In recent years, we often encounter patients of different ages in the outpatient clinic seeking treatment for various complaints such as fatigue, dizziness, headache, eye distension, memory loss, concentration problems, palpitations, chest tightness and shortness of breath, agitation, mood swings, hot and sweaty, dry mouth and bitterness, loss of appetite, distention and fullness of the abdomen, abdominal pain and diarrhea, back pain, sexual dysfunction, and dull complexion. Although, they are all aware of their health problems, they are not sure what the cause is. As a TCM practitioner, it is not difficult to make a diagnosis and treatment based on the basic theory of TCM in combination with the other clinical manifestations of the patient. However, in past clinical practice and patient’s consultation history, it is often found that there are many patients who have undergone formal treatment by Chinese and Western medicine with unsatisfactory results or short-term effectiveness, and then their symptoms quickly recur after stopping the medicine. In the process of confusion and reflection, through more careful consultation with some of these patients, it was found that most of these patients have a common underlying condition – insomnia. And it was often overlooked in the previous diagnosis and treatment process of Chinese and Western medicine. Modern research has found that sleep is an indispensable process for human beings, with one-third of a person’s life spent in sleep, and sleep is second only to breathing and heartbeat in importance. The restoration of human neurons and related tissues for reconstruction and regeneration requires rest for the organism, and only the sleep state can provide such rest. Experiments have shown that sleep deprivation results in the loss of sensation (light, sound, touch, taste) in animals and can even lead to death. Emotional changes are the first reactions to appear, such as rapid alternation of irritability, euphoria and depression, lack of interest in the surroundings, etc. There are also signs of psychomotor instability. After 3 days of sleep deprivation, subjects may experience disorganized thinking, inability to express complete meaning, and forgetfulness of recent events. The British scholar Ferrie et al. found that significant changes in an individual’s regular weekday sleep schedule-an increase or decrease in sleep-increased their risk of death. A reduction in sleep duration to <6 hours increased an individual's risk of cardiovascular death by a factor of 1; lack of sleep is known to be a risk factor for weight gain, insulin resistance, and type 2 diabetes. Reduced sleep is accompanied by increased secretion of corticosteroids and abnormal growth hormones and is associated with hypertension and certain cardiovascular diseases. Studies suggest that regular sleep on weekdays (e.g., 6, 7 or 8 hours) may protect the body from life loss. Ambulatory blood pressure studies suggest that even mildly elevated blood pressure, especially at night, can significantly increase the incidence of cardiovascular disease and mortality. Thus, sleep-related disorders that lead to elevated blood pressure may significantly affect cardiovascular disease risk. Both sleep deprivation and insomnia are associated with an increased incidence of hypertension. One study showed that the incidence of depression was four times higher in insomniacs than in non-insomniacs. Insomnia: It is usually a subjective experience in which the person is not satisfied with the duration and/or quality of sleep and affects social functioning during the day. Research has found that insomnia has become a significant influence on modern human health threats. The Global Sleep Survey (SLEEPsurvey, 2002) shows that 45.4% of Chinese people have insomnia: 45% of car accidents are related to lack of sleep; 50% of workplace accidents are related to lack of sleep; and chronic insomniacs have 4.5 times the risk rate of accidents than normal people. Is it common for such alarming modern health problems to be underdiagnosed in the clinic? For this reason, we conducted a simple survey in our outpatient work. The results showed that out of 327 respondents, 126 (38.5%) had insomnia, but only 22 (17.5%) of them had insomnia as the main complaint, 18 (14.3%) had insomnia in their medical history, and 86 (68.2%) were asked passively. In other words, if clinicians do not consciously ask patients about their sleep, it is possible that nearly 70% of patients will miss the important diagnosis of "insomnia". The treatment may only address the many symptoms caused by insomnia, and since there is no purposeful intervention for the cause (insomnia), it is unlikely that the patient's insomnia will improve significantly, resulting in a situation where the treatment is not effective or is effective in the short term, and the symptoms return quickly after stopping the medication. Why is such an important modern health issue ignored by clinicians? I think there are several reasons: ① Insomnia is an ancient disease, ancient Chinese medicine called it "sleeplessness", the "Yellow Emperor's Classic of Internal Medicine" has "can not sleep", "eyes do not close", "sleeplessness", "sleeplessness", "sleeplessness", "sleeplessness". In the Yellow Emperor's Classic of Internal Medicine, there are records of "sleeplessness", "restlessness" and "sleeplessness". However, 20 years ago, the pace of Chinese people's life was relatively slow and life was not very stressful, so the incidence of insomnia was low in clinical practice. However, in the past 20 years, with the rapid development of China's economy, social problems such as childbirth, childcare, schooling, employment, workplace conflicts, family relationships, and even marriage have actually become social problems that affect the Chinese people's state of mind and sleep. Faced with the sudden influx of