Understanding Herbs
Herbs Make It Easy to Catch Some Zs"
By Malik Cotter, D.Ac.
Ahh, the beauty of sleep. That time when the pressures of life melt into the void of peacefulness, when bodies relax and minds release the events, cares and mental chatter that tend to preoccupy our thoughts. Sleep is a time when the body, mind and spirit rejuvenate and revitalize, regenerate cells and tissues, and expand on ideas and visions. In life, activity must be balanced with repose, and going without quality sleep increases susceptibility to disease.
Insomnia can be the inability to fall asleep, restlessness while sleeping, or waking up earlier than desired and not being able to return to sleep. Any way it manifests, it is an unhealthy state. People who have chronic insomnia find the night more stressful than the day, and the sleep deprivation caused by insomnia makes their work and daytime activities less exciting as well as inefficient or even dangerous to themselves and others.
Chronic stress and tension, worry, fear, and other anxieties are usually the root of insomnia. Other causes include dietary stimulants, indigestion, overeating and pain. Blood-sugar imbalances can release stimulatory hormones that keep a person awake, as can a vitamin B6 deficiency. B6 assists in the formation of the neurotransmitter serotonin, which helps regulate sleep.1 The serotonin precursor 5-hydroxytryptophan (5-HTP) has also been shown to help bring on sleep.2
With many over-the-counter sedative drugs available to combat insomnia, people easily turn to the local pharmacy for relief. For short-term management of a high-stress situation, it may be appropriate to use sedative drugs, but their chronic use only proves detrimental to one's overall health and well-being. Sedative drugs depress nervous system function, making people unable to relax naturally. They also can become addictive and interfere with rapid eye movement (REM) sleep, the phase when dreams occur.3
Yin/Yang: East vs. West
The Western medical view of insomnia runs parallel to the Chinese outlook, each lending insight to relief and cure, but the two use quite different vocabularies to describe how stress affects the blood and prevents it from nourishing cells, tissues and organs. Western doctors describe the cascade of events this way: Stress produces cortisol, a hormone that when overproduced upsets the balance in the body, brain and nervous system—disrupting hormonal balance and causing the brain and nervous system to malfunction. Cortisol also disturbs the blood-sugar balance by consuming glucose from the blood.4
Traditional Chinese medical theory holds that sleep depends on the state and condition of the blood. An insufficiency of blood due to a spleen energy-system deficiency, for example, can cause insomnia. Without the proper quality and quantity of blood, the mind wanders at night, resulting in poor sleep. In other cases, a person who has difficulty falling asleep is viewed as having a lack of proper blood nourishing the heart. One who wakes up at night may have a deficiency of vital body fluids and essence in the kidney energy-system.5
In all, easing into the sleep state without difficulty and waking up rested and alert is a sign of good health.
Herbal Relief
Chinese medical practitioners treat insomnia primarily with herbs, acupuncture, dietary programs and lifestyle changes.
Several popular Western and Chinese herbs are effective individual sleep inducers, and Chinese herbal formulas also help to alleviate the causes and symptoms of insomnia.
Valerian (Valeriana officinalis), widely used in herbal medicine, is one of the safest sedative plants. It has been shown to relieve insomnia by calming nerves, relieving nervous tension, improving the quality of sleep and reducing the time it takes to fall asleep.6,7 The active constituents of valerian are not known. It appears from clinical anecdotes that valerian relaxes the nervous system with tranquilizing, antispasmodic and pain-relieving properties. The root is used in a decoction for anxiety and insomnia. Overuse may cause headaches and palpitations, so until more is known, customers should avoid long-term use of valerian. (See sidebar.)
Kava kava (Piper methysticum) has been used primarily by native Polynesian and Hawaiian peoples for its calming and relaxing effects. Kava kava in liquid form is a remedy with minimal toxicity—the only known negative effect is a yellow, scaly skin rash that occurred in Pacific-island natives who took great quantities of the herb; the rash disappeared after discontinued use.8 Kava kava has a combined relaxant, restorative and stimulant quality that is used to relieve muscular tensions9 and is said to break up stagnant energy. Small doses of the decocted root appear to be restorative, while larger doses are sedative.
Passion flower (Passiflora incarnata) is a sedative, pain-killing analgesic and hypnotic widely used to calm the nervous system and promote sleep.10 Harmine, one of the harmala alkaloids present in this herb, was originally thought to be responsible for inducing a euphoric and meditative state, but passion flower's active constituents and exact methods of action are still unknown.11 Passion flower is considered to be less potent than either valerian or kava kava.
Chamomile (Matricaria chamomilla) flowers are said to be a gift from the gods. Chamomile has been used to calm an excited mind and relax a nervous stomach. A tea made from the flower is used as an anti-inflammatory, antispasmodic and sedative.10 Allergic reactions to chamomile are rare.
