One of the most intriguing features of Chinese herbal medicine like Gui Pi Tang for delivering uninterrupted, quality sleep - and perhaps the reason that they are so effective - is that they don’t sedate the body. In fact, one modern scholar, Wang Mianzhi, argues that Chinese herbal medicine doesn’t have any formulas that are truly specific for treating sleep. Rather, Chinese herbal medicine therapies treat the imbalances that cause poor sleep. And because they address the root of the problem, they generally treat more than just inconsistent sleep. This may be the reason that one of my patients credited our Mental Tranquility with not only curing her debilitating sleep issues, but also saving her marriage.

A Working Mother’s Battle

When you can’t sleep it can be horrible, sometimes developing so gradually that sometimes we don’t even recognize that we’re falling into a “bad sleep pattern” when in fact we are. This was precisely the case with a recent patient who sought me out for general issues of fatigue that she attributed to the challenge of trying to succeed at a demanding job and raising three young children. Although she had been struggling with disrupted sleep for years, particularly since her oldest child was born eight years ago, she mostly thought of herself as just a “light sleeper.” When I inquired further, it was clear that she nonetheless had significant anxiety about getting a good night’s sleep. 

“Getting through the day was always a struggle, and she rarely felt mentally sharp”

Even though her husband had taken on most of the nighttime responsibilities with the younger children, this patient often woke up at night, did not go back to sleep easily, and felt exhausted when she woke in the morning. Getting through the day was always a struggle, and she rarely felt mentally sharp. In the patient’s eyes, she was just suffering from the hardships of modern family life and motherhood.

It was clear to me that she would probably benefit from Chinese herbal therapies, but I needed to understand her underlying condition more completely first. She reported that she did not feel hot at night and, in fact, tended to feel cold at most times of the day. She complained that once she was awakened at night, her mind would not stop turning, thinking about the day ahead, stressing about whether she would be rested enough to handle everything on her agenda. When I asked her about other general symptoms, I learned that she had a history of chronic stomach pain that was mostly well controlled now. Her menstrual cycle was very regular and her periods relatively uneventful. I examined her tongue, and it was pale and with a thin white coating.

Was She a Hot or Cold Sleeper?

In Chinese medicine, chronic sleep issues are usually attributed to some sort of “deficiency” (an important Chinese herbal medicine concept). In some cases, the patient will also have one or more clear signs of heat, such as a strong sensation of heat accompanied by sweating, vivid dreams or nightmares, constipation, cankers sores, irritability or anger. (In this case, our Physical Tranquility, based on Tian Wang Bu Xin Dan, would be the more appropriate formula for this type of sleeper). This patient, however, had almost no signs of heat. Instead, her fatigue, stress, the history of her digestive issues, the color of her tongue, and the fact that her disrupted sleep was brought on by the heavy demands of motherhood and work, suggested a pattern of Qi (and Blood) deficiency. Mental Tranquility, based on Gui Pi Tang, was clearly a good fit, and she decided to try it.

After Two Months, She Realized How Much Happier She Was 

Almost immediately, she noticed some benefits. On the very first night of taking Gui Pi Tang, she slept quite deeply. Was it a fluke? Over the next couple nights, she noticed that if she took Gui Pi Tang and was awakened at night, she could easily go back to sleep. The anxiety, the mental gymnastics, the long stretches of sleeplessness began to fade away. Over time, she also noticed two other fascinating developments. First, she began to notice that she felt more emotionally grounded. She was no longer stressed by the fear of sleeplessness at night, but even more importantly her mood during the day improved dramatically.

Several months after she began treatment, she remarked on how much happier she was, and that the whole family was reaping the benefits. In retrospect, she now recognized that she had been struggling with a lot of anxiety. Half jokingly, she told me that Mental Tranquility may have “saved her marriage.” I was delighted to hear this report but not surprised since I have used this formula for patients with similar patterns before. But her second discovery did truly surprise me.

