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Your liver may be causing you trouble sleeping, according to traditional Chinese medicine, but it can be treated with diet and lifestyle changes. Photo: Lisa Cam

TCM for sleep disorders: how to put out ‘liver fire’ that prevents you getting the nightly rest you need, according to traditional Chinese medicine

  • The liver regulates qi, the body’s life force, a Hong Kong traditional Chinese medicine practitioner says, and it is most active in the early hours of the day
  • To prevent the organ overheating – a condition known as ‘liver fire’ – change your lifestyle and consider acupuncture, Samuel To says

It’s late at night. The only sound is the low hum of the air conditioner working hard to keep the heat and humidity at bay, and for some reason you cannot sleep. You’ve worked out during the day and you’re absolutely exhausted. No matter – the Sandman refuses to visit.

If you were to consult a traditional Chinese medical (TCM) practitioner about your predicament, they would almost certainly point to your liver.

The function of the liver in traditional Chinese medicine is to regulate the qi, or life force, flowing through the body. In mainstream medicine, the liver is the organ that performs a number of essential biological functions.

TCM practitioner Samuel To Ching-san is a graduate of the University of Hong Kong’s School of Chinese Medicine and he has a PhD in acupuncture from Guangzhou University of Chinese Medicine. He has been practising TCM in Hong Kong for more than 13 years.

Traditional Chinese medicine practitioner Samuel To at his clinic in Central, Hong Kong. Photo: Xiaomei Chen
Sleepless nights or disrupted sleep could be attributed to a condition that can be translated as ‘liver fire’, he says. “When there is too much qi, it leads to heat. So when someone’s yin (cool, nighttime energy) and yang (warm, daytime energy) are unbalanced, where there is too much yang that leads to the qi overheating the liver, it eventually becomes liver fire,” To says.
Apart from sleeplessness, other symptoms include teeth grinding, frustration, a volatile temper and dry mouth and eyes. In extreme cases, it may also lead to depression.

The liver: organ that keeps on giving and how to give it a break

“Sleep is absolutely essential to proper liver function,” To adds. “Insomnia is a common symptom of the liver because when your body rests at night, it’s what we call in Chinese medicine a transition from yang to yin.


“The liver is most active from 1am to 3am and is the organ that regulates the qi transition. The liver is like a filter for the entire body, converting the ‘yang’ qi of the day to ‘yin’ qi at night, hence creating a balance. If that filter is dirty or blocked, the yang will overflow and you wake up.”

This TCM theory loosely aligns with Western medicine.

Fried or spicy food, coffee, alcohol and staying up late, all contribute to liver heat. The liver is at its optimum performance between 1am and 3am
TCM practitioner Samuel To Ching-san
A 2020 review of sleep disorder in patients with chronic liver disease in the Journal of Thoracic Disease notes: “Sleep disturbance is a common feature of chronic liver disease (CLD) with impact on health-related quality of life; 60 to 80 per cent of patients with CLD report subjective poor sleep; frequent presentations of sleep disturbance include insomnia, reduced sleep efficiency, increased sleep latency, reduced time in rapid eye movement sleep, restless leg syndrome and excessive daytime sleepiness.”

Why is liver fire-induced insomnia particularly prominent in the summer months? To says: “Heat is all around you in summer, and your liver has to filter all the heat you have absorbed during the day, too.”

According to TCM’s holistic approach, the largest contributory factor to imbalances in the liver are day-to-day choices in lifestyle and diet.

What saves your health, money and the planet? A whole food plant-based diet

“Fried or spicy food, coffee, alcohol and staying up late, all contribute to liver heat,” says To. “The liver is at its optimum performance between 1am and 3am so it’s best to be in bed by 11pm and make sure the body is at rest for the liver to do its job.”


TCM practitioners prescribe herbs to target liver health – and overcome insomnia – such as Chinese thorowax root, white peony root, Baikal skullcap root, adhesive rehmannia root tuber, capillary wormwood (a herb) and Siberian Solomon’s seal rhizome.

An acupuncturist can also work on relevant pressure points to help stimulate the healing of liver fire.
Double-boiled fish maw soup with conch and dendrobium from the Man Ho restaurant at the JW Marriott Hotel Hong Kong. Photo: Man Ho

Let food be your medicine. Some healing soups based on TCM ingredients are readily available at popular Hong Kong Chinese restaurants. The Royal Garden Chinese Restaurant in the basement of the Royal Garden Hotel in Tsim Sha Tsui offers double-boiled teal (duck) with cordyceps flower soup on its menu.


The JW Marriott Hotel Hong Kong’s Man Ho restaurant offers double-boiled sea cucumber soup with American ginseng, dendrobium (orchid) and chicken, and double-boiled fish maw soup with conch, cordyceps flower and Silkie chicken.

The active TCM ingredients include American ginseng, dendrobium and cordyceps flower.

Man Ho executive Chinese chef Jayson Tang compares an ‘overheated’ liver to an air conditioner with a dirty filter. Photo: JW Marriott
“We know that these ingredients help reduce heat and dispel dampness in TCM,” says chef Jayson Tang of JW Marriott Hotel Hong Kong.

“The liver helps detoxify the body, and if there are too many toxins in the body then heat will build up, much like how a dirty air conditioner filter will affect how well it functions.”

For a good night’s sleep, try these mild and simple TCM home remedies.

Papaya, snow pear and white fungus soup

1 small papaya


2 snow pears

1 carton of white fungus

1 handful of apricot kernels

2.5 litres of water

Dice papaya and pear into small chunks, and add to a pot with other ingredients. Add the water. Bring to a boil then simmer on a low heat for two to three hours. Add salt to taste.

Prunella tea

Prunella leaves (Prunella vulgaris is also called self-heal or heal all)


Rock sugar

Wash prunella leaves and then place them in a pot. Fill the pot with cold water so that it covers the herbs completely. Bring to a boil then simmer for 20 minutes. Add rock sugar to taste.

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