The etiology of episodic sleeping disease in children is no more than the difference between the real and the imaginary. The real causes are dampness blocking the middle jiao, phlegm and phlegm, liver depression and qi stagnation, and wind and phlegm blocking the ligaments; the imaginary causes are kidney yang deficiency and cold phlegm coagulation. Regardless of whether it is real or not, the treatment of phlegm is always carried out to open the orifice. Narcolepsy is a sleep disorder with irresistible daytime sleepiness and increased sleepiness as the main manifestation. Its main features are sudden onset of irresistible daytime sleep, episodic sudden collapse syndrome, sleep paralysis and sleep hallucinations, also known as the quadruple syndrome of episodic sleep disorder. The prevalence of the disease is about 0.03%-0.16% in the population, with no significant gender difference. According to its clinical manifestations and symptoms, it belongs to the category of “multiple sleep” in Chinese medicine, and its etiology, combined with the author’s long-term clinical experience, it is believed that children’s episodic sleepiness is closely related to phlegm. 1, dampness trapped in the middle Jiao, phlegm and turbidity: the spleen and stomach in the middle Jiao, the main transport water and dampness, and the lungs, kidneys, Sanjiao, bladder and other organs coordinate with each other to maintain the balance of water and fluid metabolism. If the child has a weak spleen qi and cannot transport water and dampness, the dampness will block the spleen and stomach, phlegm and turbidity will be abundant, the qi will not rise and fall properly, the qi of clear yang will not be able to moisten the head and eyes and symptoms such as dizziness and sleepiness, lethargy and sleepiness will occur. The “Danxi Xinfa in Dampness” says: “The spleen and stomach suffer from dampness, sinking and sleepiness, tiredness and sleepiness.” Li Dongyuan’s “Spleen and Stomach” cloud: “The deficiency of the spleen and stomach, idleness and sleepiness.” It can be seen that spleen deficiency and dampness, phlegm and turbidity are important etiological mechanisms of childhood episodic sleepiness. The spleen is the origin of the posterior, the source of Qi and blood production, can be water and grain essence up to the head and eyes, while transported to the limbs and bones. If the child likes to eat fatty, sweet, thick, spicy and stimulating food, dampness and turbidity will be generated inside and block the spleen and stomach, so the spleen cannot transport water and dampness normally, and it will become phlegm and turbidity, and the clear orifices will be clouded and the head and eyes will be dull, the limbs will be weak, and sleep will increase. The “Ling Shu Hai Lun” cloud: “Sea of marrow is insufficient, then the brain turns tinnitus, shin vertigo, eyes do not see, slack and rest”. If dampness is contained and heat is turned into heat, dampness and heat cross-steam up the clear orifices, internal disturbance of the liver and gallbladder, qi stagnation and aggravate the symptoms of dizziness and drowsiness. 2, kidney yang deficiency, cold phlegm cohesion: the normal path of human water metabolism mainly relies on the lung to regulate the water channel, the spleen to transfer, the kidney yang transpiration gasification and other functions to complete together, and the kidney transpiration gasification for its fundamental. The circulation and metabolism of water and fluid in the human body must depend on the normal activities of the yang of the lungs, spleen and kidneys, which are coordinated with each other, so that vaporization can be carried out normally. Kidney yang is the root of Yang energy in the whole body, and the normal metabolism of water and fluid in the human body requires the opening and closing of kidney energy to proceed. If a child is congenitally deficient, feels the evil of wind and cold or after a long illness, Yang Qi is damaged, kidney Yang is deficient, Qi transformation is unfavorable, water flow is impaired, and water is stopped in a local area, the disease is phlegm. “Phlegm is a product of pathology and can be a source of new diseases. Ming Dynasty “Shou Shi Bao Yuan” cloud: “unable to speak, dazed and forgetful, in a trance, dizziness of the head and eyes, chest annoyance and depression, phlegm and saliva congestion, mental faintness”, phlegm in addition to causing a series of symptoms, but also easy to appear a variety of mental abnormalities, such as confusion, drowsiness, etc. Zhang Xichen believes that the standard of phlegm is in the spleen and stomach, and the origin of phlegm is in the kidney. 3, liver depression and stagnation, wind and phlegm blocking: “medical from the record” said: “the wind must hold the wood potential and grasp the earth, earth disease and phlegm.” Wind phlegm is a pathological product due to the dysfunction of the spleen. In children who are depressed or under pressure from studies, the liver loses its function of draining, the qi is blocked, and the water and fluid are not properly transported and gathered into phlegm; the liver loses its draining and crosses the spleen, the spleen loses its function of transporting and transforming, and phlegm is generated internally, the qi is stagnant with the phlegm, and the wind and phlegm are intertwined. Liver wind with phlegm upward attack, on the clear orifices, the symptoms are drowsiness, confusion, etc. Wind and phlegm in the pathogenesis of episodic sleep disorders, each with its own different manifestations, wind