Drawing on Wang Qi’s 9 TCM constitution score, the differences and commonalities in the structure of TCM constitution classification scale scores between 359 diagnosed insomnia patients and 157 normal control subjects, clinical symptoms of insomnia patients, and the results of TCM treatment combined with clinical identification were found to be mostly female, with an age structure of 41-60 years old, a longer duration of illness, and complex causative factors. Wang Qi’s nine TCM constitution types entered their risk factors in logistic regression analysis for the four qualities of Yang deficiency, Yin deficiency, Qi depression and blood stasis. The results of the cluster analysis showed that there were more people with more than 2 to 3 types of body types compounded, mainly focusing on different combinations of the six types of body types: calm, qi deficiency, yang deficiency, yin deficiency, blood stasis, and qi stagnation. Patients with insomnia are mainly manifested as one or more combinations of pinghe, qi-vacant, yin-vacant, yang-vacant, blood-stasis and qi-yu. The combination of Yin deficiency, Yang deficiency, Blood stasis and Qi yu is a risk factor for the development of insomnia. It is suggested that the pathogenesis of insomnia is the imbalance of qi under the influence of these physical characteristics, with adverse qi-transformation and disconnection of yin and yang. Clinical treatment should be based on the balance of yin and yang, qi and blood, and should be tailored to the individual and the time of day, with emphasis on the combined application of attack and supplementation, and the de-stressing of qi and other methods.