Insomnia is a common clinical manifestation of tumor patients, including difficulty in falling asleep, poor sleep, dreaminess, difficulty in re-sleeping after waking up, early awakening, or self-consciousness of sleep deprivation. Insomnia itself causes mental and emotional stress, somatic discomfort, anxiety, depression, tedious diet and decreased immunity, which also directly affects the treatment and recovery of tumor. The main factors related to insomnia caused by tumor are directly or indirectly caused by tumor itself, secondary insomnia caused by surgery, chemotherapy, radiotherapy, etc., or insomnia caused by patient’s fear of tumor and its bad prognosis and fear of imminent catastrophic end. The psychological reaction of patients to tumor itself and its treatment depends on the degree and speed of somatic and psychological damage caused by tumor. The patient’s personality and psychological state also play an important role. If patients are dissatisfied with the tumor and its treatment prospect, they may even become antagonistic to medical staff and family members, uncooperative with treatment or disappointed, thus delaying the diagnosis and treatment and leading to sleepless nights. There are also some patients who are extremely concerned about the brain function damage brought about by surgery, radiotherapy and chemotherapy of tumor, thus causing insomnia, anxiety and depressive reactions. There are also a few patients who have cognitive impairment due to the continuous growth of tumor, deny those tumor phenomena that have been very touchy and show unusual optimistic emotions, such as euphoria, levity, excitement and sleeplessness. Some patients seek medical treatment indiscriminately when they are sick, and once they cannot get their satisfactory diagnosis and treatment in time, they worry about the deterioration of their condition, which leads to secondary insomnia. For insomnia in tumor patients, we should adopt the principle of treating both the symptoms and the root cause, to relieve or eliminate the symptoms of anxiety and insomnia while eradicating the tumor. Tumor is an important cause of insomnia. If malignant tumor is effectively controlled, insomnia will also be improved. Since some malignant tumors cannot be completely cured or have recurrence at present, psychological stress factors will continuously affect patients’ moods, leading to recurrence or intensification of insomnia. In addition to drug treatment, psychological treatment also appears to be important. Sleep health education can be conducted according to the degree of patients’ disease and accompanying conditions, self-help regimen can be carried out, correct view of the disease can be established, and bad sleep cognition and habits can be changed. In Chinese medicine, the key to the occurrence of tumor lesions lies in the imbalance of the internal environment of the body, resulting in the dysfunction of the internal organs, tissues and meridians, which is related to qi stagnation, blood stasis and phlegm stasis. The root of the treatment is to support the positive energy, mobilize the body’s own positive factors, control the growth of malignant tumors, and improve the quality of life and survival rate of tumor patients. It also cooperates with chemotherapy and radiotherapy to enhance the efficacy and reduce the adverse reactions of chemotherapy and radiotherapy. The method of benefitting qi and cultivating the essence, nourishing yin and supporting the righteousness, activating blood circulation and removing phlegm and stasis, and dispersing phlegm and nodules are commonly used in clinical practice. The treatment of the symptoms is to relieve clinical symptoms, improve patients’ comfort and soothe their emotions. The treatment of related insomnia is based on evidence-based treatment, which can often be clinically classified into heart fire, liver stagnation and fire, phlegm-heat internal disturbance, yin deficiency and fire, and heart and spleen deficiency, etc. The representative prescriptions are Zhu Sha An Shen Wan, Gentian Diarrhea Liver Tang, Wen Bile Tang, Liu Wei Di Huang Wan and Huang Lian Agaricus Tang, and Gui Shen Tang. For those who have sores on the mouth and tongue, add lotus seed heart and bamboo leaf to clear the heart and relieve fire; for those with chest distension, add guahua skin, aromatic herb and yujin to regulate qi and broaden the chest; for those who have excessive dreams and even stay awake all night, add magnet and raw keel to calm the mind; for those with palpitations, add mother-of-pearl, raw keel and raw oyster to calm the mind; for those with stomach distension and dullness, add fenugreek, thick park, chenpi, poria and gum wheat sprouts to strengthen the spleen and stomach, move qi and eliminate food; for those with shortness of breath and spontaneous sweating, add Astragalus, Fritillaria, Ephedra root, etc. are added to tonify the qi and fix the surface to stop sweating. Other Chinese medicines such as Jiaotai Pill, Ginseng Yangrong Pill, Zhi Bai Di Huang Pill and An Shen Tonic Heart Pill can be used to identify the evidence.