Medical Herbalism: Sleeplessness
The Nature of the Patient
A Medical Herbalist evaluates the patient’s psychological profile and character, the onset, duration and severity of sleeplessness (including insomnia), besides other associated symptoms and lifestyle factors.
Insomnia commonly manifests as delay in falling asleep, lack of deep sleep, frequent awakening during the night and / or early-morning awakening. Since adequate adult sleep requirements vary from 4 to 10 hours per night (Merck Manual 2003:467), only unrefreshing sleep may be clinically important.
Correct and individualised diagnosis of the causes of insomnia in patients is essential for successful health strategies. Common culprits are stimulants such as caffeine, alcohol, chocolate, cheese, sugar and disorderly eating associated with digestive imbalance. Sensitivity to the above foods might increase with age, as the pineal gland in the brain secretes melatonin, a hormone which diminishes by 90% in the elderly, which involves regulation of sleep-wake and appetite “body clocks” (Motilva et al 2001:920).
Also stress causes the “fight or flight” reaction affecting adrenaline and other hormones involved in sleep and wakefulness (Kapit et al 2000:106). Adrenaline and noradrenaline are released by the adrenal cortex (of glands above the kidneys) to respond to emotions of fear and anxiety (Hoffman 1990:17).
Other important causes of insomnia to be evaluated include asthma, heart disease, incontinence, muscle and joints aches and pains, snoring (apnoea), night sweats, side-effects from medications or any withdrawal symptoms.
Holistic Treatment of the Sleepless Patient with Herbal Medicines
After diagnosing the nature of the sleepless patient, a Herbalist considers the energetic temperature of herbs to match the patient’s constitutional speed of metabolism. This is comparable to examining the burning qualities of fuel types, in order to maximise the efficiency of a given car type.
For example, the anxious patient taking time to fall asleep might be given a nerve relaxant such as Humulus lupulus (Hops) or Valeriana officinalis (Valerian). Hops cool and slow down an excitable “sanguine” patient, whose blood flow is warm and fast, whereas Valerian may maintain a degree of excitement, due to its slightly warming qualities. Conversely, Hops might be avoided in patients with slow “phlegmatic” constitutions, sluggish blood flow and a tendency to complain about the cold.
Frequent wakefulness is often caused by sluggish digestion, sometimes accompanied by hot migraine, where a bitter, digestive and cooling relaxant herb such as Stachys betonica (Wood Betony) might be appropriate. Should the same patient be a menopausal woman awakening in sweat, Dioscorea villosa (Wild Yam) might be added to the prescription for its cooling digestive and hormonal qualities (oestrogen-like). Cooling, digestive bitters are also anxiolytic nervines, as the digestive organs and gut are regulated by the Vagus, cranial nerve X.
A patient sleeping lightly, due to nervous muscle twitches and joints aches and pains, may benefit from relaxant and heating herbs, similarly to using a hot water bottle. Well known heating herbs include Zingiber officinale (Ginger), Piper nigrum (Black pepper) and Capsicum minimum(Cayenne). Conversely, heating herbs might worsen the aches and pains of patients with hot constitutions and inflammation.
- Hoffman, David (1990) Herbal Stress Control. London, New York, Sydney, Toronto: Guild Publishing.
- Kapit, Wynn, Macey Robert I, Meisami, Esmail (2000) The Physiology Coloring Book. San Francisco, Reading Massachusetts, New York, Harlow England, Don Mills Ontario, Sydney, Mexico City, Madrid, Amsterdam: Addison Wesley Longman, Inc.
- Merck Manual (2003) The Merck Manual of Medical Information (2nd home edn.). Whitehouse Station NJ: Merck Research Laboratories.
- Motilva V, Cabeza J & Alarcon de La Lastra C (2001) New Issues about Melatonin and its Effects on the Digestive System. Current Pharmaceutical Design 7, 909-931.