1. From Sleepless Nights to Peaceful Rest
After menopause, Ms. Chen, a 55-year-old office worker, found herself struggling with insomnia for over a year.
She had trouble falling asleep, often woke up in the middle of the night, and couldn’t go back to sleep.
Her nights were filled with restlessness and dreams; her days, with fatigue and irritability.
She often felt palpitations, dizziness, dry throat, and inner heat — yet medical checkups found nothing unusual.
“I feel exhausted, but I just can’t sleep,” she sighed.
2. TCM Diagnosis: When Yin Deficiency Meets Emotional Stress
Upon observation, her face appeared slightly flushed, her tongue was red with little coating, and her pulse was thin and rapid.
In Traditional Chinese Medicine (TCM), this pattern indicates Liver Qi stagnation transforming into fire, combined with Yin deficiency generating internal heat.
In menopausal women, the decline of kidney Yin leads to an imbalance between Yin and Yang.
If stress and irritability constrain the Liver, the accumulated heat disturbs the Heart and mind, resulting in insomnia, irritability, and frequent dreaming.
“When the Liver fails to store the soul and the Heart spirit loses its nourishment, sleep becomes disturbed.”
3. Treatment Principle: Nourish Yin, Clear Fire, Calm the Mind
Diagnosis: Insomnia (Sleep Disorder)
Pattern: Liver Qi stagnation with Yin deficiency and internal heat
Therapeutic principle: Nourish Yin and clear heat, soothe the Liver, calm the mind, and harmonize the Heart
💊 Herbal Prescription (7 doses)
| Herb (Latin/English Name) | Function |
|---|---|
| Zhen Zhu Mu (Mother of Pearl) | Calms the spirit, anchors Yang |
| Duan Mu Li (Calcined Oyster Shell) | Calms the mind, relieves restlessness |
| Bai He (Lily Bulb) | Nourishes Yin, clears heat |
| Ye Jiao Teng (Polygoni Multiflori Caulis) | Nourishes Heart blood, calms the spirit |
| Mu Dan Pi (Moutan Cortex) | Cools blood, clears heat |
| Hu Po Fen (Amber powder) | Sedates the spirit, relieves anxiety |
| Suan Zao Ren (Zizyphi Spinosae Semen) | Nourishes Heart Yin, calms the mind |
| Zhi Yuan Zhi (Processed Polygala) | Calms the spirit, promotes Heart communication |
| Fu Shen (Poria with root) | Calms the mind, strengthens Spleen |
| Shan Yao (Chinese Yam) | Tonifies Qi, nourishes Yin |
| Fu Ling (Poria) | Strengthens Spleen, harmonizes middle Jiao |
| Fu Xiao Mai (Wheat Grain) | Stops sweating, nourishes Heart |
| Dan Shen (Salvia Root) | Invigorates blood, soothes the mind |
| Sheng Di Huang (Rehmannia Root) | Nourishes Yin, cools blood |
| Di Gu Pi (Lycium Bark) | Clears Yin-deficient heat |
| Chai Hu (Bupleurum) | Spreads Liver Qi, relieves constraint |
| Rou Gui (Cinnamon Bark, small dose) | Warms and balances Yin-Yang |
Administration: Decoction, one dose daily, divided morning and evening.
4. Formula Analysis
- Zhen Zhu Mu & Mu Li (Mother of Pearl, Oyster Shell): anchor Yang, calm the spirit, and relieve restlessness — the core of the formula.
- Sheng Di Huang, Di Gu Pi, Bai He, Mu Dan Pi: nourish Yin, clear heat, moisten dryness, and soothe irritability.
- Ye Jiao Teng, Suan Zao Ren, Fu Shen, Yuan Zhi, Hu Po Fen: calm the Heart and spirit, relieve anxiety, and improve sleep quality.
- Chai Hu: spreads Liver Qi, resolves emotional constraint, and harmonizes mood.
- Shan Yao, Fu Ling, Fu Xiao Mai: strengthen the Spleen and nourish Heart Qi, helping emotional stability.
- Rou Gui (in small dose): warms and balances Yin-Yang, promoting circulation.
🪷 The formula harmonizes Yin and Yang, nourishes both Heart and Liver, and restores tranquility — embodying the TCM concept that “When Yin and Yang are in harmony, the spirit rests in peace.”
5. Clinical Outcome
After one week of treatment, Ms. Chen reported better sleep onset, fewer awakenings, and less dryness and irritability.
After three weeks, she could sleep soundly through the night, with improved energy and calmness during the day.
“Treating insomnia isn’t just about inducing sleep,” the physician remarked.
“It’s about restoring the balance between Yin and Yang — healing both body and spirit.”
6. Lifestyle and Self-Care Guidance
🌿 Emotional balance: keep a calm mind, avoid overthinking or anger.
🫖 Diet: eat light meals, avoid caffeine, alcohol, and spicy foods.
🦶 Before bed: soak feet in warm water for 15 minutes to improve circulation and relaxation.
🧘♀️ Exercise: gentle practices such as Ba Duan Jin, Tai Chi, or meditation help soothe Liver Qi and calm the mind.
7. Key Takeaway
From a TCM perspective, insomnia is not just a sleep issue — it’s a manifestation of internal imbalance.
Each person’s root cause differs: some from Heart-Spleen deficiency, others from Liver fire or Yin deficiency.
The key lies in pattern differentiation and personalized herbal therapy.
“A good night’s sleep begins not with a pill, but with harmony within.”
🌙 Menopausal insomnia isn’t just about sleeplessness — it’s a reflection of inner imbalance.
Through TCM’s philosophy of Yin-Yang harmony and herbal healing, Ms. Chen finally found peaceful sleep.
© 2025 Wally Wang — TCM Case Studies Series. Reproduction with attribution permitted.