For years, this patient had suffered from one to two debilitating “pelvic floor spasms” a month. They were so intense that they could make her pass out for a moment. Initially I was at a loss for how to treat this condition and essentially ignored it to focus on her sleep issues. But after several months of using Mental Tranquility, she noticed that her pelvic floor has been unusually quiet. There had been occasional spasms but all of them were relatively mild. It was too early to say, but she felt confident that this bizarre condition which had plagued her for more than a dozen years was getting better and might one day go away entirely.

A Chinese Herbal Medicine Explanation

How is it possible for this formula to treat so many seemingly disparate conditions? In order to understand better, let's review the classic understandings of Restore the Spleen Decoction (or Gui Pi Tang in Chinese), the inspiration behind Mental Tranquility. First, classic Chinese herbal medicine textbooks state that it treats pensiveness, anxiety, and physical exhaustion that lead to heart palpitations, mental fogginess and poor sleep. In Chinese medicine, this combination of symptoms is caused by a “Spleen Qi and Heart Blood deficiency.“ Although this expression may be perplexing to the lay reader, what is interesting here is how it links together what Westerners usually regard as the separate realms of the body and mind. Pensiveness, anxiety, and fatigue are considered to be problems of the Spleen; forgetfulness, disturbed sleep, and heart palpitations are conditions of the Heart. By treating deficient Spleen Qi, this formula promotes digestion, alleviates fatigue, and gives movement to one’s thought, preventing dwelling and pensiveness. By treating deficient Heart Blood, the Spirit - a term that broadly refers to one’s mental and emotional faculties - is settled and takes up its proper residence in the Heart. Sleep improves, and mental clarity is restored. 

Textbooks also note that Restore the Spleen Decoction treats a number of conditions related to Blood, such as excess menstrual bleeding or blood in the stools. How can disrupted sleep and anxiety be related bleeding disorders? The explanation in Chinese medicine is that Qi is intimately related to Blood. Qi both “produces” Blood and helps “retain” Blood. By supplementing Qi, Restore the Spleen Decoction therefore also treats milder bleeding conditions, making it ideal for conditions were blood loss is relatively minor, such as the spotting that a woman might experience at the beginning or end of her period. Moreover, supplementing Qi also indirectly supplements Blood, helping the body to recover from any lost blood. In fact, most textbooks in China consider Restore the Spleen Decoction to be a Blood supplementing formula. Although it does not “supplement Blood” as powerfully as other formulas, such as Si Wu Tang (Dao Women’s Formula), it represents an important strategy for addressing these concerns when there is evidence of a Qi deficiency. This fact also helps explain the mystery of my patient’s pelvic floor spasms, which in retrospect I realized were a sign of Blood deficiency. (In Chinese medicine, “Blood stagnation” and “Blood deficiency” are thought to be two important causes of pain.)

In addition to the main symptoms discussed above, researchers in China have also observed positive clinical outcomes using this formula to treat cases of depression, anxiety, menopause, post-concussion syndrome, iron deficiency anemia, gastric bleeding, dysfunctional uterine bleeding, certain heart conditions, and idiopathic thrombocytopenic purpura. In each instance, the patient should present with an underlying pattern of Spleen Qi and Heart Blood Deficiencies. Mental Tranquility has the potential to transform the lives of countless people suffering from disrupted sleep, as well as a wide variety of other related conditions. It is not for all types of disrupted sleep (please consult my other article comparing DAO Mental Tranquility and Physical Tranquility), but if it is the right fit for you, it may transform your evenings, and perhaps something even more significant, such as your marriage.

These statements have not ben evaluated by the Food & Drug Administration.  These products are not intended to treat, mitigate or cure any disease.  The information contained in the above article is not intended to be a substitute for professional medical advise.  

Dr. Eric Karchmer is a practicing Chinese medical doctor, medical anthropologist, and co-founder and Chief Doctor of Chinese Medicine for DAO Labs. From 1995-2000, Eric studied at the Beijing University of Chinese Medicine and today is both a licensed acupuncturist and professor at Appalachian State University. Eric can be reached at drkarchmer@mydaolabs.com.