insomnia, we doctors are not really comfortable with it and inevitably respond poorly - neglecting to ask about sleep. Think about how many opportunities we all lost after the government released 4 trillion to get rich with the real estate boom, you can understand the doctor's "poor consideration". In addition to the specific manifestations of insomnia such as difficulty in falling asleep, difficulty in maintaining sleep (easy to wake up, dreamy, early awakening, etc.), excessive dreaming, and inability to recover energy from sleep, many other clinical manifestations that may be caused by or related to it are not specific. The patient is not aware of the relationship between many clinical manifestations and insomnia. In addition, some patients have been sleeping poorly for a long time and are used to it, so when doctors ask about sleep, they often respond by saying "it's okay", and if doctors do not follow up carefully, they often miss the diagnosis of insomnia. (3) Many patients in the clinical process of continuous consultation, after a variety of tests, found evidence of organic disease, thus attracting the attention of doctors and patients to those with a clear diagnosis of disease, but ignore the possible culprit - insomnia. Although Chinese medicine has a long history of treating insomnia, the prevalence of insomnia was low in the ancient farming culture, so the "Ten Questions Song" (a question of cold and heat, two questions of sweat, three questions of head and body, four questions of stool, five questions of diet, six questions of chest, seven deafness and eight thirst should be identified, nine questions of old illnesses and ten questions of causes, and then take medicine with reference to the changes in the mechanism) was formed in the Ming and Qing dynasties. The following are some of the most important questions to ask. Women must especially ask about menstruation, late and fast closed collapse are visible. (Add another piece to tell the pediatrician, smallpox and measles all accounted for the test.) The question of sleep is not included in the list. Therefore, some doctors who strictly adhere to the traditional way of consultation and habits have missed the questioning of sleep. The clinical manifestations of insomnia are as follows: 1. sleep latency: falling asleep for more than 30 minutes; 2. sleep maintenance: waking up more than 2 times at night or waking up early in the morning; 3. sleep quality: more nightmares; 4. total sleep time less than 6 hours; 5. daytime residual effects: feeling dizzy the next morning, lack of energy, drowsiness, weakness, etc. Classification by duration: 1. Transient or acute insomnia: duration less than 4 weeks; 2. Short-term or subacute insomnia: duration greater than 4 weeks and less than 3-6 months; 3. Long-term or chronic insomnia: duration greater than 6 months. Classification by severity: 1, mild: occasional, little impact on quality of life; 2, moderate: occurring every night, moderate impact on quality of life, with certain symptoms (irritability, anxiety, fatigue, etc.); 3, severe: occurring every night, seriously affecting quality of life, with prominent clinical symptoms. The difference between Chinese and Western medicine in the treatment of insomnia 1, the treatment target is different: sleeping drugs, acting directly on the nervous system, by antagonizing the relevant receptors, producing sedation, sleeping effect. They have no direct effect on the cause of insomnia, and we can only hope that the body will adjust and recover naturally after getting a certain amount of sleep, which is a kind of passive truncated treatment (regardless of the cause). In contrast, Chinese medicine considers insomnia to be a manifestation of internal disturbance of disease and evil, imbalance of yin and yang, and dysfunction of internal organs, therefore, the treatment does not focus on sedation and tranquility, but aims at eliminating disease and evil, adjusting yin and yang, and restoring the function of internal organs. Therefore, the treatment of Chinese medicine is an active treatment for the cause and pathological mechanism. 2, the treatment time is different: sleeping drugs are mainly forced hypnotic, fast-acting, mostly taken at bedtime, and only when the patient's sleep is thoroughly improved can the drug be stopped, so it is difficult to predict the time of stopping the drug clinically. Therefore, it is difficult to predict the time of stopping the medication. As the time of taking the medication increases, the dosage often needs to be increased. Although the World Health Organization's medication regimen for insomnia is: the general prescription of sleeping pills should not exceed a maximum of 4 weeks, and then should be discontinued for 2 weeks, and if needed again, another sleeping pill is prescribed. This is to avoid the occurrence of sleeping pill addiction or drug dependence. However, this medication regimen is often difficult to achieve in the treatment of patients with chronic or moderate to severe insomnia, so it is not uncommon to see insomnia rebounding after discontinuation, long-term application of a single drug, and withdrawal syndrome. Chinese medicine to eliminate the cause of the purpose, the onset of effect, although relatively slow, but the daily 2 to 3 times the way to take drugs to ensure continuous action time, in general, the efficacy of the treatment time with the continuation of more and more obvious, from the elimination of the cause, the pathology of sleep improvement will not appear to stop rebound, much less withdrawal syndrome. In conclusion, I hope that all patients will pay attention to their sleep and all doctors will care about their patients' sleep. By giving full play to the advantages of Chinese and Western medicine in treating insomnia, may all of us have high-quality sleep, abundant energy, and a happy and wonderful life.