Gina Johnson
Sleep has always been considered important for health in Chinese culture, as evidenced by the proverb, A full night's sleep is better than taking ginseng. Traditional Chinese Medicine (TCM) has a long history of research in sleep and sleep disorders, with records of insomnia, hypersomnolence, and dream disorders dating back to 403 BC. The ancient Chinese developed various tools and methods to promote sleep, such as the Boshan Censer, a bronze incense burner believed to circulate fragrant smoke within the room. Another traditional practice is soaking the feet in warm water before bedtime to promote blood circulation and Qi circulation. In terms of herbal remedies, Polygonum multiflorum (Shou-wu-teng) and Suan-zao-ren-tang have been commonly prescribed in Chinese medicine to treat insomnia.
| Characteristics | Values |
|---|---|
| Traditional Chinese Medicine Sleep Tips | Soaking feet in warm water at night before sleep to promote blood circulation and Qi circulation |
| Massaging Yongquan acupoint on the bottom of the feet to help with blood circulation, reduce tiredness, and improve sleep quality | |
| A quiet and peaceful sleep environment | |
| Circulating fresh air in the room | |
| Exposing the eyes to light of sufficient intensity and duration at the appropriate time of day | |
| Cognitive-behavioral therapy | |
| Relaxation exercises | |
| Positive self-talk | |
| Imagery rehearsal | |
| Daytime naps | |
| Chinese Herbal Medicines | Shou-wu-teng (Polygonum multiflorum) |
| Suan-zao-ren-tang | |
| Long-dan-xie-gan-tang | |
| Albizia julibrissin | |
| P. multiflorum | |
| P. cocos extract |
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What You'll Learn
Herbal medicines like Suan-zao-ren-tang
In the context of sleep, the ancient Chinese valued a good night's rest and developed various tools and methods to achieve this. One notable practice is the use of herbal medicines, with Suan-zao-ren-tang (SZRT) being the most commonly prescribed Chinese herbal formula for treating insomnia. SZRT is a combination of five medicinal Chinese herbs:
- Semen Zizyphi Spinosae (Suanzaoren)
- Sclerotium Poriae Cocos (Fuling)
- Radix Ligustici Chuanxiong (Chuanxiong)
- Rhizoma Anemarrhena (Zhimu)
- Radix Glycyrrhizae (Gancao)
SZRT is believed to "nourish the blood and calm the nerves," ultimately inducing a tranquilizing effect and reducing sleep disturbances. Its use is supported by the ancient Chinese book, "Synopsis of Prescriptions of the Golden Chamber," written by Chang Chung Ching (AD 150–219). Clinical trials have shown that SZRT improves sleep quality and efficiency, with one trial reporting a reduction in the time taken to fall asleep and an increase in total sleep time for methadone-maintained patients.
In addition to SZRT, Polygonum multiflorum (Shou-wu-teng) is another commonly prescribed Chinese herb for insomnia, known for its anti-inflammatory and neuroprotective effects. Traditional practices also include soaking the feet in warm water before sleep to promote blood and Qi circulation, as well as massaging specific acupoints on the feet, such as the Yongquan acupoint, to improve sleep quality.
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Soaking feet in warm water
Soaking one's feet in warm water before sleep is a common Chinese tradition. This practice is believed to promote blood circulation and Qi circulation, with the latter being the life force according to traditional Chinese medicine. The water temperature should be between 40 to 45 degrees Celsius (104 to 113 degrees Fahrenheit), and the water level should be high enough to cover the ankles.
The process involves soaking the feet for around 20 to 30 minutes. During this time, one can rub their feet together or use their hands to massage them. After soaking, it is important to dry the feet with a towel. Following this, one can sit on the bed and massage the Yongquan acupoint located on the bottom of each foot. Massaging this point helps with blood circulation, reduces tiredness, and improves sleep quality. It is recommended to massage each foot's Yongquan acupoint 36 times, repeating the process 2 to 3 times.
Foot baths are an ancient Chinese practice with numerous health benefits that vary with the seasons. In spring, for example, foot baths are believed to tone the Yang (energy) and prevent the depletion of Qi. Traditional Chinese Medicine (TCM) compares the human body to a tree, where the head represents the branches, the body is the trunk, and the feet are the roots. Therefore, taking care of one's feet is essential for overall well-being.
Additionally, foot baths increase circulation, making them particularly beneficial in colder regions. Soaking the feet increases the heart rate, similar to exercising, which is advantageous for those who are physically inactive. Foot baths can also be enhanced by adding various substances to the water, such as herbs, salts, and oils, which enter the bloodstream through the skin and provide additional medicinal benefits.
