Why Can’t I Have a Good Night’s Sleep?

by Harry Hong, Ph.D., L.Ac.

Patricia, a 60-year-old female, came to see me a few years ago with the main complaints of fatigue and insomnia. She had experienced these symptoms for over 20 years. She was once very busy taking care of her two children while managing a small business. In her memory, she never had any good nights’ sleep. After a full day of work, she was unable to fall asleep and took sleeping pills often. In the morning, it normally took her an hour to completely wake up with the help of two cups of coffee, and she felt tired again in the afternoon. In the past two years, her children left home for college and Patricia retired from her business. Even though she no longer had a packed schedule, her insomnia and fatigue persisted. She fell asleep alright but always awoke in the middle of the night, two to three times, sometimes with heart pounding, mind racing and sweats. It usually took her an hour to fall back to sleep. She also complained of mental fog, memory loss, craving sweets, weight gain, irritability and mood swings.

Insomnia and fatigue are common health concerns for people with a busy modern lifestyle. Insomnia is the common reason that causes fatigue. The main complaints for insomnia include:

Cannot fall asleep

Disturbed sleep, easily wake up at night with difficulty falling back to sleep

Feel not rested and still tired in the morning

Slow starter in the morning

Fatigue during the day

The common cause for insomnia is the malfunction of the Hypothalamus-Pituitary-Adrenal system (HPA), aka adrenal system, the stress responding system in the body. Long-term stress causes adrenal malfunction which can be roughly classified into two stages: stress stage and fatigue stage. The characteristics of the stress stage include:

Cannot fall asleep (adrenal hyper function)

Afternoon fatigue or headache

Slow sugar metabolism (insulin resistance)

Low appetite control (hippocampus destruction)

Low sex drive (suppressed LH)

Low thyroid function (suppressed T3 conversion)

Low liver detox function

Slow bone growth (low calcium absorption)

If the stress factors are not resolved in a period of time, the malfunction of the adrenal system further develops into fatigue stage in which patients experience tiring easily, slow stress response, low healing ability and other degeneration related symptoms. The characteristics of the fatigue stage include:

Cannot stay asleep (adrenal hypo function)

Hypoglycemic reaction

Get shaky, fatigued or lightheaded if meals are missed or delayed

Irritability or moodiness before meals

Eating relieves fatigue

Crave sweets and/or salt

To identify detailed stages of adrenal problems, a saliva test for cortisol pattern is helpful. To identify the stage of the adrenal malfunction is the key to help insomnia because the treatment plan is going to be different for the two stages. The common complaints for insomnia and their associated adrenal stages include:

Cannot fall asleep (stress stage)

Disturbed sleep, easily wake up at night and difficulty falling back to sleep (fatigue stage and possibly hypoglycemic)

Feel not rested and tired in the morning (both stages)

Slow starter in the morning (stress stage)

Afternoon fatigue and energy bouncing back at night (stress stage)

Patricia’s insomnia in her early years belongs to the stress stage. The guidelines for treating stress stage are:

Calm adrenal down before bedtime

Avoid exciting activities such as TV, computer and games

Relaxation such as hot bath, reading, yoga or meditation

Supplements such as chamomile tea, valerian root, 5-HTP and melatonin

Avoid afternoon fatigue by rest and adding a snack

Avoid strong exercise, do mild one for a longer time

Avoid coffee, caffeinated drinks, alcohol and tea

Normally do not use animal adrenal glandular

Patricia’s later years of insomnia belong to the more severe stage of the adrenal malfunction, the fatigue stage. The adrenal system nearly or completely lost its ability to respond to stresses, including balancing blood sugar. Frequently, hypoglycemic reactions during the day and night cause more adrenal stresses and lead to a vicious cycle. In addition to those for treating the stress stage, the guidelines for treating fatigue stage are:

Stabilizing blood sugar by having small meals more frequently

Introducing more breaks and relaxation during the day to save adrenal energy

Adding snacks before bed to prevent hypoglycemic reaction at night

Using animal glandular and herbal supplements to support adrenal system and balance blood sugar

However, to help the adrenal recover completely, eliminating stress factors is always the first choice while supporting the adrenal system with supplementation is secondary. Without solving the root issues, adrenal therapy will not work in the long-run. The common causes for adrenal stress are:

Busy lifestyle; long working hours and not enough sleep

Working at night or frequent travel across time zones

Emotional stress

Indigestion and food sensitivity

Toxin accumulation

Low liver detox function

Intestinal dysbiosis

Female hormone imbalance

Neurological conditions such as anxiety and depression



Addressing the above factors efficiently helps adrenal recover faster and completely. Managing toxin factor is sometimes crucial to reduce adrenal stress. According to ancient Chinese medicine, energy circulates the body through a meridian system following a circadian cycle. The daily energy waves reach to the Liver and Gallbladder meridians, the main detox organs of the body, between 11 p.m. and 3 a.m. During this period of time, the body is under heavy detoxification process. If the body produces excessive toxins or the liver detox function is compromised, stress occurs. This may disturb the adrenal system and cause the patient to wake up. Thus, addressing the toxin issue and supporting the liver are important in the treatment of insomnia cases.

Hormone and neurotransmitter imbalances are common stressors to adrenal system. Women during pre-menstruation and menopause period experience insomnia. Our body’s hormones are highly controlled with a negative feedback system. Excess amounts of certain hormones signal hypothalamus, which in turn sends a signal to lower the production of the hormone. However, excess hormone and neurotransmitter already produced in the system have to be detoxed by liver through ubiquitous pathways. Meanwhile, xeno-estrogens (estrogen-like toxins) and other environmental toxins also interfere with the hormone system and disturb the balance. Thus, balancing hormone and neurotransmitter by supporting liver and detoxing the body always help insomnia patients.

Patricia received individualized therapies including detailed dietary and lifestyle plan, intestinal cleansing, liver detoxification, female hormone balancing, and adrenal support with a variety of natural modalities such as Chinese herbs, homeopathy, energy and functional medicine and nutritional supplementation. After a year of treatment, she was able to sleep through the night and had more energy during the day. She understands that lifestyle changes are necessary to assure a complete recovery of adrenal system. Maintaining her healthy lifestyle, she is enjoying retired life happily.

Dr. Harry Hong is a licensed acupuncture physician specializing in holistic healing for the Highly Sensitive. He teaches highly sensitive people to listen to their body and take charge of their own health. With his own systematic IBMT protocol that includes Chinese medicine, modern homeopathy, energetic testing and allergy desensitization, he helps Highly Sensitive people gain back their immune strength and get their life back. He has offices in South Florida and Chicago. HighlySensitiveBody.com.

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