Cross-tradition comparison: how 7 medical traditions approach insomnia.
7
Traditions
8
Treatments
3
Plants & Sources
19
Evidence
1
Shared Across Traditions
plants used independently by multiple traditions
Independent Discovery
1 plant was used independently by traditions that never met. 1 shared mechanism of action in the body.
Treatment Comparison
| Tradition | Treatment | Plant | How It Works | Evidence | Preparation | Dosage |
|---|---|---|---|---|---|---|
| Traditional Chinese Medicine | 归脾汤 (Gui Pi Tang) — Restore the Spleen Decoction | Panax ginseng | Adaptogenic (HPA axis normalization), eNOS-mediated vasodilation, AMPK activation, PI3K/Akt neuroprotection | High | Decoction: standard method. Also available as Gui … | Decoction: one formula daily in 2 doses. Granule: … |
By Tradition
Insomnia caused by deficiency of Heart Blood and Spleen Qi. The Heart houses the Shen (spirit); when Heart Blood is insufficient, the Shen becomes unanchored, causing difficulty falling asleep and dream-disturbed sleep.
Treatments (1)
归脾汤 (Gui Pi Tang) — Restore the Spleen Decoction
Classical formula from the Ji Sheng Fang (済生方) for Heart-Spleen Deficiency. Tonifies Qi and Blood, nourishes the Heart, calms the Shen. The primary TCM formula for insomnia from overthinking and worry.
| Ayurveda | अश्वगन्धा (Ashwagandha) — Withania somnifera | Withania somnifera | IKK-beta direct binding inhibition, HPA axis adaptogenic modulation, STAT3 Tyr705 suppression | High | Churna with Kshira (milk decoction): boil 3-5g in … | 3-6g root powder daily, divided into 2 doses with … |
| Ayurveda | ब्राह्मी (Brahmi) — Bacopa monnieri | — | — | High | Swarasa (expressed juice): 10-20ml fresh juice. Ch… | 300-600mg standardized extract daily; or 3-6g whol… |
| Unani Medicine | اسگند (Asgandh) — Ashwagandha | Withania somnifera | IKK-beta direct binding inhibition, HPA axis adaptogenic modulation, STAT3 Tyr705 suppression | High | Safoof (powder): 3-5g with warm milk. Joshanda (de… | 3-5g root powder twice daily with milk |
| Kampo (Japanese Traditional Medicine) | 抑肝散 (Yoku-Kan-San) — Restrain the Liver Powder | — | — | High | Standardized extract granule: TJ-54. | Extract granule: 7.5g/day divided into 3 doses bef… |
| Polynesian Medicine (Rongoā Māori / La'au Lapa'au) | 'Awa (Hawaiian) / Kava (general Polynesian) — Piper methysticum | Piper methysticum | GABA-A positive allosteric modulation (non-benzodiazepine site), voltage-gated Na+/Ca2+ channel blockade, reversible MAO-B inhibition | High | Traditional: roots pounded on stone, mixed with wa… | Traditional serving: 100-250ml of prepared beverag… |
| Tibetan Medicine (Sowa Rigpa) | དཛཱ་ཏི (Dza-ti) — Myristica fragrans / Nutmeg compound | — | — | High | Powdered nutmeg in compound formulas (ril-bu — pil… | In formula: per specification. Single use: 0.5-1g … |
| Unani Medicine | گل سرخ / ورد (Gul-e-Surkh / Ward) — Rosa damascena | — | — | Moderate | Gulqand (rose petal preserve): petals layered with… | Gulqand: 10g twice daily. Rose water: 50ml twice d… |
Active Compounds
Contraindications
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Evidence (3)
Ji Sheng Fang (济生方) by Yan Yonghe, 1253 CE
Original formulation for Heart-Spleen Deficiency with insomnia, poor memory, palpitations, and fatigue. Prescribes tonification of both Qi and Blood to nourish the Heart and calm the Shen.
Gui Pi Tang granules for insomnia with Heart-Spleen Deficiency pattern: randomized double-blind placebo-controlled trial
Gui Pi Tang significantly improved Pittsburgh Sleep Quality Index (PSQI) scores vs placebo (p<0.001). Improved sleep onset latency and total sleep time. Significant improvement in anxiety (HAM-A) and depression (HAM-D) scores. Effects maintained at 4-week follow-up.
Gui Pi Tang for insomnia: meta-analysis of randomized controlled trials
Gui Pi Tang significantly improved PSQI total scores (MD -3.12, 95% CI -4.01 to -2.23) compared to placebo or standard care. Subgroup analysis showed greatest benefit in patients with concurrent anxiety and fatigue.
