Treatment of Sleep Disorders in Ancient Cultures

While sleep is universal, the customs, routines, and attitudes related to sleep can vary greatly between cultures. As previously noted, a study conducted by the Organization for Economic Cooperation and Development (OECD) found that the hours slept differed by country, which indicates a cultural component to sleep.

A specific example is demonstrated by a study conducted by Royal Philips Electronics. This study concluded that Americans, more than any other people, are most likely to lose sleep because of work-related stress. 

They also have a harder time falling asleep and snore more than anywhere else in the world.

Finally, more people in the United States are willing to take sleep medication than in any other culture.

Even within countries, there can be differences based on ethnicity, religion, or other beliefs. In the United States, only one percent of Asian-Americans are likely to have an alcoholic drink before bed compared to seven percent of Caucasians. 

Caucasians are also much more likely to sleep with their pets, with 16 percent sharing their beds. On the other hand, Caucasians also sleep with their spouse in greater numbers: only 48 percent of African Americans and Asians sleep with their significant other and only 54 percent of Hispanics, while 72 percent of Caucasians report sleeping with their spouse.

Despite these differences, researchers have found that awareness of the importance of sleep has improved all over the world in recent years. However, what constitutes a good night sleep remains culture specific in many ways. 

In the United States and Canada, it is customary to make an effort not to disturb someone who is sleeping. But in other countries, your friends or family would think nothing of waking you up to ask a non-emergency question. Looking at how a country or religion or ethnicity sleeps can offer a unique glimpse into their culture.

Chinese Sleep Practices

China’s integration into the global economy has brought some significant cultural changes to the long-isolated country. But traditional sleep patterns persist among many Chinese. For example, most businesses and schools still close from noon to 2:00 so people can take a nap after eating lunch. 

The Chinese also tend to go to bed earlier than people in the United States and other Western countries. They also get up very early in the morning, often right after dawn. The Chinese traditionally prefer simple beds. In fact, most people in China do not use a mattress the way Americans do. 

Instead they use a thinner cushion placed on top of a board. The pillows used in China tend to be smaller and less thick than the typical fluffy pillows Americans prefer.

Culturally, the Chinese have viewed sleep as an essential element of maintaining health since the time of the first dynasties. There is an old Chinese saying that replenishing health with medicine is not as good as replenishing health with diet, but the best way to stay healthy is with sleep. 

The Chinese have long believed sleep is restorative and healing and people who have restless or bad sleep will get sick more easily.

Dr Yuan Canxing, chief physician at Shanghai University’s Longhua Hospital says, “A healthy heart relies on sufficient blood nourishment and people who have sleep problems usually suffer from inadequacies of the heart. For most people, this is caused by an unhealthy lifestyle,” and that starts with a lack of enough, proper sleep.

Sleep According to Traditional Chinese Medicine (TCM) is a centuries-old practice of medicine that uses a variety of methods to bring balance to the mind, body, and spirit. 

A TCM practitioner studies each individual’s signs, symptoms, tongue, pulse, and lifestyle to create a holistic Pattern of Disharmony. Based on each person’s Pattern of Disharmony, the practitioner creates a treatment strategy that can include herbs, food therapy, acupuncture, bodywork, and lifestyle recommendations.

In TCM, night is the time of Yin, a time of rest, quiet, coolness, and calm, when the Yang aspects of each person must contract and sink into the body for rest and repair. Our Yang aspects include the spirit, parts of ourselves that are expansive, hot, and that reaches out toward the world.

The ancient medical text, The Yellow Emperor’s Classic of Medicine (Huangdi Neijing) describes sleep as when yin (cold) and yang (hot) energies shift inside the body. When yang energy enters yin, people sleep; when yang energy exits yin, people wake. 

Staying up too late and suffering from constant stress can lead to heart problems, the text warns. Depression and irritation prevent energy and blood from flowing to the heart. Eating rich food before sleeping robs the heart of blood and energy is used for digestion.

Specifically, according to Traditional Chinese Medicine, each internal organ houses a different Yang aspect of our spirit or consciousness. The heart and liver are the two most prevalent organs involved in sleep disorders. When they are undernourished by Yin and blood or are agitated by internal inflammation, insomnia can result.

The heart organ in TCM not only governs the circulation of blood and Qi within the body; when it is balanced it promotes inspiration, communication, vision, artistic expression, and joy. When the Heart is imbalanced or agitated, anxiety, mental restlessness and insomnia can result.

The liver organ in TCM governs the body and the being’s ability to take action in life. The liver regulates the smooth flow of Qi in the entire body, including hormones, neurotransmitters, Qi, Blood, and the menstrual cycle

When the liver is balanced, a person is able to go about their day in a free-flowing manner.

