Hong Kong Chinese medicine clinical practice guideline for insomnia

Introduction

Insomnia in Chinese Medicine can be defined as inability to sleep or inability to relax when lying down. Insomnia is common among people in Hong Kong and requires appropriate management. Approximately 39.4% of adults are thought to suffer from insomnia in Hong Kong, a significant proportion of whom seek Chinese Medicine (CM) therapies as supportive care. This article provides a CM clinical practice guideline (CPG) for insomnia to guide local licensed CM practitioners which can be beneficial by providing a reference point for medical decision makers as well as patients. 

Methods

A systematic search of clinical research regarding CM treatments for insomnia was conducted. After data retrieval and evaluation, the guideline was drafted on the basis of clinical evidence, data mining, consensus of experts in Hong Kong and overseas, and synthesizing information by the process of assessment and consultation. 

Results

Based on the results of data mining and consensus by experts, common patterns of insomnia included: transformation of liver depression into fire, harassment of interior phlegm-heat, yin deficiency with internal fire, dual deficiency of the heart and spleen and lack of interaction between the heart and kidney. The recommended CM herbal prescriptions were: Longdanxiegan decoction, Modified Wendan decoction, Huanglianejiao decoction, Renshenguipi decoction and Jiaotai pill respectively. Appropriate acupuncture points were also identified

Conclusions

This article provides the first CM CPG for insomnia for Hong Kong local use which will provide a milestone in the development of CM in Hong Kong. It may help standardize and secure CM clinical practice thus improving efficacy and safety of CM.