Anidra (insomnia) is commonly associated with Chittodvega (anxiety/mental restlessness). Vata aggravation disturbs the Manas (mind), preventing proper Nidra (sleep).
Treatments (2)
अश्वगन्धा (Ashwagandha) — Withania somnifera
Ashwagandha is a Rasayana (rejuvenative) par excellence. Described as Balya (strength-promoting), Vajikara (aphrodisiac), and Medhya (intellect-promoting).
Plants used
Active Compounds
Contraindications
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ब्राह्मी (Brahmi) — Bacopa monnieri
Brahmi is the premier Medhya Rasayana (intellect-enhancing rejuvenative) in Ayurveda. Charaka Samhita classifies it as the foremost herb for mental function. Used for anxiety, insomnia, cognitive decline, and headache.
Contraindications
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Evidence (3)
Ashwagandha root extract for insomnia and anxiety: prospective randomized double-blind placebo-controlled study
Ashwagandha root extract (300mg BID) significantly improved sleep quality (PSQI, p<0.001), reduced sleep onset latency, and improved anxiety scores (HAM-A, p<0.001). Cortisol levels decreased significantly in treatment group.
Bacopa monnieri for anxiety reduction: meta-analysis
Significant reduction in anxiety measures across studies. Effect maintained at 4-week follow-up. Minimal adverse events. Also improved attention and cognitive processing speed.
Sahar (insomnia) and Malankhuliya (melancholia) are closely linked in Unani medicine. Both involve excess Sauda (black bile) or its vapors affecting the brain, disturbing sleep and mood.
Treatments (2)
اسگند (Asgandh) — Ashwagandha
Asgandh is classified in Unani as Haar Yabis (hot and dry), Muqawwi-e-Aam (general tonic), Muqawwi-e-Bah (aphrodisiac), and Munawwim (sleep-inducing). Used for debility, nervous conditions, and insomnia.
Plants used
Active Compounds
Contraindications
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گل سرخ / ورد (Gul-e-Surkh / Ward) — Rosa damascena
Gul-e-Surkh is classified as Barid Yabis (cold and dry). Premier Mufarrih (exhilarant) in Unani medicine. Muqawwi-e-Qalb (cardiac tonic), Muqawwi-e-Dimagh (brain tonic), and Muskin-e-Safra (yellow bile sedative).
Contraindications
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Evidence (4)
Kitab al-Hawi (Comprehensive Book), Abu Bakr al-Razi
Asgandh classified as Muqawwi-e-Aam (general tonic) and Munawwim (sleep-inducing). Prescribed for debility, sleeplessness, and nervous exhaustion.
Withania somnifera root extract for insomnia in Unani clinical setting: randomized controlled trial
Ashwagandha root extract (300mg BID for 8 weeks) significantly improved PSQI scores and actigraphy-measured sleep efficiency. Cortisol levels decreased significantly. Results consistent with Munawwim (sleep-inducing) classification.
Insomnia in Kampo is primarily attributed to Ki-Gyaku (Ki reversal ascending) preventing the normal descent of Ki needed for sleep. Also involves Oketsu and Sui imbalance patterns.
Treatments (1)
抑肝散 (Yoku-Kan-San) — Restrain the Liver Powder
Originally a pediatric formula, now one of the most researched Kampo medicines for neuropsychiatric conditions. Calms Ki-Gyaku (Ki reversal) from the Liver, reduces irritability, improves sleep. Widely studied for behavioral and psychological symptoms of dementia (BPSD).
Contraindications
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Evidence (3)
Yoku-Kan-San for insomnia and behavioral symptoms: randomized controlled trial
Yoku-Kan-San significantly improved sleep quality (PSQI), reduced anxiety (STAI), and decreased irritability scores compared to standard care. Mechanism involves serotonin 5-HT1A partial agonism and glutamate regulation.
Yoku-Kan-San for behavioral and psychological symptoms of dementia (BPSD): meta-analysis
Yoku-Kan-San significantly reduced agitation, aggression, and sleep disturbance in BPSD patients. Fewer adverse events than atypical antipsychotics. Geissoschizine methyl ether (from Chōtōkō) identified as key active compound.
Yoku-Kan-San versus suvorexant for primary insomnia: randomized non-inferiority trial
Yoku-Kan-San was not non-inferior to suvorexant for total sleep time improvement at 4 weeks (primary endpoint not met, p=0.22). However, Yoku-Kan-San showed significantly better outcomes for daytime irritability and next-day cognitive function. No rebound insomnia in Kampo group.
