Breathing Stops While Asleep? Doctor Zhang Xichun’s Modified Shengxian Decoction (Lift the Sinking) for Sinking of Great Qi That Causes Sleep Apnea

Search terms this page answers: breathing stops in my sleep / I realize I wasn’t breathing in my sleep / can’t catch my breath at night / can’t breathe lying flat / like a stone on my chest / shortness of breath / sleep apnea

Medical terms: sinking of great qi (da qi xia xian) · sleep apnea syndrome · shortness of breath (duan qi)

Opening: waking in the middle of the night to discover you “weren’t breathing”

Many people know this experience: you fall asleep, then suddenly jerk awake and realize that a moment ago you seemed to not be breathing at all. You gasp several deep breaths before the air feels “connected” again. Some put it down to snoring, some to nightmares. But Doctor Luo Dalun says — this may well be a warning sign of the sinking of great qi (da qi xia xian). More than a hundred years ago, Doctor Zhang Xichun recorded an almost identical case.

💬 Note from Doctor Luo: Today’s session is one of the most important talks in Doctor Zhang Xichun’s sinking-of-great-qi series: what sinking of great qi looks like during sleep. Very many people have this problem but have no idea what disease it is. Let’s break it apart and explain it thoroughly.

Who was the patient? A sturdy young man in his twenties

The patient this time was a young man in his twenties. At that age a man should be in the prime of his strength — how could his great qi sink?

The cause in one sentence: he worked too hard in the fields. Doctor Luo added a telling detail — in the old society, ordinary people often could not eat their fill; they had to go out and work the fields on an empty stomach. They labored until they were exhausted and worn down, and the great qi of the chest was, so to speak, “worked” right out of place and dropped down.

Symptoms: heavy limbs, no appetite, and a chest that always feels stuffed

The classic symptoms of sinking great qi arrived one by one:

• Heavy, reluctant limbs (si zhi lan dong) — no strength anywhere. Why? The great qi in the chest governs heart and lung function and drives the movement of qi through the whole body. When the qi has no strength, the four limbs naturally refuse to move.
• Loss of appetite — he didn’t want to eat. When the transforming power of the body is insufficient, the appetite fades.
• He said his chest felt full and oppressed — as if something were stuffed inside it.

💬 Note from Doctor Luo: This “fullness and oppression of the chest” is the most deceptive symptom of all. Doctor Zhang Xichun said it is not really a blockage — it is shortness of breath: the qi is simply not enough. There is no strength inside, so even breathing feels laborious, and ordinary people describe that feeling as “stuffed up.” Doctor Zhang Xichun’s original words: “crude people cannot describe their illness well” — uneducated country folk cannot describe sensations precisely; they can only say “it’s clogged.” So the physician must examine the pattern with great care and not be led astray by a single word “clogged.” Doctor Zhang Xichun stressed this again and again in many case records.

The first mistake: treated as “stagnant qi” — the more treatment, the worse

The young man called in a doctor, who said: the qi in the chest is blocked — let’s prescribe some qi-moving, qi-regulating herbs (xing qi li qi).

💬 Note from Doctor Luo: That was the ruin of it. Sinking of great qi means the upright qi is insufficient — the person is already depleted. To “move the qi” at this point is to burn away what little qi remains. The illness could only get worse. And sure enough, after taking the medicine, it did get worse.

Seeing that his approach had failed, the doctor switched to a half-tonify, half-break strategy — tonifying on one side, breaking up the qi on the other. The result: two more doses, and the illness was worse again.

The second mistake: jie geng worked — then swapping in su geng ruined it

With no other choice, the family hurriedly changed doctors. The second doctor’s prescription was very simple: jie geng (platycodon root), dang gui (Chinese angelica), and mu xiang (costus root), a few qian of each. This formula showed some judgment — just three herbs, in modest doses. Dang gui nourishes the blood; jie geng moves the qi upward, lifting it; mu xiang moves the qi. After drinking it, the illness improved.

💬 Note from Doctor Luo: The illness improved because jie geng lifted the qi mechanism upward. But this doctor did not understand why it worked. On the second visit he changed the formula and replaced jie geng with su geng (perilla stem). Su geng moves the qi downward — it opens the chest, regulates qi, transforms phlegm, and sends qi down. The jie geng had improved things by lifting; now this herb pressed downward — and it broke the whole treatment. The illness immediately grew worse. That is the price of not understanding the ascending and descending nature of herbs: when the disease is below and needs to be lifted, you push it down instead — the direction is simply wrong.

The young man dared not take any more medicine. Altogether more than twenty days passed, and he was in critical condition.

