In TCM, a primary concept is the idea of "root and branch." Symptoms like insomnia are considered to be the branches of a disease. The root of a disease is a dysfunction or imbalance of the fundamental substances (Chi, blood, Yin, Yang, Jing, Shen), or of the major organ systems (Lungs, Heart, Spleen, Liver, Kidneys).

When a person suffers from insomnia, the two organs most often out of balance are the Heart and the Liver. Each of these two organs houses a specific aspect of the spirit. If these organs are out of balance, they will not be able to house the spirit properly, and the spirit will wander. (TCM, although a very complex medical system, had its origins in Taoism, and before that in shamanism. Therefore, there is a spiritual consciousness built into TCM theory.)

A wandering spirit, or Shen disturbance, can manifest in a number of ways, including mood disorders and heart palpitations, but insomnia is one of the commonest symptoms.

The commonest types of insomnia are as follows:
Difficulty falling asleep: This is usually related to an excess condition of the Liver or Liver and Gall Bladder. People will lie awake, tossing and turning for hours.
Waking up easily: Many people can fall asleep easily, but then they wake up later and find it difficult to go back to sleep again.
Waking up at a specific time every night: For example, some people regularly wake up at three o’clock in the morning. In Chinese medicine theory, the body's energy (Chi) circulates through the twelve principal meridians over a 24-hour period.

Other symptoms: When a Chinese medicine practitioner is analyzing a patient's sleeping problems, he narrows down the possibilities by looking for other symptoms that are characteristic of a particular disorder.