Acupuncture points for insomnia, chosen by pattern
There is no single set of points for insomnia in Chinese medicine; the points follow the pattern, and the pattern is read from how the sleep fails. Trouble falling asleep with a mind that will not stop, in a tired person, is Heart and Spleen deficiency, treated at HT7 Shenmen, SP6 Sanyinjiao, BL15 Xinshu, BL20 Pishu, ST36 Zusanli, and Anmian. Waking between one and three in the morning, irritable, is Liver qi stagnation turning to fire, treated at LR3 Taichong, LR2 Xingjian, GB20 Fengchi, HT7, PC6 Neiguan, and Yintang. Waking often through the night with hot palms and night sweats is Heart and Kidney failing to communicate, treated at HT7, HT6 Yinxi, KI3 Taixi, KI6 Zhaohai, BL62 Shenmai, and BL23 Shenshu. Heavy, restless sleep after a large evening meal is phlegm-heat or food stagnation, treated at ST40 Fenglong, CV12 Zhongwan, ST44 Neiting, and PC7 Daling. Waking at the least sound with palpitations and timidity is Heart and Gallbladder qi deficiency, treated at HT7, GB40 Qiuxu, BL19 Danshu, and PC6.
How Chinese medicine reads sleep
The Lingshu explains sleep by the circuit of the wei qi, the defensive qi: by day it travels in the yang and the eyes are open; at night it enters the yin and the eyes close; and when it cannot enter the yin, the person lies awake. The Yin Qiao and Yang Qiao vessels are the gate of that passage, and their two opening points, KI6 Zhaohai for the Yin Qiao and BL62 Shenmai for the Yang Qiao, are the classical pair for insomnia, KI6 tonified and BL62 reduced to bring the qi into the yin; the same pair reversed treats the person who cannot stay awake. The Shen rests at night in the Heart's Blood, so whatever leaves the Heart short of Blood or yin, or stirs it with heat or phlegm, unsettles sleep. The Suwen adds that when the Stomach is not at harmony, lying down is not at peace, which is the ground for treating the digestion in the person who sleeps badly after eating.
The patterns and their points
Heart and Spleen deficiency
Sleep that will not come for hours, a mind circling over the day's worries, light sleep with many dreams, palpitations, poor memory, fatigue, a poor appetite and loose stools, a pale face and lips, a pale tongue, and a thin weak pulse. The Spleen is not making Blood and the Heart has nothing to rest in. HT7 Shenmen, the source point of the Heart, calms the Shen; SP6 Sanyinjiao, where the three leg yin channels meet, builds Blood and yin; BL15 Xinshu and BL20 Pishu, the back-shu points, tonify the Heart and Spleen directly; ST36 Zusanli builds the qi that makes Blood; Anmian, the extra point behind the ear whose name means peaceful sleep, is added to nearly every prescription for insomnia.
Liver qi stagnation turning to fire
Falling asleep is easy but the night breaks between one and three, the Liver's hours on the organ clock, with irritability, vivid or angry dreams, a tight chest, a bitter taste in the morning, headache at the temples, red sides to the tongue with a yellow coat, and a wiry pulse that is rapid once fire has formed. LR3 Taichong, the source point of the Liver, spreads the qi; LR2 Xingjian, the fire point, drains the heat; GB20 Fengchi clears the head; PC6 Neiguan eases the chest; HT7 and Yintang, the point between the brows, settle the spirit.
Heart and Kidney not communicating
Waking repeatedly, or lying awake from three or four with the body hot, a dry mouth, heat in the palms and soles, night sweats, a sore lower back, tinnitus, a red tongue with little or no coat, and a thin rapid pulse. The Kidney's water is too low to rise and cool the Heart's fire. KI3 Taixi and KI6 Zhaohai nourish the Kidney yin; HT6 Yinxi, the cleft point, clears the deficiency heat and stops the night sweats; HT7 calms; BL62 Shenmai is reduced against KI6; BL23 Shenshu strengthens the Kidney. SP6 is added, and moxibustion is not used.
Phlegm-heat and food stagnation
Sleep that is heavy but not restful, with a full chest, a stuffy stomach, nausea, belching, dizziness, a thick greasy yellow coat, and a slippery rapid pulse, worse after a late or heavy meal. ST40 Fenglong, the point that transforms phlegm, is the lead; CV12 Zhongwan and ST44 Neiting clear the Stomach; PC7 Daling drains heat from the Pericardium and the mind. The evening meal is moved earlier and made smaller.
Heart and Gallbladder deficiency
The timid sleeper: easily startled awake, palpitations at the least noise, sighing, indecision, a pale tongue and a wiry thin pulse. GB40 Qiuxu, the source point of the Gallbladder, with BL19 Danshu, gives the Gallbladder its courage back; HT7 and PC6 steady the Heart.
Points that run through every prescription
HT7 Shenmen lies at the wrist crease on the little-finger side, in the hollow at the radial edge of the tendon of flexor carpi ulnaris. Yintang lies between the eyebrows. Anmian lies behind the ear, midway between GB20 Fengchi and TE17 Yifeng. Sishencong, the four points around GV20 Baihui at the crown, calm a spirit that will not settle. SP6 Sanyinjiao is not needled in pregnancy. The same points are pressed at bedtime with the thumb between treatments.