Pulse of Oriental Medicine: Alternative Medicine That Works for Regular Folks
Alternative Medicine That Works for Regular Folks

First Published December 15, 2002

Natural Sleep Herbs:
Insomnia and Dizziness

by Brian Benjamin Carter


I am glad you added the 'if you ever need any help' to your response... I am in need. I have been taking the herbal preparation that was given to me at the herb shop since last week as well as drinking the korean Ginseng tea I got there as well. The herbal prep is Tian Wang Bu Xin Dan.

Today I followed my normal morning routine of taking the herb mixture at around 8:30 after breakfast and then having tea a bit later. Around 11:00 I began feeling very dizzy and by 11:30 felt very odd... I was at work and continued working to my lunch break. I was sitting at the table of kids I work with while they were eating and realized that when I looked at the milk carton in front of me it seemed to be sliding across the table, which is wasn't actually doing.

As soon as lunch was finished with the kids I went to the Health Center and rested. The nurse took my BP which was normal for me, about 108/56. I fell into a deep sleep for about an hour and woke up feeling much better and have not had any symptoms for the remainder of the day. I did not take the noon dose of the herb mixture nor did I drink more tea as I wanted to check in with you. Any suggestions of what was going on?

Thank you for taking time with this!

Blessings, Darren


Well I'm sorry to hear that after your initial enthusiasm you had a bad experience. My suspicion is that you were given the wrong formula.

If I were you, I'd check back with the person in the herb store who prescribed the formula. Find out if she is a licensed acupuncturist... if she was trained in herbs or not. From your email, it's hard to tell if it was a health food type store... lots of amateur "experts" there- some of them do know what they're talking about - don't get me wrong... I've heard some pretty right-on things from health store employees. But I don't think it's time to dispense with formal education yet, and most people have little appreciation for the power and complexity of chinese herbal medicine.

Tian Wang Bu Xin Dan - Insomnia Herb Formula

Tian Wang Bu Xin Dan is one of a number of standard insomnia formulas... as with all Chinese Herbal Medicine, we can' t just prescribe based on one symptom or chief complaint. We consider your whole health - all your symptoms and signs - and the best herbalists will modify the basic formula to fit you better. The goal is to increase healing and prevent the kind of adverse effects you experienced.

It's the same in western medicine, believe it or not. There's not just one kind of drug for hypertension... nor is there just one formula (let alone one herb) for insomnia in Chinese Medicine. If you had hypertension, your biomedical doc would have to choose between beta blockers, ace inhibitors, etc. in the light of your "whole case."

Why Would Insomnia Herbs Cause Dizziness and Visual Disturbances?

As far as your reaction to the herbs, there are a couple of possibilties... you may have more Spleen qi deficiency than your friend thought. In that case, the Tian Wang Bu Xin Dan (TWBXD) would be too cloying (too hard to digest), and could lead to the dizziness you experienced. Also, the Korean Ginseng could be too hot for you... the combination of the heat and the cloying herbs could lead to a phlegm rising pattern which would result in dizziness.

This is the most likely scenario... if your spleen (digestion) is too deficient to process the herbs, then that would create dampness/phlegm. The Korean ginseng is hot, and so it could all "go to your head" so to speak, leading to the dizziness and visual disturbance. We'll go into this more below.

Another possibility is that since your diastolic BP is rather low, perhaps you do need the TWBXD but the Korean Ginseng is too yang and hot for you. For more about who ginseng is and is not for, read our basic ginseng article.

Sleep Better with Chinese Herbal Formulas

Here are the major insomnia formulas and the patterns and symptoms they treat:

Herbal Formula

Pattern Diagnosis

Symptoms and Signs
(Distinct Symptoms in Bold)