When the liver is imbalanced, a person may experience anger, frustration, irritability, tight neck and shoulders, menstrual irregularity, digestion disorders, depression, headaches or migraines, and more.

According to TCM, the best sleep is achieved when the Shen, the Heartmind, is able to come to rest within the heart and when the Po, the Corporeal Soul, is able to come to rest within the liver.

Additionally, fatigue and exhaustion of a few various fluids can create insomnia. In TCM we all have a form of Qi that circulates on our exterior body during the day. This Qi is known as Wei Qi or Defensive Qi. It helps to promote immunity. 

If it is not able to sink into the body for regeneration at night, it can become weak, leaving the body vulnerable to illness. The body needs a sufficient supply of Yin and blood in which to store the Wei Qi and night. Yin and blood are liquid substances that lubricate and nourish the muscles, tendons, and internal organs.

Food stagnation can also result in insomnia. If food is ingested too close to bedtime or in excess, the food can fester and create heat that rises and harasses the heart. Therefore, a common TCM recommendation is to eat dinner no later than two hours before going to bed.

The theory of sleep according to TCM can be summarized by the words of Zhang Jingyue, a famous physician of the Ming Dynasty, “The insufficiency of genuine Yin, Essence, and blood will cause disconnection of Yin and Yang, thus disturbing the peace of the Spirit and generating insomnia. The heart shelters the Spirit and is the house of the Yang….Sleep occurs when the Wei Qi enters the Yin and creates a quiet environment. In the words of the ancients, when the Yang has a home to return to, the sleep will ensue. When the Heart is disturbed by worry and shakes the Spirit, restlessness occurs, which generates insomnia.”

Foods and Individual Herbs That Promote Sleep

Mulberry: Mulberry fruit is classified in the TCM Materia Medica as a blood tonic. Traditionally, Mulberry fruit has been used as a medicinal agent to nourish the Yin and Blood, benefit the kidneys, and treat fatigue, anemia, the graying of hair, urinary incontinence, tinnitus, dizziness, and constipation.

Bai Zi Ren (Arborvitae Seed or Biota Seed): Bai Zi Ren primarily affects the Heart and digestive system. Bai Zi Ren is used as a sedative, and is often a component of various Shen tonics. Bai Zi Ren treats irritability, insomnia, memory loss, anxiety, constipation and night sweats.

Fu Shen (Poria Paradicis): Fu Shen primarily is used to treat Shen disturbance, irritability, palpitations, insomnia, and forgetfulness, especially when the body tends to retain fluid. This herb is used as a gentle diuretic. If the body retains too much fluid, it can create imbalance that can harass the Heart.

Wu Wei Zi (Schizandra Fruit): Schizandra is considered a premier adaptogen herb. Known as the Five Flavor herb, it nourishes It can support the body during times of extreme stress and exhaustion. It promotes mental alertness and memory without over-stimulating the body.

Herbal Formulas That May Promote Sleep

Suan Zao Ren Tang (Jujube Seed Decoction): Suan Zao Ren Tang is a herbal formula commonly used for insomnia in TCM, especially when a person also has signs of Yin deficiency: palpitations, night sweats, thirst, dry throat, irritability, and restlessness.

It contains the following ingredients: Jujube seeds, Poria sclerotium, Anemarrhena rhizome, Ligusticum wallichii rhizome, and Chinese licorice root

Other Recommendations for Getting  Better Sleep

Acupuncture: Acupuncture is the insertion of thin, sterile needles into specific points of the body to reduce pain, promote relaxation, and treat various health concerns. Insomnia and sleep disorders are common reasons why people visit an acupuncturist.

The World Health Organization (WHO) lists insomnia as a condition for which the therapeutic effect of acupuncture has been shown. Research is currently evaluating the effectiveness of acupuncture for sleep issues. The Journal of Alternative and Complementary Medicine recently published a review of randomized controlled trials of acupuncture treatment for insomnia. A review of 46 randomized trials concluded that acupuncture appears to be effective in the treatment of insomnia.

Asian Bodywork Therapy: Asian Bodywork Therapy can include practices such as Acupressure, Tui Na, Shiatsu, Thai massage, and other forms of massage. All Asian Bodywork Therapies apply pressure to specific points on the body (acupressure) and involve techniques such as kneading, rolling, and pressing. Asian Bodywork Therapies have demonstrated effectiveness for improving the quality of sleep. 

Research from China reports the effectiveness of acupressure and Tui Na in the treatment of insomnia patients. An Italian study reported improved sleep after acupressure for sleep disorders with an emphasis on cancer patients who are experiencing sleep difficulty after chemotherapy and radiation treatment.

