Insomnia - Heart-Spleen Deficiency Pattern
TCM differentiation and treatment for insomnia with
Insomnia · Heart-Spleen Deficiency 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-Spleen Deficiency is a common pattern in insomnia, characterized
by **melatonin rhythm disruption, insomnia, fatigue, poor memory, and
palpitations. The core pathogenesis is insufficient Blood
nourishment of the Heart due to Spleen deficiency**, leading to Shen
(spirit) restlessness, difficulty falling asleep, and restless sleep.
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Key Symptoms and Differentiation Points
| Differentiation Dimension | Manifestations |
|---|---|
| **Primary Symptoms** |
fatigue, poor memory |
| **Associated Symptoms** |
appetite, loose stools |
| **Tongue and Pulse** |
|---|
and weak pulse |
| **Pathogenesis** | Heart Blood deficiency and Spleen Qi deficiency |
| **Etiology** |
excessive thinking |
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Acupuncture Point Prescription
| Point | Location | Function |
|---|---|---|
| **Shenmen (HT7)** | On the wrist crease, ulnar side |
Heart meridian; calms the spirit |
| **Xinshu (BL15)** | Lower back, 1.5 cun lateral to T5 |
of Heart meridian; nourishes Heart Blood |
| **Pishu (BL20)** | Lower back, 1.5 cun lateral to T11 |
|---|
of Spleen meridian; strengthens Spleen Qi |
| **Sanyinjiao (SP6)** | 3 cun above the medial malleolus |
Blood and Yin; regulates the Spleen and Kidney |
| **Anmian (EX-HN22)** |
|---|
mastoid process and the mandible | Extra point specifically for
insomnia; calms the spirit |
Clinical Recommendation: Filiform needle, reinforcing method;
moxibustion may be applied to Pishu to strengthen Spleen Qi.
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Herbal Formula
Base Formula: Gui Pi Tang (归脾汤)
Composition:
Astragalus (Huang Qi), Ginseng (Ren Shen), Atractylodes (Bai Zhu), Poria
(Fu Ling), Sour Jujube Seed (Suan Zao Ren), Longan (Long Yan Rou),
Angelica (Dang Gui), Polygala (Yuan Zhi), Licorice (Gan Cao)
Action: Nourishes Heart Blood, strengthens Spleen Qi, and calms the
spirit.
Modifications
| Associated Symptoms | Additions/Subtractions |
|---|---|
| Severe palpitations | Add Bai Zi Ren, Mu Li to calm the spirit |
| Poor appetite | Add Sha Ren, Mu Xiang to harmonize the Stomach |
| Nightmares | Add Long Gu, Mu Li to anchor the spirit |
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Western Mechanism Reference
Melatonin secretion rhythm disruption, GABAergic inhibition
insufficiency, and chronic fatigue-induced cortical
excitation-inhibition imbalance. Heart-Spleen Deficiency corresponds to
insomnia with fatigue and cognitive symptoms, where reduced GABAergic
function and impaired melatonin secretion contribute to sleep
disturbance.
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References
1. Internal Medicine of TCM - Insomnia with Heart-Spleen Deficiency.
2. DB-XJB: Gui Pi Tang.
3. WHO. (2023). *Sleep disorders*. World Health Organization.
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Explore More
- **Find your solution at [MendGod.com](https://mendgod.com)** –
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- **Deepen your knowledge at [TcmCIO.com](https://tcmcio.com)** – Full
research papers and clinical case studies on TCM sleep health.
Last reviewed: June 2026 | Lead author: Dr. Li Wei, DACM
Disclaimer: This guide is for educational purposes only. Consult a licensed healthcare provider.