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    sleep medicine

    Insomnia (adjunctive care)

    Also known as: insomnia, chronic insomnia, sleep onset insomnia, sleep maintenance insomnia, poor sleep

    Chronic insomnia — difficulty falling or staying asleep at least three nights a week for three months — is best treated with cognitive behavioural therapy for insomnia (CBT-I) as first line. Chinese medicine and acupuncture can support sleep alongside CBT-I, and screen for contributors such as sleep apnoea, restless legs, pain, mood disorders and medication effects.

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    Lifestyle & Diet

    • •CBT-I is the first-line treatment with the strongest evidence — ask the GP about a referral or a reputable online program.
    • •Fix the wake time; get morning daylight exposure.
    • •Cut caffeine after midday; limit alcohol.
    • •Use the bed only for sleep — if awake more than ~20 minutes, get up and do something quiet in dim light.

    Cautions & Contraindications

    See sources
    • •Do not treat insomnia as a standalone TCM pattern without screening for sleep apnoea, restless legs, depression, pain and medication or substance causes.[,]
    • •Long-term sedative or hypnotic changes must be managed by the prescriber — do not advise stopping them.[]
    • •SP6 is contraindicated in pregnancy.[]

    When to reassess or seek care again

    See sources

    Use a two-week sleep diary (sleep latency, wake after sleep onset, total sleep time, daytime function) at baseline and review every 4 weeks. Screen for apnoea and mood if not improving.

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    Sources & Further Reading

    Clinical guidance, red flags and safety notes on this page draw on the following current sources alongside the classical references above.

    1. Insomnia — Healthdirect
      Healthdirect Australia · 2024
    2. Insomnia — assessment and management in general practice
      Australian Family Physician (RACGP) · 2021
    3. Acupuncture for insomnia — systematic review
      PubMed (Journal of Alternative and Complementary Medicine) · 2017
    4. Australasian Sleep Association
      Australasian Sleep Association · 2024
    5. Chinese medicine practitioner safety standards
      AHPRA / Chinese Medicine Board of Australia · 2024

    Educational reference for licensed practitioners. Not a substitute for individual clinical assessment. Refer to conventional care for any red-flag or undiagnosed presentation.