Waking up at 1-3am consistently?

Here’s what to do!

Good quality sleep is important to maintain good brain function, physical health and mood.  It is, however, common that people struggle get quality sleep or enough sleep for various reasons. We explore one common clinical presentation of disturbed sleep through the lens of Traditional Chinese Medicine (TCM).

The Chinese Clock

Sleep is governed by our internal circadian rhythm – our internal body clock.  In TCM, there is also an internal Organ Clock where each two-hour segment corresponds with a different organ.  Consistent sleep disturbance (or other health presentations) at a particular time could point to an underlying imbalance in energy from an organ such as the heart or lungs.

Waking up in the early hours of the morning is common – frequently between 1-3am.  This falls within the Liver time on the Organ Clock, and maybe indicative of an imbalance with the function of the Liver. The Liver governs the smooth flow of Qi energy and Blood in the body. As part of the TCM assessment, we will check for other symptoms of Liver Qi or Liver Blood imbalance.

Some examples of Liver Qi and/or Liver Blood imbalance are:

• Emotional Symptoms: “Anger” is emotion of the Liver.  This may present in milder forms such as irritability or frustration.  As the Liver governs free flow, a stagnation in the movement of Liver Qi may present with the tendency for sighing as well.

• Digestive Issues: A stagnation in the movement of Liver Qi may present with bloating, indigestion, reflux, and/or irregular bowel movements.

• Menstrual Problems: In TCM, the Liver plays a crucial role in the female gynaecology due to its function of storing Blood. As such, symptoms of irregular or painful periods, pre-menstrual symptoms such as breast tenderness and emotional tendencies could suggest a Liver imbalance.

• Physical Discomfort: Liver Qi stagnation may present with headaches, and a stifling or full sensation in the chest, ribs and upper belly (particularly around the bottom of the breastbone).

How TCM may help through acupuncture and/or other TCM therapies

A recent study (Zhuang et al. 2022) showed that TCM, particularly acupuncture, was found to significantly improve sleep quality. In addition to acupuncture, your acupuncturist will recommend supporting your Liver Qi and Blood flow with diet and lifestyle changes, herbs, moxa, cupping or other therapies.

Sleep hygiene to promote better sleep

While TCM may help to address the contributing pattern leading to sleep disturbance, it remains important to practice good sleep hygiene to promote and maintain better sleep. Some practices that should be considered include:

• Helping the sleep-wake cycle align with the circadian rhythm: the circadian rhythm (the body’s internal clock) loves a regular schedule for meal times (particularly the last meal of the day), bedtime and wake times.

• Engaging in relaxing activities before bed: a relaxing bath or foot soak, meditation practice, journaling, reading or engaging in some art and craft activities.  This helps to reduce stress to aid sleep.

• Limit exposure to electronic devices: this could be stimulating and the blue light interferes with the production of melatonin for promoting sleep.

• Avoiding large or late meals, caffeine or over consumption of alcohol: as these may disrupt sleep. Passing out isn’t the same as having a restful night’s sleep.

• Keeping the bedroom dark and cool to help sleep.  The darkness will encourage the production of melatonin, while the body temperature declines in sleep.  According to the Sleep Foundation, keeping the room between 15.6 to 20°C is often recommended.

• Exposure to morning sunlight: Since light affects melatonin production, this can help regulate the hormone and the circadian rhythm.

Conclusion

Many factors could affect sleep and sleep quality.  TCM and the Organ Clock system may provide an insight into the body’s imbalance and help address identified imbalances through acupuncture and other TCM therapies.  For those experiencing frequent awakenings between 1 to 3am, addressing the Liver imbalance which may involve moving Qi, nourishing and/or moving Blood may provide relief for the sleep disturbance.  In addition to treatments addressing the identified imbalance, it is also important to practice good sleep hygiene to improve sleep quality as well.