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Natural approaches to insomnia: what the research says about Herbal Medicine and Ear Acupuncture

  • Categorized As Chinese Medicine

koala insomnia

Natural approaches to insomnia: what the research says about Chinese Herbal Medicine, and Ear Acupuncture

Insomnia affects a large number of Australians and often becomes chronic, lowering daytime energy, mood and concentration. At Centre of Health we draw on acupuncture, ear (auricular) acupuncture, and evidence-based Chinese herbal protocols when appropriate. Below is a concise, research-grounded look at three commonly used treatments: Suan Zao Ren Tang, Chai Hu Jia Long Gu Mu Li Tang, and auricular (ear) acupuncture — what studies show, how they might help, and important safety notes.

1) Suan Zao Ren Tang (酸棗仁湯) — the evidence

What it is: A classical TCM formula built around Suan Zao Ren (Ziziphi spinosae seed) traditionally used to nourish the Heart and calm the spirit — commonly prescribed for difficulty falling asleep, frequent waking, and anxiety-related insomnia.

What the research shows: Multiple randomized trials and systematic reviews have found benefits for Suan Zao Ren-based formulas compared with placebo or wait-list controls, and several meta-analyses of Chinese herbal medicine identify Suan Zao Ren Tang as one of the formulas with consistent positive signals for improving subjective sleep quality and sleep duration. Not every trial is large or methodologically perfect, but the body of evidence supports clinical benefit — especially for insomnia with anxiety or “heart/mind” disturbance patterns. (BioMed Central)

Practical note: Suan Zao Ren Tang is often used alone or combined with anxiety-calming formulas (e.g., combined with Zhi Zi Chi Tang in trials for insomnia with anxious features). Dosing and preparation vary (decoction vs granule/extract).

2) Chai Hu Jia Long Gu Mu Li Tang (柴胡加龍骨牡蠣湯) — calming & grounding formula

What it is: A modified Shaoyang formula (based on Xiao Chai Hu Tang) with Long Gu (dragon bone) and Mu Li (oyster shell) added to provide stronger grounding and sedation. Clinically it’s used for agitation, irritability, nightmares, anxiety and insomnia where the patient demonstrates constraint, agitation or a Shaoyang/Shao Yin pattern in TCM terms.

What the research shows: Compared with Suan Zao Ren Tang, there are fewer high-quality randomized trials specifically for Chai Hu Jia Long Gu Mu Li Tang and insomnia. However, broader systematic reviews of TCM formulas for insomnia identify this formula among several with reported clinical effectiveness in Chinese trials and clinical reports; mechanistic and preclinical work suggests anxiolytic and sedative properties for constituent herbs and mineral components. Evidence is promising but less robust and more heterogeneous than for Suan Zao Ren Tang. (Research Square)

Practical note: Because this formula contains mineral substances (Long Gu / Mu Li), practitioner supervision is important. It’s typically chosen after pattern differentiation — for example when there is agitation, insomnia with a sense of constraint or withdrawal, or sleep disturbance with anxiety and somatic symptoms.

3) Auricular (ear) acupuncture / auriculotherapy — targeted, low-burden option

What it is: Stimulation of points on the ear (needles, pellets/seeds, or auricular acupressure) aiming to modulate autonomic tone and the central nervous system to improve sleep.

What the research shows: Multiple systematic reviews and meta-analyses (including recent 2023–2025 analyses) report that auricular acupressure/acupuncture can improve measures such as sleep onset latency, total sleep time, sleep efficiency and PSQI (Pittsburgh Sleep Quality Index) compared with control conditions. Results are encouraging, and several reviews reported effects comparable to some short-term hypnotic medications in the trials analysed — but study quality and heterogeneity (different protocols, point selections, and control types) mean conclusions should be cautious. Auricular approaches are attractive because they are low risk, can be delivered in-clinic or via patient-applied seeds, and combine well with body acupuncture and herbs. (Frontiers)

Practical note: Common auricular points used in insomnia studies include Shenmen, Heart, Subcortex, and Sleep-related points. Protocols vary in needle vs seed/pellet use and in treatment schedule; many trials used repeated weekly treatments over several weeks.

Safety, interactions and clinical considerations

  • Quality of evidence: Overall, Suan Zao Ren Tang has the most consistent RCT/meta-analytic support among the three; Chai Hu Jia Long Gu Mu Li Tang has traditional and case-series support with fewer high-quality RCTs; auricular acupuncture has several meta-analyses showing benefit but with variable trial quality. (BioMed Central)
  • Herb–drug interactions: Some herbs can interact with medications (e.g., sedatives, anticoagulants). Always tell your practitioner about prescription meds, supplements, pregnancy or breastfeeding.
  • Side effects: Herbs can cause GI upset, allergic reactions, or idiosyncratic effects; mineral components (Long Gu / Mu Li) require careful sourcing and dosing. Auricular acupuncture has low adverse event rates (minor local discomfort, transient dizziness). (Acupuncture Today)
  • Individualisation matters: TCM formulas are chosen based on pattern differentiation. Two patients both with “insomnia” may receive different formulas and acupuncture point prescriptions depending on whether anxiety, phlegm-heat, yin deficiency, blood deficiency, or other patterns predominate.

How we use these approaches at Centre of Health

At Centre of Health we:

  • Assess sleep history and screen for medical sleep disorders (e.g., sleep apnea) and medication causes before recommending TCM therapies.
  • Use pattern diagnosis to choose herbs (for example, Suan Zao Ren Tang for Heart-Spirit disturbance; Chai Hu Jia Long Gu Mu Li Tang when there is agitated, constrained Shaoyang or withdrawal).
  • Combine body acupuncture, auricular acupuncture/seeds and herbal protocols where appropriate, with sleep hygiene advice and cognitive-behavioural approaches when needed.
  • Monitor response and adjust formulas, and liaise with GPs or sleep specialists if the presentation is complex or medication review is required.

Bottom line

  • Suan Zao Ren Tang: the strongest and most consistent clinical signal among these three for improving subjective sleep in many RCTs and systematic reviews — especially when insomnia has an anxious component. (BioMed Central)
  • Chai Hu Jia Long Gu Mu Li Tang: clinically valuable for agitated, constrained presentations; evidence is promising but less numerous and more heterogeneous. (Research Square)
  • Auricular acupuncture: multiple meta-analyses find beneficial effects on sleep measures; a low-risk option that pairs well with herbal treatment and body acupuncture. (Frontiers)

If you’re experiencing persistent insomnia, book an assessment so we can do a full history and pattern diagnosis. From there we can discuss whether a Suan Zao Ren Tang-based approach, a grounding Chai Hu Jia Long Gu Mu Li Tang protocol, auricular acupuncture, or a combined program is the best next step for you.