歯科科学と医学のジャーナル

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Comprehensive Line of Treatment for Nidranash (Clinical Insomnia)-A Case Report

Amol Deshpande

Sleep is the best phase for relaxation. It is important in every individual for being fit and fine. It not only relaxes but also rejuvenates for next day chores. Ayurveda has included sleep that is nidra in three pillars of life namely Aahar (diet), Bramhacharya (abstinence) and nidra (sleep). Nidranash i.e insomnia is the commonest complaint heard in OPDs after pain [1].

There are various reasons behind having insomnia. Senility, diseases related to respiratory system, painful conditions, certain drugs like propanol, steroids, mental conditions like mania, anxiety causes sleeplessness [2]. The prevalence rate of insomnia is 10-30% [3]. Idiopathic insomnia, Psychophysiologic insomnia, Paradoxical insomnia, Inadequate sleep hygiene insomnia, Physiological insomnia, Insomnia NOS, Insomnia due to mental illness, Insomnia due to medical illness, Insomnia due to substance use/abuse or withdrawal [4]. There are various medicaments which are used in modern medicine for Insomnia but the drugs used in insomnia causes various other sides - effects like cancer of various origins and harm to the indwelling foetus [5]. There is description of each and every disease in Ayurveda. Nidranash is also described by Charak Acharya under the heading vatajnanatmajvyadhi (different diseases of vata origin) [6]. Happiness, sadness, nourishment, undernourishment, Strongness, weakness, fertility, infertility, sanity, insanity, life and death depends on appropriate and inappropriate sleep [7]. Acharya Charak said that when mind and soul get tired, they get distracted from sensory as well as motor sensations and person sleeps. According to Acharya Sushruta, when the seat of chetas (mind) that heart gets covered with Tamoguna (Mode of ignorance), an individual goes to sleep. According to Acharya Vaghbhata, Manovahastrotas (channels of intellectuals) gets filled up with Kaphadosha and blocks sensations due exhaustion, an individual sleeps. Acharya Charak has given seven types of nidra namely Tamodbhava (Due to increase in mode of ignorance), Shleshmasamodbhava (due to increase in kapha dosha), Mana shramasambhava (dur to exhaustion of mind), Sharirshramasambhava (due to exhaustion of body), Agantukinidra (acquired), Vyadhinuvartininidra (due to illness), Ratriswabhavaprabhavanidra (physiological sleep induced at night) [8]. There are various treatment modalities in Ayurveda to combat with Nidranash. Acharya Charak has given Abhyanga (massage), Utsadana (massage with powdered drugs), Samvahana (pressing body parts), Akshi-tarpana (instillation of oil in eyes), Shiro- Lepa (Head pack), Karna-Purana (instillation of oil in ears), Shiro-Basti (keeping oil over head with special type of taping), Shiro- Dhara (dripping medicated oil on forehead), Moordhni Taila (dripping of oil) as bahyaupacharas (external application). Charaka mentioned Manonukulavishayagrahana (Desired conditions), Manonukula Shabdagranaha (desired words), Manonukulagandhagranaha (desired perfumes), as Manasikaupacharas (mental treatment) [9]. There are many patients who have Anidra or Nidranash. Insomia causes lack of interest in surrounding, lack of interest in work and other activities.

Here we have a case report of female patient having insomnia which was treated with simple line of treatment of Ayurveda.