Insomnia - Heart-Kidney Disharmony Pattern

TCM differentiation and treatment for insomnia with

Insomnia · Heart-Kidney Disharmony Pattern

Updated: June 23, 2026

Reviewed by: Dr. Li Wei, DACM

Reading Time: 7 min

Body Area: Head

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Pattern Overview

Heart-Kidney Disharmony is a common pattern in insomnia, characterized

by **HPA axis hyperactivity, insomnia, palpitations, night sweats, and

restlessness. The core pathogenesis is insufficient Kidney Yin

failing to nourish Heart Yang**, leading to ascendant deficiency heat,

Shen (spirit) restlessness, and difficulty sleeping.

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Key Symptoms and Differentiation Points

Differentiation DimensionManifestations
**Primary Symptoms**

sweats |

**Associated Symptoms**

dizziness, tinnitus |

**Tongue and Pulse**

rapid pulse |

**Pathogenesis**

to nourish the Heart |

**Etiology**

overwork |

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Acupuncture Point Prescription

PointLocationFunction
**Shenmen (HT7)**On the wrist crease, ulnar side

Heart meridian; calms the spirit |

**Taixi (KI3)**

tendon | Source point of Kidney meridian; nourishes Kidney Yin |

**Xinshu (BL15)**Lower back, 1.5 cun lateral to T5

of Heart meridian; nourishes Heart Blood |

**Shenshu (BL23)**Lower back, 1.5 cun lateral to L2

point of Kidney meridian; nourishes Kidney Yin |

**Anmian (EX-HN22)**

mastoid process and the mandible | Extra point specifically for

insomnia; calms the spirit |

Clinical Recommendation: Filiform needle, reinforcing method; may

combine with moxibustion on Shenshu to warm and tonify Kidney Yin.

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Herbal Formula

Base Formula: Tian Wang Bu Xin Dan (天王补心丹) + Jiao Tai Wan

(交泰丸)

Composition (Tian Wang Bu Xin Dan):

Rehmannia (Sheng Di), Scrophularia (Xuan Shen), Asparagus (Tian Dong),

Ophiopogon (Mai Dong), Angelica (Dang Gui), Sour Jujube Seed (Suan Zao

Ren), Coptis (Huang Lian), Cinnamon (Rou Gui), Polygala (Yuan Zhi)

Action: Nourishes Heart and Kidney Yin, clears deficiency heat, and

calms the spirit.

Modifications

Associated SymptomsAdditions/Subtractions
Severe night sweats
Severe palpitationsAdd Long Gu, Mu Li to anchor the spirit
IrritabilityAdd Zhi Zi, Dan Pi to clear deficiency heat

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Western Mechanism Reference

HPA axis hyperactivity with excessive sympathetic tone and reversed

melatonin-cortisol rhythm. Heart-Kidney Disharmony corresponds to

insomnia with anxiety and autonomic dysfunction, where HPA axis

hyperactivity and reduced melatonin secretion contribute to sleep

disturbance.

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References

1. Internal Medicine of TCM - Insomnia with Heart-Kidney Disharmony.

2. DB-XJB: Tian Wang Bu Xin Dan.

3. WHO. (2023). *Sleep disorders*. World Health Organization.

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Last reviewed: June 2026 | Lead author: Dr. Li Wei, DACM

Disclaimer: This guide is for educational purposes only. Consult a licensed healthcare provider.