Tian Wang Bu Xin Dan (Celestial Emperor's Special Pill to Tonify the Heart) Heart and Kidney Yin Vacuity Irritability, palpitations, anxiety, fatigue, insomnia with restless sleep, inability to think or concentrate, night-time emissions, forgetfulness, dry stool, red tongue with little coating, thin rapid pulse
Suan Zao Ren Tang (Sour Jujube Decoction) Liver Xue Vacuity with Vacuity Heat Irritability, inability to sleep, palpitations, night sweats, dizziness and vertigo, dry throat and mouth, dry red tongue and wiry or thin rapid pulse
Gui Pi Tang (Restore the Spleen Decoction) Spleen qi and Heart Xue Vacuity Forgetfulness, palpitations, insomnia, dream-disturbed sleep, anxiety and phobia, feverishness, withdrawal, reduced appetite, pallid and wan complexion, pale tongue with thin white coating and thin frail pulse. Women may have early periods with lots of pale blood or prolonged nearly continuous periods without much flow.
Huang Lian E Jiao Tang (Coptis and Donkey Skin Glue Decoction) Breakdown of Interaction between Heart and Kidneys Difficulty falling asleep or insomnia the whole night, dizziness, tinnitus, night sweats, heat feeling in the 5 soles (palms, soles and heart), impaired memory, low back and knee soreness and weakness, seminal emission, red tongue with little coat, fine rapid pulse
Ding Zhi Wan (Stabilize the Mind Pills) Gallbladder Vacuity and Qi Timidity Insomnia, fear of sleeping alone, gallbladder timidity (lack of "gall"), heart palpitations, frequent sighing, dizziness, being awoken in a fright, possible vomiting of bitter fluids, pale tongue with fine weak wiry pulse
Huang Lian Wen Dan Tang (Coptis Warm Gallbladder Decoction) Phlegm Fire Difficulty falling asleep due to severe restlessness, chest oppression, epigastric fullness, nausea, vomiting, heavy-headedness, dizziness, bitter taste in mouth, red tongue tip with slimy yellow coat and slippery rapid pulse
Xie Qing Wan (Drain the Green Decoction) Liver Fire Difficulty falling asleep due to dizziness and headache, hot feeling in chest with restlessness, impatience, extreme irritability, chest and ribside distention and fullness, frequent sighing, thirst, bitter taste in mouth, red eyes, dark urination, constipation, red tongue with yellow coat, wiry rapid pulse
Dao Chi San (Guide out the Red Powder) Heart fire exuberance Insomnia, restless heat in chest and heart, thirst with desire for cold drinks, red facial complexion, sores in mouth or on tongue, short dark colored urination, red tip of tongue, rapid forceful pulse
Shu Mi Tang (Sorghum Decoction) Food stagnation Insomnia, pain, distention and fullnes in stomach and abdomen, aversion to food, retching or sour regurgitation, nausea, thick slimy tongue coat, slippery pulse
Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction) Damaged Fluids and Retained Heat after Febrile Disease Insomnia, fever, profuse sweating, chest and diaphragmatic oppression, thirst with desire to drink, always hungry stomach, desire to vomit, red tongue with little coat, fine rapid pulse

Wrong Pattern = Wrong Formula = Bad Idea

To see how the wrong herbs could mess you up, let's look at the Phlegm Fire pattern. Huang Lian Wen Dan Tang is an awesome formula that's based on Er Chen Tang, the basic phlegm-treating herb formula. These herbs clear out accumulated dampness and phlegm with their aromatic, moving, and diuretic properties. Wen Dan Tang means adding Zhu Ru and Zhi Shi to Er Chen Tang. These two herbs add the ability to clear heat from the Gallbladder and Stomach, and rectify the qi in the abdominal area. Huang Lian is added to that to make Huang Lian Wen Dan Tang (HLWDT). Huang Lian clear Stomach and Heart heat. Overall, this is a really strong formula to clear out the excess phlegm and heat. However, if you had a Spleen Vacuity, these herbs would cause you even more digestive problems. HLWDT is for a clearly excess (repletion) situation.

On the other hand, about one-third of the herbs in Tian Wang Bu Xin Dan (TWBXD) are cloying (thick, substantial, harder to digest), and would worsen a damp/phlegm/Spleen deficient person. We have to be cautious when we prescribe cloying herbs and make sure their digestion is strong enough. Otherwise, the Spleen is injured and this leads to more dampness and phlegm. So, if you had Phlegm Fire and were given TWBXD, you could experience fullness, bloating, nausea, fatigue, dizziness, or even slight hallucinations. The last symptom is a result of Phlegm clouding the Heart. In Chinese Medicine, the Heart is the consciousness and corresponds to some brain functions.

So the point is- if you get the pattern diagnosis wrong and take the wrong herbs, they'll mess you up.

Food and Insomnia

A little sidebar- Philippe Sionneau (see the references below) told me that he believes that food stagnation is an often under-diagnosed cause of insomnia. I remembered that and when I found myself having trouble falling asleep and having sour regurgitation, I took some digestive enzymes (similar to food stagnation herbal formulas) and went right to sleep!

Overly Simple Solutions Can Lead to More Problems

I also want to warn you against choosing a formula based on just one symptom (e.g. insomnia, forgetfulness, palpitations, etc.). This logically will lead to poor results. Chinese Medicine is based in large part on pattern differentiation- this means finding out what type of insomnia you have... what symptoms accompany it? What causes it? Once we know its character and surrounding constellation of symptoms, we can choose the appropriate herbal formula (and suggest dietary modifications).

Even choosing the right one of these formulas above is just a start. Each of these formulas has from 5-15 herbs. The pinnacle and power of chinese herbal medicine lies in personalization of the formula for the disease as it manifests now. Your formula will change as you heal. Herbs are added or taken away from the formula, and dosages change. The herbal formula should fit you like a glove.

To make sure you always get the right herbs for your condition, you should consult with someone who was formally educated in Chinese Herbal Medicine. You can find such people from my list of resources.

I wish you all the best!

Find a licensed acupuncturist here:
"Resources for Finding Acupuncturists and Herbalists"

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