In the last three articles about insomnia, we detailed the types of insomnia characterized by difficulty falling asleep. Today, we will shift focus to insomnia that causes a sleeping person to wake up frequently throughout the night, or to wake up and remain awake, unable to fall back to sleep. Insomnia marked by interrupted sleep may not seem as severe as insomnia that inhibits falling asleep in the first place, but it can be equally draining. Typically, the person suffering from this sort of insomnia feels acutely frustrated during the night and exhausted at the start of their day.
While it is considered normal for people to wake up once or twice a night to urinate, waking up more than three times a night, or waking up at about 3 or 4 AM and not being able to fall back to sleep, is considered insomnia. There are two main biological reasons for waking up frequently during the night: sleep apnea and a change in body temperature.
Sleep apnea often afflicts those who snore loudly. When a person snores while sleeping, the oxygen supply to the brain decreases. A suffocating brain will try to alert us by preventing us from staying asleep. Essentially, with sleep apnea, the brain naturally causes us to wake up when oxygen deprivation hits a certain point. If you feel inexplicably tired in the morning, it may be because of sleep apnea, although you may or may not be aware of being jolted out of sleep during the night. It is, therefore, a good idea to have yourself checked for sleep apnea if you experience inordinate fatigue from the time you get up in the morning.
It is important to be aware that sleep apnea is typically aggravated by weight gain, and conditions such as chronic rhinitis or sinusitis. As a result, losing weight, or treating sinus conditions, can be crucial to improving sleep quality. An herb called ‘MaHuang (Herba Ephedrae)’ is frequently used to treat biventricular diseases, such as rhinitis and sinusitis. Because ephedrine, an active component in MaHuang, has a caffeine-like effect, MaHuang is generally not prescribed to patients who also complain about insomnia. However, patients with certain body constitutions respond very well to MaHuang, becoming able to sleep more soundly and feel far less fatigued in the morning. For these people, it appears that MaHuang’s function is to improve breathing during sleep so that the brain gets enough oxygen supply.
The second reason for waking up at night is due to an increase or decrease in body temperature. Our body’s ability to control its temperature has a great influence on sleep patterns. When we are asleep, our body temperature falls slightly, and when our body temperature rises again, we are triggered to wake up. Insomnia occurs when our body temperature rises prematurely at about 2 to 3 o’clock in the morning. For some reason, our body temperature goes up when we are in the middle, rather than at the end, of our sleep, tricking the brain into giving us a wake-up signal. Sometimes in these circumstances, the person will wake up sweating. Conversely, we may wake up in the middle of the night because our body temperature has fallen too much to maintain sleep. This often happens when a person is under constant stress, resulting in high cortisol secretion, and thus blood sugar levels too low to sustain sleep.
Insomnia caused by abnormally high body temperatures at night has long been treated by Eastern medicine using an herb called ‘Zhi Zi (Fructus Gardeniae)’, traditionally used as a natural dye (yellow). Our body generates heat through the metabolism of the liver so, naturally, enhancing the liver function aids in bringing down our body temperature. More specifically, Crocine and Crocetin, contained in the yellow pigments of Zhi Zi, enhance liver function to promote detoxification, alleviate congestion in blood vessels, help smooth the rate of bile secretion.
In addition to the herb remedies mentioned above, just as in the case of insomnia characterized by an inability to fall asleep, Eastern Medicine also utilizes acupuncture to treat insomnia involving interrupted sleep.