Lo Siu-ching had suffered from severe insomnia for more than a decade. She tried endless sleep-inducing methods, taking melatonin supplements, drinking a cup of hot milk before bedtime, counting sheep.
You name it, she tried it, but all to no avail. To get a respite from the exhaustion that comes with severe insomnia, she sometimes took sleeping pills.
"Though I still woke up in the middle of the night, the few hours of sleep under the influence of pills was better than nothing," says Lo, 62.
Worried that long-term use of sleeping pills would lead to dependence, she signed up to qigong classes six months ago to try to ease her sleeping problem. The exercises include tendon stretching, breathing techniques, and maintaining stationary postures for extended periods.
"Although I still suffer from insomnia sometimes, I fell asleep more easily after doing qigong for a couple of months," she says.
Qigong is the ancient Chinese art of co-ordinating breath with a series of repetitive fluid movements which enables energy, or qi, to move through the body, promoting mental and physical well-being. It has long been used by Chinese medicine practitioners to treat insomnia together with herbal medicine and acupuncture.
The effects of practising qigong on insomnia patients will be studied clinically and scientifically for the first time in a study by Hong Kong University's (HKU) Centre on Behavioural Health in October. Three hundred insomnia sufferers will be put into qigong and control groups to check the effect of the Taoist mental and physical exercise.
The research participants will have blood tests before and after the qigong classes, which will run for eight weeks. Researchers will study the levels of brain-derived neurotrophic factor (BDNF) in patients, a protein found primarily in the brain which is capable of regulating the development of neurons.
Variations in BDNF levels have been linked with mental illness, developmental delay and neurological diseases.
Cecilia Chan Lai-wan, a professor in health and social work at HKU, says practising qigong can speed up the flow of energy and blood circulation and help ease insomnia.
"In the concept of Chinese medicine, insomnia can be caused by blocked meridians (the pathway system through which qi flows). Qigong can help remove the blockages so that qi and blood can flow to the internal organs."
Dr Yuen Lai-ping, chairman with the International Association for Health and Yangsheng, which is collaborating with HKU on the study, says qigong can help attain balance between yin and yang, which in turn can help with insomnia and mood disorder.
"The qigong exercise regime is called Five Elements and Balance Qigong which consists of five simple exercises involving kicking legs and whole-body relaxation," Yuen says. "It's also mental training, as it requires concentration and regular breathing rhythm that helps the practitioner achieve a focused mind.
"We have done studies before which show that qigong can help lessen the chronic exhaustion and depression symptoms of those suffering from chronic fatigue."
Since 2001, the Centre on Behavioural Health has developed an integrated approach which involves the body, mind and spirit to boost people's holistic well-being, says Chan.
"We integrate traditional Chinese wisdom with Western psychotherapy principles. The integrated approach incorporates mindfulness practice, acupressure techniques and easy-to-learn physical exercises like qigong," she says.
"It can boost people's flexibility and resilience in dealing with life adversities. Our studies have shown that the integrated approach helps improve mood and quality of life and reduces stress which is among the major causes of insomnia."
Health Department figures show that about 20 per cent of the population, or around 1.4 million people, suffer from sleep disturbance.
While Western doctors prescribe sleeping pills, or refer patients to psychologists or psychiatrists for cognitive behavioural therapy or psychotropic drug intervention, Chinese doctors use herbal medicine and acupuncture as the first line of treatment.
Zhang Shiping, associate professor and expert in acupuncture and neuroscience with the Baptist University's School of Chinese Medicine, says a Chinese medicine doctor will first find out the underlying mechanisms for insomnia.
"We look at the person as a whole and look at which organ in the body is in imbalance. For example, insomnia is commonly related to four organs: heart, spleen and liver and gall bladder. For heart, spleen and gall bladder, we often see deficiency of the chi of these organs. For liver, it can be caused by the chi stagnation of liver, which can cause a fire," Zhang says.
"Deficiency in kidney due to ageing will also cause insomnia. You see lots of elderly people suffering from insomnia because their kidney functions are weakening due to ageing."
It's important to know the differences in how Chinese and Western medicine define deficiency in organs, Zhang says. "When Chinese medicine talks about kidney, spleen and heart, etc, we are referring to a group of functions rather than the actual organ. I have patients who were told that their insomnia is due to deficiency in [a] kidney.
"They then go to Western medical practitioners to have their kidney function tested. But the results turn out to be normal. They are very puzzled as to which practitioner is correct.
"In this case both are correct. It's because Chinese medicine is talking about the function of kidney, which includes the growth of the individual, the reproductive function of the individual, his urinary function and also the functions in sex hormones and growth hormones.
Herbs with different properties will be prescribed to treat the imbalance of these organs, Zhang says. "With acupuncture, we can select different acupuncture points to adjust the balance of the energy within all these organs. And qigong, meditation techniques, can also help."
Multiple approaches are needed to cure insomnia. Lifestyle changes such as doing exercise, taking a hot bath before bedtime and avoiding caffeine after midday, can help, Zhang says.