Cupping: Cupping refers to the TCM practice in which a glass, plastic, or bamboo cup is applied to the skin. The pressure in the cup is reduced by using change in heat or by suctioning out air, so that the skin and superficial muscle layer is drawn into and held in the cup. This practice invigorates the blood, draws excess heat from the body, and relaxes tense muscles to aid in sleep.

References

  • Kaptchuk, Ted. The Web That Has No Weaver. McGraw-Hill, 2000.

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Ayurvedic Sleep Practices

Ayurvedic medicine evolved in the Indian subcontinent during the Vedic-Aryan civilization whose beginnings date back to 4500 B.C. The word Ayurveda essentially means science of life and the discipline promotes healthy living and ways to achieve physical, mental, social, and spiritual balance and harmony.

Ayurveda describes three fundamental energies that govern our inner and outer environments: movement, transformation, and structure. These forces are known in Ayurvedic Medicine as Vata (Wind), Pitta (Fire), and Kapha (Earth). These forces are responsible for the unique characteristics of our mind and body. Ayurveda organizes natural and human behavior into the Three Doshas: Vata, Pitta, and Kapha.

The Doshas derive from the Five Elements and their related properties. They are biological energies found throughout the human body and mind. They govern all physical and mental processes and provide every living being with an individual pattern for health and wellness.

The Five Elements of Ayurveda are Space/Ether, Air, Water, Earth, and Fire. When one element is imbalanced in an individual, that imbalance can lead to physical, emotional, mental, or behavioral imbalance.

According to the Chopra Center, “If Vata is dominant in our system, we tend to be thin, light, enthusiastic, energetic, and changeable. If Pitta predominates in our nature, we tend to be intense, intelligent, and goal-oriented and we have a strong appetite for life. When Kapha prevails, we tend to be easy-going, methodical and nurturing. Although each of us has all three forces, most people have one or two elements that predominate.”

Pitta Type

Pitta is composed of the elements, Fire and Water and translates into “that which cooks.”

It is the energy of digestion and metabolism in the body and is represented by organic acids, hormones, enzymes, and bile. Pitta individuals may experience difficulty sleeping between 10pm-2am, the time of night ruled by Pitta. 

Pitta individuals may have a tendency to “burn the midnight oil.” Indulging in midnight snacks can further impair their quality of sleep and digestion. Pittas may have a difficult time letting go of stress from the day.

Kapha Type

Kapha is composed of the elements Earth and Water and translates into “that which sticks.” Kapha is the energy that provides the body with physical form, structure, and smooth functioning. 

Kapha is often thought of as the cement, glue, and lubrication of the body. Kapha is moist, cold, heavy, dull, soft, sticky, and static. Kapha sleep disorders generally manifest as excessive sleep and lethargy. The Kapha person may sleep long and deep but not wake up feeling well-rested.

Vata Type

Vata is composed of the elements of Space and Air and translates into “wind” or “that which moves things.” Vata is the energy of movement and the force governing all biological activity. It governs the body’s life force and gives motion to Pitta and Kapha. Vata dominant individuals often have light, restless sleep. They tend to wake in the early morning hours, between 2-4am, and are unable to fall back asleep.

Ayurveda Philosophy of Sleep

The Ayurvedic approach for better sleep centers on creating more ojas, which in Sanskrit means vigor. Ojas is the essential energy of the body, similar to the way Western cultures refer to life blood. Through ojas we achieve clarity of thought, improved mind-body coordination, and strengthened immunity. Only the deepest, most restful sleep can create ojas.

The Ayurvedic routine is to eat the day’s main meal at noon, when the sun is at its highest because it is believed that’s when a person’s digestive fire, or agni, is strongest. A light dinner should be eaten in the early evening, which then enables your digestive system to cleanse and repair itself while you sleep.

The keys to good health in the Ayurvedic culture are a healthy diet, an active life, and ample sleep. When any one of these pillars of health suffers, the entire body suffers.

The ancient texts Charaka Samhita, Bhava Prakasha, and Ashtanga Hridayam have this to say about sleep:

  • Happiness and unhappiness, nourishment and emaciation, strength and debility, virility and sterility, knowledge and ignorance, life and death—all are dependent on proper sleep. 
  • Sleeping at the proper time produces normalcy of the tissues, absence of lassitude, nourishment, good complexion, strength, enthusiasm, and strong digestive power.
  • Sleep indulged at improper time, in excess or not at all, destroys happiness (health) and life.
  • Like a proper diet, proper sleep is also essential for the maintenance of the body.
  • Corpulence and emaciation are specially conditioned by proper or improper sleep and diet. 