At the crisis: he couldn’t lie down to breathe, and when he dozed, the breathing stopped

How bad did it get? This passage is the heart of the whole case record:

• Wheezing and unable to lie flat — the wheezing was so bad he could not lie down; day and night he sat propped against the wall, because lying flat made the wheezing worse.
• The moment he dozed, the breath stopped — sitting up, he would close his eyes for a brief nap, and his breathing would stop; then his abdomen would suddenly swell up, his family would hurry to wake him, and he would gasp again and again before the breath felt connected.
• A belly heavy as a thousand jin — when he was truly exhausted and lay down for a while, his belly felt as if a thousand jin (about 500 kg) were pressing on it; he could not turn over — he lacked the strength even to roll; he dared not lie on his back and could only lie on his side.

💬 Note from Doctor Luo: Why does the breathing stop during sleep? Because in a person with sinking great qi, heart and lung function are severely weakened. Normally the chest cavity opens and closes without our noticing any effort. When the heart and lungs are weak, every single expansion and contraction takes effort. During the day it is tolerable; at night, when every organ of the body rests, the effort of breathing stands out all the more. When it reaches a certain degree, the breathing simply “stops in place” during sleep.

Why lying flat makes it worse — and side-lying feels better

There is another key question: why does the belly feel heavy as a thousand jin when lying down, and why is lying on the back unbearable? Doctor Luo explained it clearly:

When you breathe standing up, the chest moves in a horizontal, back-and-forth plane. When you lie down, breathing becomes an up-and-down movement — you must lift the entire chest and let it fall again, which takes far more effort than the horizontal motion. A healthy person does this unconsciously without a thought; a person with sinking great qi must breathe with deliberate effort, or it feels as if the breath will stop.

💬 Note from Doctor Luo: That is why a person with sinking great qi is more comfortable on the side — in side-lying, the breath returns to a horizontal movement. The moment they lie on their back, breathing becomes a burden. Many patients describe it to me exactly like this: lying down, it feels as if a stone is pressing on the chest — every breath requires effort to lift it up. This is an extremely typical sleep manifestation of sinking great qi. “Breathing stops during sleep” can serve as a diagnostic sign of sinking great qi — remember that.

The modern match: a portion of sleep apnea syndrome is sinking of great qi

Doctor Luo deliberately connects this case to modern medicine:

💬 Note from Doctor Luo: Western medicine calls it sleep apnea syndrome — and in fact a portion of those patients are suffering from sinking of great qi. People have genuinely told me stories that match Doctor Zhang Xichun’s record exactly: just as they are about to fall asleep, they suddenly realize they are not breathing, and they must force a deep breath to get back to normal. I asked whether snoring and a blocked throat were the cause; they said no — the breath simply stopped without their noticing. And snoring itself: obese people snore because their muscles are lax and the throat collapses — but why are the muscles lax? My view is that it is related to qi deficiency: the muscles droop and go slack and block the throat. So to treat snoring, one should exercise and eat lightly on one side, and tonify qi on the other. Among people whose sleep monitors record apnea many times a night, the proportion with sinking of great qi is very high — and there are indeed classic cases where sinking of great qi caused breathing to stop during sleep.

Doctor Zhang Xichun makes the call: boldly prescribing raw astragalus, one liang

Only now does Doctor Zhang Xichun appear. He felt the pulse: it was now appearing, now vanishing (zha you zha wu) — faint to the extreme; among the cun, guan, and chi positions, sometimes only one position appeared, sometimes two — a beat, then a pause, extremely uneven. The illness had reached a critical point.

Doctor Zhang Xichun identified sinking of great qi and boldly prescribed sheng huang qi (raw astragalus), one liang (30 g):

💬 Note from Doctor Luo: One liang of raw astragalus is a dose we use all the time — 50 or 60 g is common. When Doctor Zhang Xichun said “boldly,” he was actually being very cautious — with the patient’s breathing stopping and his pulse fading in and out, he still used only a routine amount. That is the caution of a great physician. To it he added chai hu (bupleurum) and sheng ma (bugbane rhizome), two qian (6 g) each — herbs that lift the qi upward — plus shan yu rou (cornus fruit, without the pit), two qian (6 g) — because at this point the upright qi was about to scatter, and shan yu rou is sour and astringent, gathering the upright qi in. Whenever Doctor Zhang Xichun treated critical illness, he often added shan yu rou to anchor the upright qi — this was one of his signature moves.

The medicine works: his belly rumbled loudly, and he woke as if from a dream

The decoction was prepared and drunk. After a short while, a great rumbling rose from his abdomen, and the young man — as if waking from a dream — suddenly came to himself. From that moment his breathing returned to normal; he could lie down peacefully and turn over with ease — one dose, and his mind was clear again.