Mental and emotional conditions understood primarily through the spiritual (taha wairua) dimension. Mate Wairua indicates that the wairua (spirit) is disturbed, displaced, or weakened. Ho'oponopono (Hawaiian family reconciliation) is a key therapeutic approach.
Treatments (1)
'Awa (Hawaiian) / Kava (general Polynesian) — Piper methysticum
Kava is the most culturally significant plant medicine in Polynesia. Used ceremonially and medicinally across the Pacific for anxiety, insomnia, pain, and as a social-spiritual drink. The root is pounded and mixed with water to produce a calming, mildly euphoric beverage.
Plants used
Active Compounds
Contraindications
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Evidence (4)
Kava (Piper methysticum) for generalized anxiety: Cochrane systematic review and meta-analysis
Kava extract significantly reduced anxiety (HAM-A scale) compared to placebo. Effect size comparable to benzodiazepines but without cognitive impairment or dependence. Aqueous extracts appear safer than organic solvent extracts.
Kava (Piper methysticum) in Polynesian culture: ethnobotanical and archaeological evidence
Kava has been cultivated and used medicinally/ceremonially for 3000+ years across Polynesia. Vanuatu identified as likely center of domestication. Traditional aqueous preparation method appears to have maximized efficacy while minimizing hepatotoxicity risk.
rLung-Sems disorders are the Tibetan category encompassing depression, anxiety, and insomnia. rLung (wind) and Sems (mind) are intimately connected in Tibetan medicine — disturbed rLung directly disturbs the mind.
Treatments (1)
དཛཱ་ཏི (Dza-ti) — Myristica fragrans / Nutmeg compound
Nutmeg (Dza-ti) is the principal rLung-calming medicine in Tibetan pharmacology. Used in the famous A-gar 35 and other rLung-pacifying formulas. Warm, oily nature directly counteracts rLung's cold, dry, mobile qualities.
Contraindications
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Evidence (2)
Tibetan medicine formula containing Myristica fragrans for insomnia and anxiety: randomized controlled trial
Nutmeg-containing Tibetan formula significantly improved sleep quality (PSQI) and anxiety scores (STAI) compared to standard care over 4 weeks. No significant adverse events. Myristicin and elemicin identified as neuroactive compounds.
Tibetan medicine formula containing nutmeg for chronic insomnia: randomized placebo-controlled trial
The nutmeg-based Tibetan formula significantly improved PSQI total scores and actigraphy-measured sleep onset latency at 4 weeks. No significant improvement in total sleep time. No next-day sedation reported. Myristicin blood levels below psychoactive threshold.
Also recognized by (1)
These traditions recognize this condition but we don't have treatment or evidence data for them yet.
Bacopa monnieri extract for insomnia in older adults: randomized placebo-controlled trial
Bacopa monnieri (300mg standardized extract BID) failed to significantly improve PSQI total score compared to placebo at 12 weeks (p=0.08). Sleep onset latency improved significantly, but total sleep time and sleep efficiency did not differ between groups.
Rosa damascena (Gul-e-Surkh) preparations for anxiety and insomnia: randomized double-blind trial
Rosa damascena extract capsules (500mg BID) significantly reduced anxiety (HAM-A) and improved sleep quality (PSQI) at 4 weeks compared to placebo. Citronellol and geraniol identified as neuroactive compounds with GABAergic properties.
Withania somnifera for anxiety and insomnia: systematic review and meta-analysis
Ashwagandha significantly reduced anxiety (SMD -1.55, p<0.001) and improved sleep quality (SMD -0.89, p<0.001) compared to placebo. Dose-response relationship observed — 600mg/day optimal. Effects apparent within 2 weeks.
Kava extract WS 1490 for generalized anxiety disorder: a 6-week double-blind, placebo-controlled trial
Kava extract (120mg kavalactones/day) significantly reduced HAM-A scores compared to placebo (p=0.046). SIGMA global assessment also favored kava. No significant liver function changes detected over the 6-week trial period.
Kava versus buspirone for generalized anxiety: a 4-week non-inferiority randomized trial
Kava failed to meet the pre-specified non-inferiority margin against buspirone at 4 weeks (HAM-A reduction: kava -8.2 vs buspirone -11.4, difference 3.2 points, margin was 3.0). However, kava showed faster onset of action (significant at week 1 vs week 3 for buspirone) and better tolerability profile.