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Massage Yongquan acupoint on feet
In traditional Chinese medicine (TCM), the feet are considered one of the most important parts of the human body. The Yongquan acupoint, located on the sole of the foot, is believed to be the starting point of the kidney meridian. Stimulating this point is thought to promote blood circulation, reduce tiredness, and improve sleep quality.
- Begin by soaking your feet in warm water for about 30 minutes before bedtime. The water temperature should be between 40 and 45 degrees Celsius (104 to 113 degrees Fahrenheit), and high enough to cover your ankles. You can add a little salt to the water or use ginger or pepper water instead for added benefits.
- After soaking, dry your feet with a towel.
- Sit comfortably on a chair or on your bed. If sitting on a chair, place your right foot on your left leg and hold your toe with your right hand.
- Using your left hand, rub or gently tap the Yongquan acupoint on the center of your right foot until it feels warm. This point is located in a slight depression near the base of the big toe, about one-third of the distance from the toes to the heel.
- Repeat the process for the left foot, using your right hand to rub or tap the acupoint.
- Massage each foot's Yongquan acupoint 36 times (either in circles or with gentle presses). Repeat this process 2 to 3 times.
Additionally, you can enhance the effects by incorporating mild moxibustion. Burn a moxa stick and apply mild moxibustion to the Yongquan point until it feels hot and comfortable. Perform this for about 20 minutes, once a day or every other day, up to 10 times a month.
Massaging the Yongquan acupoint is a traditional Chinese technique that may help improve your sleep quality and overall well-being.
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Bright light therapy
The duration of light exposure is also important, with longer exposure times generally being more beneficial. The recommended exposure duration is 30-90 minutes. However, some patients may reduce their daily treatment to 15 minutes or use the lamp every other day or every third day. The degree of success varies from person to person.
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Cognitive-behavioural therapy
Digital Cognitive Behavioral Therapy for Insomnia (DCBT-I)
Digital cognitive behavioural therapy for insomnia has been adapted for the Chinese cultural context. A pilot randomised clinical trial conducted from March 2021 to January 2022 used a smartphone-based app with a Chinese interface to deliver DCBT-I to participants. The app emphasised the principles and effects of sleeping restriction to correct misconceptions and facilitate the CBT-I process. It also featured a chatbot that simulated the language expressions of a real-world therapist. The results showed that the DCBT-I application reduced insomnia severity in the Chinese cultural context.
Chinese Chan-Based Mind-Body Intervention
A randomised controlled trial compared the effect of a newly developed Chinese Chan-based intervention, namely Dejian mind-body intervention (DMBI), with CBT on improving sleep problems of patients with depression. Seventy-five participants diagnosed with major depressive disorder were randomly assigned to receive 10 weekly sessions of either CBT or DMBI. Results indicated that both the CBT and DMBI groups demonstrated significantly reduced sleep onset latency and wake time after sleep onset compared to the waitlist group.
Culturally Adapted CBTI for Chinese Insomnia Patients
A one-arm pilot trial developed an 8-week culturally adapted CBTI program that included mixed group and individual sessions and culturally adapted relaxation and cognitive restructuring treatment components. Seventy-two Chinese adults with insomnia disorder underwent the program. Sleep diaries and self-report scales, as well as polysomnography, were used to assess qualitative and quantitative measures of sleep, mental health status, and quality of life at baseline, post-treatment, and 4-month follow-up. The results showed significant changes in sleep diary sleep onset latency, wake after sleep onset, and total sleep time. Self-reported sleep quality, mental health, and quality of life improved compared to baseline.
CBT for Sleep: How it Works
CBT for insomnia (CBT-i) is part cognitive and part behavioural. The cognitive part addresses what you think, while the behavioural part addresses what you do. CBT-i typically involves stimulus control therapy, relaxation training, sleep restriction, and cognitive therapy. It may include techniques such as progressive muscle relaxation, which is recommended for practice at bedtime every night to improve sleep.
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Frequently asked questions
The Chinese herb, Shou-wu-teng (Polygonum multiflorum), was the most commonly prescribed herb for insomnia in Taiwan during 2002. Suan-zao-ren-tang was the most commonly prescribed Chinese herbal formula.
The ancient Chinese would soak their feet in warm water before bed, which was believed to promote blood circulation and Qi circulation. They also used censers, incense burners that circulated fragrance around the room.
The ancient Chinese believed that sleep was of great importance to one's health. A proverb states, "A full night's sleep is better than taking ginseng." The process of falling asleep was explained as the defensive Qi (wei), a variety of yang-qi, descending into yin and changing from activity to repose, resulting in sleep.