💬 Note from Doctor Luo: At this point all six pulse positions could be felt, but the rhythm was still irregular — a sparrow-pecking pulse (que zhuo mai), beating like a bird pecking at grain. The patient himself said “all my illnesses are gone,” except that his chest still felt a little hot and restless — the yin fluids were still insufficient. Doctor Zhang Xichun reduced the sheng ma and chai hu and added zhi mu (anemarrhena) and xuan shen (figwort root) — two cool, moistening herbs to clear heat and generate fluids. After one dose the pulse was essentially restored, with only the left guan (middle) position still beating irregularly — the root of the qi was not yet fully solid.

The finish: wild codonopsis, one liang — tonifying qi and yin together, two doses to complete recovery

Finally, Doctor Zhang Xichun switched to ye tai shen (wild codonopsis from Mount Wutai), one liang (30 g) — the qi-tonifying herb he trusted most — at the head of the formula, adding xuan shen, tian dong (asparagus root), and mai dong (ophiopogon), three qian (9 g) each — tonifying qi and nourishing yin at the same time. This is exactly the approach of Doctor Zhang Zhongjing’s Zhi Gan Cao Tang (Honey-Fried Licorice Decoction, also called the Pulse-Restoring Decoction): when the pulse still skips a beat, you restore the pulse by tonifying qi and yin together. Two doses — and the patient recovered completely.

💬 Note from Doctor Luo: This case is a classic. Heart and lung function had failed, the man was at death’s door — and Doctor Zhang Xichun brought him back with a few doses. Sinking of great qi does not look like a serious disease, but its harm is enormous — the movement of qi and blood through the body, the entire activity of life, depends on normal heart and lung function. Once the heart and lungs collapse, the whole body collapses. Sometimes it truly threatens life; sometimes it just leaves a person languishing, unable to find any disease on examination. That is why the sleep manifestations matter so much: when a person sleeps, the organs all rest, and whatever problem exists shows itself most readily — gathering diagnostic evidence at that time is an excellent opportunity to identify sinking of great qi. I work in Chinese medicine diagnostics, so I pay particular attention to collecting this kind of information.

Closing: breaking the symptoms apart for you, piece by piece

Doctor Zhang Xichun wrote his case records tersely — a few lines and done. Doctor Luo’s work is to take those brief records, break them apart, and explain the reasoning behind them clearly.

💬 Note from Doctor Luo: If I did not explain, you would read this and pass on, and it might never occur to you that “breathing stopping in sleep” has anything to do with your own symptoms. Explained like this, you understand: sinking of great qi causes breathing problems, and the reaction is especially obvious during sleep. Once you master this, you can analyze it for yourself, for your family, and for your friends — you can become the guardian of your own and your family’s health. One more thing — I have turned off the “like” button: everyone has been so enthusiastic, and the daily volume of likes is quite large, which puts some psychological pressure on me. Telling you these case records is my happiness; your willingness to listen is my blessing. So I no longer accept likes. Next week, we continue with how Doctor Zhang Xichun examined and treated disease.

What to take away

1. Breathing that “stops” during sleep can be sinking of great qi. If you wake with a start realizing you were not breathing, or feel like a stone is pressing on your chest when lying down — especially if side-lying is easier and lying on your back is a burden — think of the great qi sinking. It is a legitimate diagnostic sign.
2. Not every “stuffiness” is a blockage. “Crude people cannot describe their illness well” — a chest that feels full and oppressed can actually be shortness of breath from deficiency. Treating it with qi-moving, qi-breaking herbs makes it worse. A person who is already depleted must not have their qi “moved” away.
3. Direction matters in herb use. Jie geng lifts the qi and helped; su geng sends the qi down and worsened the case. When the qi has sunk, the treatment must lift — pushing down only makes the sinking deeper.
4. The formula is Modified Shengxian Decoction: sheng huang qi (raw astragalus) 1 liang (30 g) to tonify the chest great qi, chai hu and sheng ma to lift it, plus shan yu rou (cornus fruit, pit removed) to anchor the upright qi when it threatens to scatter — Doctor Zhang Xichun’s signature move in critical cases. As the heat of yin deficiency appeared, he added zhi mu and xuan shen; and when the pulse still skipped, he closed with ye tai shen (wild codonopsis) plus xuan shen, tian dong, and mai dong — the qi-and-yin dual tonification of the Pulse-Restoring Decoction. Two doses completed the cure.
5. Heart-lung function is the foundation of life. Sinking of great qi can endanger life or leave you chronically unwell with no diagnosis. Sleep, when the organs rest, is the best time to gather the diagnostic evidence.

Adapted from Doctor Luo Dalun’s explanation of Doctor Zhang Xichun’s case records. Source: Records of Chinese Medicine with Western Reference (《医学衷中参西录》), published in installments 1918–1934.