In essence, Ayurvedic medicine promotes a holistic approach that emphasizes better sleep as crucial to overall wellness.

Ayurvedic Approach to Better Sleep

In Ayurveda, insomnia is known as Anidra. According to Ayurveda, the doshas responsible for this disease are Tarpak Kapha, Sadhak Pitta, or Prana Vata. Lifestyle, dietary, and herbal approaches can help bring the doshas into balance and help you sleep:

  • Include nuts like almonds, walnuts, sesame seeds, pumpkin seeds, and peanuts in your daily diet.
  • Include cherries in your diet. Eating 10 to 20 cherries per day may help reduce fatigue and stress, which contribute to insomnia.
  • Use whole wheat flour and brown rice instead of white flour or white rice.
  • Avoid caffeinated drinks, alcohol, and carbonated drinks after noon.
  • Avoid watching television or working on the computer late at night. Turn off all screens one hour before going to bed.
  • Have a body massage at night with sesame oil, followed by a hot bath or shower.
  • Massage your feet with lukewarm mustard oil 2-3 times a day and before going to bed.

Here are a few typical sleep problems mentioned in a selection of Ayurvedic literature:

The first is caused by stress, where an individual can’t fall asleep because their brain won’t turn off. The treatment for this restlessness is to eat sweet, sour, and salty foods and have three cooked meals at the same time every day.  Herbal green tea is recommended before going to bed.

The second disorder is the result of emotional trauma, which is characterized by being able to fall asleep easily enough but then waking up every 90 minutes with a racing heart and feeling fearful, angry, or sad.

The third sleep disorder is from waking up tired even after sleeping an ample number of hours. Typical Ayurvedic treatments include avoiding spicy foods in favor of sweeter, bitter, and astringent tasting food. It is also advised not to skip meals and to eat enough dinner so you don’t wake up hungry.

Additional Ayurvedic General Home Remedies

  • Drink chamomile tea before bed.
  • Have a glass of whole milk (full cream milk; without the cream removed) with green cardamom powder, crushed almonds, or nutmeg before going to bed.
  • Try mixing together 1 cup of milk, 1⁄4 cup of water, and one clove of fresh, chopped garlic. Boil gently until one cup of liquid remains. Drink this before bed.
  • Drink one cup of tomato juice between 4-5 in the afternoon and add 2 tsp natural sugar and 2 pinches of nutmeg.
  • Have 1 teaspoon of licorice root powder with a glass of milk on an empty stomach in the morning.
  • Take 1 glass of milk, add 1 tsp of honey and drink every night before bedtime.
  • Take 1⁄2 L of water, add 1 tsp of anise seed, heat the mixture for 15 min, strain, and drink the liquid when it’s hot. You may add hot milk or honey to improve taste. Drink this before going to bed.

Ayurvedic Herbal Treatment

Brahmi: Brahmi is used to help enhance brain function. You can find it as a pill, capsule, or use as a powder dissolved in oil such as ghee (clarified butter). Try using Brahmi as a powder in warm milk with a pinch of cardamom and a half teaspoon of ghee. Take this mixture every morning to reduce stress and decrease sleep and memory problems

Jatamansi: The seeds and fruit of Jatamansi are used as a nervine tonics and memory enhancer. Jatamansi is also used to treat neurological disorders like epilepsy, hysteria, syncope, convulsions, and mental weakness. Due to its sedative action, Jatamansi is very effective in chronic anxiety, depression, insomnia, migraine and tension headaches.

Valerian: Valerian can help with many symptoms of anxiety, tremors, panic, palpitations, and nervous sweating. Valerian relaxes tense muscles and is helpful for asthma, colic, irritable bowel syndrome, and menstrual pain. Valerian has a remarkable influence on the cerebrospinal system and is used as a sedative. You can take it as a powder mixed in warm milk or as a tea.

Amla: Amla is used for supporting the digestive system, reducing constipation, reducing fever, purifying the blood, reducing cough, alleviating asthma, strengthening the heart and circulation, benefiting the eyes, stimulating hair growth, benefiting memory, and reducing insomnia. Take it daily as a capsule, fresh, or as a juice.

Specific Guidelines for Each Type

Pitta Type

  • Eat a Pitta-balancing diet: 50% whole grains, 20-30% protein (beans, no lentils, tofu, tempeh, cottage, cheese, turkey, chicken, no red meat, shrimp, rabbit, venison), and 20-30% fresh vegetables (with 10% optional fruit).
  • Eat in a peaceful environment.
  • Avoid artificial stimulants.
  • Engage in calming activities, like spending time in nature.
  • Meditate daily.
  • Do calming physical exercise, such as yoga, swimming, tai chi, or walking.

