A 55 year-old woman had been suffering from insomnia for 4 years. She was falling asleep easily, but would wake up at least 3 or 4 times during the night. After waking, she would be reliably able to fall sleep again. She also lacked an appetite, and would eat only because she knew that she needed the nutrition. When she did eat, it was usually small meals, and she did not like eating dairy products. She had recently not noticed that her memory was not very good, and was drinking water a great deal, although not urinating especially frequently. She did not always need to urinate when waking in the middle of the night.

She had already been through menopause, but was able to describe how her periods had been. Her menses had always been quite thin and light, and usually lasted only 3 days. Her periods had been regular every month, at approximately a 30 day cycle. She had not experienced any cramps or abnormal discharge.

The patient complained of having always felt tired, especially at the end of the day. The tiredness preceded the insomnia by many years (ie her whole life), and had been present even before her sleep issues. She recently also often felt dizzy and would have to sit down.

Her tongue was pale, with a thin white coating, and her pulse was slightly weak and soft. It was weaker on the left side.

Diagnosis: Insomnia due to deficiency of the Heart and of the Spleen, with deficiency of both Qi and Blood. The Qi deficiency was evident in her tiredness, dizziness, lack of appetite, and her weak pulse. The Blood deficiency was evident in her insomnia, poor memory, and light menses. The excessive drinking of water and pulse may have been related to some Kidney Yin deficiency.

Treatment Principle: Tonify the Spleen generate more Qi and Blood, and thus the Heart as well. In addition, help to sedate the Mind, and also nourish the Kidney Yin to assist the Spleen and Heart and treat the patient of her excessive thirst.

Acupuncture Points Used: Sishenchong, HT 7, SP 6, ST 36, KD 3, KD 9, RN 6, SP 10

After 5 weekly treatments, the patient was able to sleep better and felt like she had more energy. She appeared to be drinking less water, but was not entirely sure how much less. Her mind also appeared a bit sharper. Treatments were continued once a month for several months to consolidate the effect.