subsequent purchaser.
A CIP catalogue record for this title is available from the
British Library and the Library of Congress
ISBN 978 1 83997 230 0
eISBN 978 1 83997 231 7
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Contents
Foreword by Jane Lyttleton . . . . . . . . . . . . . . . . . . . . . . 7
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Part A: Integrative Knowledge on Insomnia
1. Sleep and Its Mechanism. . . . . . . . . . . . . . . . . . . . . . . 17
2. The Characteristics of Insomnia . . . . . . . . . . . . . . . . . . 25
3. The Pathology of Insomnia . . . . . . . . . . . . . . . . . . . . . 33
4. The Treatment of Insomnia. . . . . . . . . . . . . . . . . . . . . 45
Part B: Clinical Experience Synthesis
5. General Considerations in the Treatment of Insomnia
with Chinese Medicine. . . . . . . . . . . . . . . . . . . . . . . . 57
6. Pattern-Based Treatment of Insomnia with Chinese
Herbal Medicine. . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
7. Atypical Patterns of Insomnia. . . . . . . . . . . . . . . . . . . . 104
8. Classical Formulas . . . . . . . . . . . . . . . . . . . . . . . . . . 119
9. Disease-Based Treatment with Chinese Herbal Medicine . . . 142
10. Treatment Adaptation According to the Person,
the Season and the Location . . . . . . . . . . . . . . . . . . . . 151
11. Treatment According to Insomnia Subtype. . . . . . . . . . . . 163
12. Managing Comorbidities . . . . . . . . . . . . . . . . . . . . . . 173
13. Cooking, Intake Methods and Treatment Duration. . . . . . . 183
14. Shen-Calming Herbs . . . . . . . . . . . . . . . . . . . . . . . . . 186
15. Herb Combinations. . . . . . . . . . . . . . . . . . . . . . . . . . 194
16. Clinical Tips on the Use of Herbs. . . . . . . . . . . . . . . . . . 200
17. Other Herbal Treatments . . . . . . . . . . . . . . . . . . . . . . 202
18. Body Acupuncture Treatment . . . . . . . . . . . . . . . . . . . 206
19. Scalp Acupuncture and Ear Acupuncture . . . . . . . . . . . . . 220
20. Other Acupuncture-Related Therapies . . . . . . . . . . . . . . 222
21. Tuina Massage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 226
22. Psychology and Music Therapy. . . . . . . . . . . . . . . . . . . 234
23. Integrative Chinese Medicine. . . . . . . . . . . . . . . . . . . . 238
24. Yangsheng and Self-Treatment . . . . . . . . . . . . . . . . . . . 240
25. Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 248
Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 267
Subject Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 275
Author Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 287
Foreword
When Yoann asked me to write the foreword to this book he could not
have known that sleep is one of my favourite topics (and a favourite
pastime). Sleep is also an intriguing mystery of human behaviour, that
peculiar state akin to coma, death or anaesthesia about which we still
know so little. So needless to say, I was delighted by the request.
I, like so many parents of babies who don’t sleep, developed an
enduring obsession with sleep some decades ago. We, the legion of
exhausted parents kept awake during the wee hours of the night, have
insight into the effects of sleep deprivation. It is a kind of torture not
confined to the pages of spy novels.
Sleep deprivation however is not the same as insomnia. But after
month or years of interrupted sleep many parents do lose the capacity
to sleep well. As do people who work shift work for an extended period
of time. The same can apply to people who experience damaging stress,
illness, mood disorders or hormone disruptions. In fact, we might think
that modern city life is creating for all of us a nightmare scenario when
it comes to healthy sleep conditions (even without a baby). We are seem-
ingly always switched on, constantly bathed in the blue light from the
screens of displays and devices, and have artificial lighting illuminating
the city and the sky all night. But sleep historian Professor Roger Ekirch
claims that at ‘no time in history have conditions from human slum-
ber been better than today. Compared with 99 percent of our ancient
ancestors, we have better beds, better blankets, better houses, and fewer
late-night pests.’1 So I wonder, as did Yoann, what is it that brings so
many patients to a Chinese medicine clinic seeking help for insomnia?
Humankind has long been intrigued by the phenomenon of sleep.
1 R. Ekirch in Thompson, D. (2022) Can Medieval Sleeping Habits Fix America’s Insom-
nia? Accessed on 14/04/2022 at https://www.theatlantic.com/ideas/archive/2022/01/
medieval-sleeping-habits-insomnia-segmented-biphasic/621372
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TreaTing insomnia wiTh Chinese mediCine
There have been many books written about sleep – from popular ones
like Ariana Huffington’s (of the famous eponymous Posts), and best-
selling ones like Matthew Walker’s Why We Sleep, to historical treatises
and scientific books covering sleep medicine reviews. A quick internet
search for books on sleep gives more than 50 current titles – I have read
quite a few of them. But this book on sleep may well turn out to be my
best pick due to a number of reasons:
• it looks at sleep from a traditional Chinese medicine (TCM)
perspective (another favourite subject)
• it explores some of the mysteries of why we sleep, and what is
going on when we can’t
• it tells stories about real people and real sleep problems as
described by hundreds of TCM doctors in China
• it creates an easy to understand synthesis that analyses and sum-
marizes what our TCM forbears have thought important when
treating insomnia
• it explores solutions to various pathologies that cause debilitating
chronic insomnia.
Most TCM doctors will read this book to learn more about techniques
they can use to make them more effective in the clinic. But what makes
this book different is the author’s interest in finding and creating clini-
cal guidelines by searching through literally hundreds of case histories.
Yoann analyses 560 clinical experience reports that he found in the
Chinese academic literature to generate a clinical experience synthesis
(CES), the result of which is a large part of the book you hold in your
hands (or see on your screen). He claims (and no one can argue his point)
that the strength of this book is in the pooling of clinical experience
from many different sources. Yoann’s academic training gives him the
tools to analyse this large pool of clinical experience in such a way as
to create useful hierarchies that can guide clinicians to make the best
treatment decisions.
At the outset this book offers a physiological description of the parts
of the nervous system responsible for sleep and wakefulness – located
in the back of the neck, base of the head and top of the spine – the
dumai of course. And just so you get the point of CES straight away, we
are told that dumai is the most commonly used meridian for insomnia
treatment. That may be news to a number of acupuncturists I know.
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