The concept of constitution in Traditional Chinese Medicine (TCM) has long been recognized as a potential factor in the prevention and treatment of insomnia. However, the current scarcity of rigorous statistics on the relationship between TCM constitutions, especially mixed constitutions, and insomnia has driven researchers at the Yueyang Hospital of Integrative Medicine, Shanghai University of Traditional Chinese Medicine to investigate the topic in a study published in the Journal of Integrative Medicine.
Implications of Insomnia
Discontent with sleep duration or quality, together with difficulties in initiating or maintaining sleep, defines insomnia—a disorder affecting roughly 10%–15% of the global population—and impacts and degrades daytime performance, with potential progression to mental and physical health issues, including major depression, anxiety disorders, and cardiometabolic diseases.
Beyond diminishing quality of life, insomnia carries social implications: workplace absenteeism, a potential rise in motor-vehicle crash rates, and increased economic and caregiving burdens on society. Although cognitive-behavioral therapy for insomnia (CBT-I) is considered the gold standard intervention, evidence shows a substantial portion of patients do not respond adequately to this therapy, opening the door to studying complementary or alternative treatment strategies.
TCM appears to offer opportunities for preventing and treating insomnia: clinical studies, for example, have demonstrated the effectiveness of various TCM approaches in improving sleep quality, particularly in perimenopausal insomnia. Among these, acupuncture, when combined with traditional Chinese medicine, seems to yield outcomes that, relative to Western medicine alone, benefit from TCM and may also reduce states of anxiety and depression. Such findings suggest that TCM could be a promising complementary or alternative approach in managing insomnia and its associated effects.
The Study
In TCM, therapeutic interventions are individualized based on an individual’s body constitution, reflecting the holistic state of the body, including physical and emotional characteristics that influence sensations, behaviors, and responses to pathogenic factors.
The assessment of body constitution thus underpins diagnosis, treatment, and prevention of disease. However, the association between specific TCM constitutions and insomnia had not been robustly examined, which was precisely the aim of this study.
Chinese researchers launched a cross-sectional study at the Department of Preventive Medicine of Yueyang Hospital of Traditional Chinese and Western Integrative Medicine in Shanghai, from November 2022 to December 2023, investigating the role of the nine constitutions in TCM, with particular emphasis on mixed constitutions, using the Chinese Constitution Questionnaire. The study involved 1,065 participants, of whom 242 had insomnia and 823 served as controls. Among the participants, 862 (80.94%) displayed distorted constitutions, and of these, 75.30% had mixed constitutions.
The Results
Logistic regression analysis revealed a negative association between the甜 (Sweet) constitution and insomnia (odds ratio [OR] = 0.28, 95% confidence interval [CI] [0.12, 0.64], P = 0.003). By contrast, constitutions characterized by qi deficiency (OR = 1.52, 95% CI [1.06, 2.17], P = 0.023), yang deficiency (OR = 1.54, 95% CI [1.08, 2.21], P = 0.018), damp-phlegm (OR = 1.97, 95% CI [1.37, 2.85], P < 0.001), and qi stagnation/depression (qi depression) (OR = 2.12, 95% CI [1.45, 3.12], P < 0.001) were positively associated with insomnia.
Conversely, there were no statistically significant associations for yin-deficiency, damp-heat, blood stasis, or special diathesis with insomnia. These relationships remained significant after adjusting for potential confounding factors and were further validated through sensitivity analyses using propensity score matching.
In Conclusion
The study’s findings appear to indicate significant associations between TCM constitutions and insomnia; however, these findings require validation through further longitudinal and interventional studies to deepen understanding of the mechanisms by which insomnia develops across different constitutions and to enhance the clinical applicability of the various therapeutic approaches.
Source
Han Y, Wang Y, Shi MY et al. Integrating traditional Chinese medicine constitutions into insomnia management: Findings from a cross-sectional study. J Integr Med, 2025, 23(4):382-389. Doi: 10.1016/j.joim.2025.05.004.
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