Reishi mushroom (Ganoderma lucidum) has long been used in Chinese medicine as a tranquilizer and sedative. It is used to tonify or strengthen the blood and restore vital energy of the body and mind. This mushroom is said to inhibit the central nervous system, promote muscular relaxation and prolong sleep. Used as a cardiotonic, reishi mushrooms lower blood pressure and blood cholesterol and increase white blood cell count.12
Wild jujube seed (Ziziphus jujuba) is another Chinese herb with sedative and tranquilizing properties. It is used in formulas where prime symptoms are insomnia, night sweats, palpitations and nervous body movements. This seed also has analgesic properties and is an anticonvulsive. It is thought to supply necessary nutrients directly to the heart.12
Chinese Herbal Formulas
Chinese herbs are usually combined in formulas to enhance their individual actions and properties. They are sold under their Chinese herbal formula names. Some stores shelve Chinese herbs together and others organize their natural agents by specific conditions. Manufacturers often offer formulas that contain more herbs than prescribed in traditional Chinese medical texts.
To use the Chinese medical model effectively, it is important to differentiate which affected system in the patient is manifesting as insomnia. A deficiency of spleen and heart blood is the most common cause of insomnia. Symptoms are difficulty in falling asleep, poor appetite, pale complexion, blurred vision and tiredness. The 12-herb formula Gui Pi Tang, sometimes called Ginseng and Longan Combination, is used in this instance because it gives a tonic effect to the blood, spleen and heart.
A heart-blood deficiency is marked by waking frequently at night, poor memory, dry throat, mental restlessness and palpitations. The 12-herb formula Yang Xin Tang is a good choice for this condition.
A kidney energy-system centered insomnia, manifesting as tinnitus and lower back pain, might call for the 15-herb formula Tian Wan Bu Xin Dan, sometimes called Ginseng and Ziziphus Formula.
A liver energy-system insomnia will reveal a heat involvement displaying symptoms of restless sleep, unpleasant dreams, irritability, dry stools and thirst. For this pattern of disharmony, try the gentian (Gentiana lutea) root-containing 10-herb formula Long Dan Xie Gan Tang for its heat-removing properties, or the five-herb ziziphus combination called Suan Zao Ren Tang to nourish the blood and essence of the liver.
When the gallbladder and heart are mutually affected due to deficient blood and energy, symptoms are dreaming a lot and waking up earlier than usual without being able to go back to sleep. Daytime symptoms include being easily startled, submissive and tired. The formula An Shen Ding Zhi Wan, which literally means "calms the spirit and settles the emotions," is considered for this type of insomnia.13
Herbs can relieve the symptoms and treat the underlying causes of mild insomnia. When insomnia is long term and displays complex symptoms amounting to more than just difficulty in getting to sleep, tell your customers to consult with a professional health care practitioner who can suggest necessary lifestyle changes. Anyone suffering from insomnia must search deeply for the underlying cause. Once corrected, the person will have a greater momentum for living with optimal health, a prerequisite of which is enjoyable and nurturing sleep.
Sidebars:
Commission E Monograph: Valerian Root
Malik Cotter, doctor of acupuncture, diplomate of Chinese medicine and professor of Chinese medicine at the Chengdu Medical University, China, directs a medical clinic and herbal pharmacy in Hawaii.
References
1. Lal KJ, Dakshinamurti K. Hypotensive action of 5-HT receptor agonists in the vitamin B6-deficient rat. Eur J Pharmacol 1993 Apr 6;234:183-9.
2. Sourlairac A, et al. Action of 5-hydroxytryptophan, serotonin precursor, on insomniacs. Ann Med-Psychol 1977;135:792-8.
3. Grozinger M, et al. Effects of Lorazepam on the automatic online evaluation of sleep EEG data in healthy volunteers. Pharmacopsychiatry 1998 Mar;31(2):55-9.
4. Khalsa DS. Brain longevity. New York: Warner Books; 1997. p 19.
5. Giovanni M. The foundations of Chinese medicine. London: Churchill Livingstone; 1989. p 158.
6. Bundesanzeiger. Cologne (Germany); 1990 Mar 6.
7. Leatherwood PD, Chauffard F. Quantifying the effects of mild sedatives. J Psychiatr Res 1983;17(2):115-22.
8. Norton SA, et al. Kava dermopathy. J Am Acad Dermatol 1994;31(1):89-97.
9. Singh YN. Effects of kava on neuromuscular transmission and muscle contractility. J Ethnopharmacol 1983;7:267-76.
10. Ody P. The complete medicinal herbal. New York: Dorling Kindersley; 1993. p 47,164.
11. Embodden W. Narcotic plants. New York: Collier books: 1980.
12. Yeung H. Handbook of Chinese herbs and formulas. Los Angeles: Institute of Chinese Medicine; 1985. p 349, 497.
13. Giovanni M. The practice of Chinese medicine. London: Churchill Livingstone; 1989. p 286-96.
