Table 2.

Clinical features of the 10 most common TCM patterns for insomnia.

TCM patterns	Sleep-related symptoms	Non-sleep-related symptoms and signs	Tongue features	Pulse features
Excess patterns
Liver-qi stagnation  transforming into fire	Insomnia, difficulty falling asleep, excessive dreaming	Vexation, irritability, bitter taste, constipation, reddish eyes, yellow urine, headache, dizziness, hypochondriac pain, impatience, reddened complexion, thirst, poor appetite, oppression in the chest, tinnitus, hypochondriac distension, favour of drinking, reddish urine, pain in the chest and hypochondrium, frequent sighing	Red tongue with yellow coating	Rapid and string-like pulse, fine pulse
Internal disturbance of  phlegm-heat	Insomnia, restless sleep	Dizziness, vexation, bitter taste, profuse sputum, oppression in the chest, gastric stuffiness, heavy headedness, acid regurgitation, poor appetite, belching, headache, nausea	Red tongue with yellow and slimy coating	Slippery and rapid pulse
Liver fire flaming   upward	Insomnia, difficulty falling asleep	Vexation, bitter taste, dry mouth, reddish eyes, tinnitus, irritability, constipation, dizziness, dizziness with headache, dry throat, nocturnal emission, feverish sensations in the palms and soles, hypochondriac pain, impatience, reddened complexion, night sweating, palpitation and restless, aphthous stomatitis, backache, poor memory, yellow urine	Thin coating, yellow coating, red in the tip of tongue, red tongue, scanty coating, no coating	Rapid, string-like pulse, fine pulse
Stomach disharmony	Difficulty falling asleep, excessive dreaming, difficulty staying asleep, insomnia with vexation, restless sleep, unrefreshing sleep, insomnia, shallow sleep	Vexation, belching, dizziness, dry mouth, dry throat, feverish sensations in the palms, soles, and chest, night sweating, gastric stuffiness, stuffiness and pain in stomach and abdomen, sore knees, backache, hot flashes, constipation, flusteredness, poor appetite, oppression in the chest, stuffiness in stomach and abdomen, sloppy stool, tinnitus	Slimy coating, red tongue, scanty coating, thick coating, white coating, yellow coating	Slippery pulse, fine pulse, rapid pulse, string-like pulse, weak pulse
Stomach qi disharmony	∗	Abdominal distention, belching	∗	∗
Deficiency patterns
Deficiency of both the   heart and spleen	Excessive dreaming, difficulty staying asleep, difficulty falling asleep, insomnia, half asleep	Palpitation, lassitude, reduction in luster complexion, poor memory, dizziness, fatigue, tasteless, weary limbs, poor appetite, sloppy stool	Pale tongue with thin coating, white thin coating	Fine and weak pulse
Hyperactivity of fire due   to yin deficiency	Insomnia, difficulty staying asleep, insomnia with vexation, excessive dreaming, difficulty falling asleep	Tinnitus, palpitation, poor memory, dizziness, feverish sensations in the palms, soles and chest, dry mouth, backache, vexation, nocturnal emission, acid regurgitation, sore knees, sweating, dry throat, seminal emission, poor appetite, bitter taste, hot flashes, reddened cheeks	Red tongue, scanty coating, slimy coating, white coating, yellow coating	Fine and rapid pulse, slippery pulse
Qi deficiency of the   heart and gallbladder	Insomnia, excessive dreaming, frequent awakening with a start, difficulty falling asleep, difficulty falling asleep alone, difficulty staying asleep	Palpitation, fatigue, susceptibility to fright, dyspnea, pale and large amount of urine, vexation in sitting and lying down, thoughtful	Pale tongue, thin coating	Fine and string-like pulse
Heart-kidney  noninteraction	Insomnia, excessive dreaming, difficulty falling asleep, difficulty falling asleep with vexation, insomnia with vexation, difficulty staying asleep, restless sleep	Backache, dizziness, tinnitus, palpitation, vexation, feverish sensations in the palms, soles, and chest, seminal emission, night sweating, sore knees, dry mouth, susceptibility to fright, aphthous stomatitis, cold extremities, fright palpitation, irritability, reddened complexion, reddish eyes, poor memory, dry throat, hot flashes, impatience, nocturnal emission, spermatorrhea	Red tongue, scanty coating, thin coating, pale tongue, yellow coating, red in the tip of the tongue	Fine and rapid pulse, string-like pulse, sunken pulse, weak pulse
Heart deficiency with  timidity	Excessive dreaming, sleeping late at night, frequent awakening with a start	Palpitation, susceptibility to fright, dyspnea, oppression in the chest, gastric stuffiness	Pale tongue, thin coating, white coating	Fine and string-like pulse, weak pulse

Symptoms mentioned in more than 50% of the studies that described the TCM pattern are bolded.

*No study provided information regarding sleep-related symptoms and tongue and pulse features of stomach qi disharmony.