is hyperactive liver yang, prone to impatience and irritability, insomnia and dreaminess; phlegm is obscuring the clear orifices and confusion, sleepiness and so on. Phlegm follows wind and is nowhere to be found. When wind meets phlegm, it runs across the meridians, which can affect qi and blood and lead to stasis symptoms over time. 4, the phlegm method of opening the orifice through the children’s episodic sleeping disease always The Golden Plaque is said: “the disease phlegm drinker, when warm medicine and the”, this is the general principle of treatment of phlegm drink disease in the broad sense. The phlegm is formed for different reasons and manifests itself in different pathological phenomena in the corresponding internal organs and meridians, but only the “Yuan Shen” is most closely related to phlegm. Episodic sleep disorder is caused by the dysfunction of the spleen, kidney and liver, and the onset of phlegm is not unrelated to phlegm. Therefore, the key to its treatment lies in resolving phlegm and opening the orifices, and this is done throughout the disease. If the patient is fatigued, drowsy, dizzy, weak, withered, loose stools, timid and easily frightened, with a pale tongue, thin white fur and weak pulse. The treatment is to strengthen the spleen and dispel dampness, resolve phlegm and open the orifice, with the formula of Ginseng Ling Bai Zhu San plus or minus. If drowsiness, heavy body and sleepiness, weakness of limbs, dizziness and lethargy, easy to sleep after eating, fat body, pale tongue, white greasy coating, slow pulse. The treatment is to dry the dampness and awaken the spleen, resolve phlegm and open the orifice, with the addition and subtraction of Huopu Xia Ling Tang. If the patient is depressed, drowsy, sleepy, not warm in the hands and feet, afraid of cold, etc., with a light red tongue, white or greasy coating, and a weak pulse. In case of kidney yang deficiency, the treatment is to warm the middle and disperse cold, dissolve phlegm and open the orifice, and at the same time to supplement with Eucommia and Epimedium to benefit the kidney. If the symptoms include drowsiness, sudden collapse with laughter, dreaming at night, waking up easily with panic, anxious temperament, red tongue, yellow fur, and stringy pulse. If the Chinese medicine diagnosis is damp-heat of liver and gallbladder, the treatment is to clear the heat from gallbladder, resolve phlegm and open the orifice, and the formula is to add and reduce Huang Lian Wen Bile Tang. A male, 8 years old, presented with “daytime episodes of involuntary sleep for more than 2 years” as the main cause. The child’s family did not pay attention to the increase in daytime sleep for no apparent cause more than 2 years ago, and gradually developed weakness of the limbs after laughing, restless sleep at night, nightmares, paralysis after waking up, memory and academic performance decreased, and gradually gained weight and increased diet after the onset. The child was given oral medication such as central stimulants, which reduced his sleep for a while, but his sleep did not improve at night, and he stopped taking the medication on his own. The family heard that traditional Chinese medicine was effective in treating episodic sleepiness, so they brought the child to the clinic. The family heard that Chinese herbal medicine was effective in treating episodic sleepiness, so they brought the child to the clinic. The child’s symptoms were: episodic involuntary sleepiness, rapid sleepiness when the pulse was checked, sudden collapse after laughing, poor sleep at night, dreaminess, irritability, obesity, easy hunger, gradually increasing food intake, dry stools, yellow urine, red tongue, yellow greasy coating, smooth pulse. The diagnosis of Chinese medicine is that dampness traps the spleen and the stomach, and heat is caused by depression and phlegm-heat clouds the orifices. The treatment is to clear the bile and heat, phlegm and open the orifice as the rule, the formula with Huang Lian Wen Bile Tang plus or minus: Huang Lian 10g, Chen Pi 6g, Han Xia 6g, Poria 10g, Hovenia 9g, Bamboo Roo 10g, Calamus 9g, Yu Jin 9g, Licorice 6g, Hooked vine 10g, ginger 6g. 7 payments, water decoction. 2 diagnosis, the child daytime sleep less than before, still sleep poorly at night, the drug has been in the ground, the effect is not more prescription, the above followed by 14 payments The child’s daytime sleep condition improved significantly, the basic daytime sleep or occasionally 1 sleep, night sleep significantly better than before, adjust the prescription to continue treatment. In this case, the child usually eat fatty, sweet, thick and greasy food, dampness trapped spleen and stomach, can not transport water and dampness, gathered and for phlegm, phlegm turbidity depression and heat, phlegm and heat cross blocking on the clear orifice is sleepy; medulla obliterata memory, learning performance decline; phlegm and heat disturbing the heart is dreamy at night; phlegm blocking the qi, liver drainage is not normal easy to be impatient and irritable. The Ling Shu Jing Yin: “If the Qi is strong, the body is hot before, and if there is a surplus in the stomach, it will eliminate grain and be hungry, and the drowning color will be yellow.” If the heat in the middle Jiao is strong, then the food is easily digested and one often feels hungry. Huang Lian Wen Bile Tang is used to clear heat and dampness, resolve phlegm and open the orifice. When the phlegm is removed and the heat is cleared, the mind is clear and drowsiness is greatly reduced.