Kapha Type

  • Eat a Kapha-balancing diet: 30-40% whole grains (emphasize rye crackers), 20% protein (chicken, turkey, boiled and poached eggs, and most beans, such as adzuki, chickpeas, pintos, black beans, red lentils, navy beans, split peas, black eyed peas), and 40-50% fresh vegetables (a daily salad is good with optional 10% fruit).
  • Eat in a loving environment.
  • Avoid a sedentary lifestyle.
  • Do emotional housekeeping regularly.
  • Make time for introspective activities, like meditation and writing.
  • Honor healthy boundaries. Make a distinction between being nice and being taken advantage of.
  • Go to bed early and rise early, with no daytime naps.

Vata Type

  • Eat a Vata-balancing diet: 50% whole grains, 20% protein (black and red lentils, tofu, beef), and 30% fresh vegetables (with 10% optional fruit).
  • Eat in a peaceful environment.
  • Go to bed early.
  • Meditate daily.
  • Do gentle physical exercise like yoga, swimming, tai chi, or walking.

Unani Treatment of Sleep Disorders

Unani medicine believes that disease is a natural process and its symptoms are the reactions of the body to the disease. It discusses the presence of four humours in the body: dam [blood], balgham [phlegm], safra [yellow bile] and sauda [black bile].

Humours are fluids, which the human body obtains from food and includes various hormones and enzymes. Blood is hot and moist; phlegm is cold and moist; yellow bile is hot and dry, and black bile is cold and dry. A person is considered healthy, if these four main humours and their primary qualities are all in a state of balance.

A common herbal treatment for Insomnia in the Unani Tradition is Ashwaganda. Ashwagandha is used for treating a variety of conditions including nervous disorders, gynecological disorders, respiratory disorders, anxiety, insomnia and arthritic inflammation. It helps increase energy, virility in men, enhances resistance to stress, controls and regulates body metabolism, and promotes general well-being.

Unani Medicine also recommends:

  • 10 mL of Poppy Seed (Khus Khus) Sheera per day
  • Badam Ka Harira: warm milk with almond powder, sugar, flour and milk
  • Pumpkin oil (Rogan Kaddo) or Almond oil (Rogan Baadam) for scalp massage
  • 10 grams of Poppy Seed (Khus Khus) Khameera with 10 mL of Lettuce Seed Sheera (Tukhm Kahoo Sheera) 10 ml two times per day
  • 30 mL of Poppy Seed Sherbet (Sharbat Khus Khus) with 70 mL of Goat Willow Flowers (Arq Baid Mushk) two times per day
  • 7 grams of Poppy Seeds (Tukhm Khus Khus), 4 grams of Egyptian Lettuce Seed (Tukhm Kahoo Muqassar), 100 mL distillate of Borage officinalis (Arq gau zaban) and use with 30 mL of Poppy Seed Sherbet (Sharbat Khus Khus) two times per day.

References

  • “Ayurveda: the Science of Life.” www.chopra.com
  • “Ayurvedic Home Remedies.” www.dharmony.com 
  • Hasan, Izharul. “Insomnia and Unani Treatment.” www.webindia123.com
  • Lad, Vasant. The Complete Book of Ayurveda Home Remedies. Three Rivers Press, 1998.
  • Tiwari, Maya. A Life in Balance. Healing Arts Press, 1995.
  • Tiwari, Maya. Ayurveda Secrets of Healing. Maya Tiwari, 1995.

Conclusion

Most cultures acknowledge the importance of sleep although modern life can make it difficult to always sleep as much as we should. A shared trait among many otherwise diverse cultures is that many traditions related to getting better sleep complement modern scientific assessments, suggesting that the quest for enough sleep has been part of the human condition from the earliest recorded civilizations.

Today, melatonin supplements are a popular sleep aid, especially when the melatonin cycle is disturbed by jet lag or other factors

Because melatonin’s production and release cycle fluctuate with the time of day, with levels naturally increasing in the evening and falling in the morning.

Resurge is one of the most popular melatonin supplements that promise to help you sleep better.

Although more research is needed, current evidence suggests that melatonin can be useful in helping people get to sleep. When taken for short or long periods of time, melatonin supplements appear to be safe for adults, according to studies

Resurge supplements might allow your body to absorb enough melatonin to maximize your natural melatonin production. Apart from that, it is also marketed as a weight-loss supplement because epidemiological studies show that insufficient sleep is associated with a higher risk of obesity

However, since the supplement industry is barely regulated, you might want to read some reviews for the Resurge supplement before making any purchase.

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