Impact of complementary and Alternative Medicine on Sleep Disorders: A systematic review

About Author

Correspondence Address

Dr.S.K.Danga
Professor, Dept of Kayachikitsa ,
Jupiter Ayurveda Medical College, Nagpur.
E-Mail: sunder147@gmail.com

Contact No. : 9372045685, Email : sunder147@gmail.com

Date of Acceptance : 06 Jul 2023

Date of Publication : 10 Aug 2023

Article ID : SD-IJAY_030

How to cite this article : Danga SK. Impact of complementary and Alternative Medicine on Sleep Disorders: A systematic review. Sanjivani Darshan National Journal of Ayurveda & Yoga 2023;1(1):31-37 http://doi.org/10.55552/SDNJAY.2023.1105

Abstract

According theory of Ayurveda  Ahara, Nidra and Brahmacharya as a Trayoupastambha of life. Anidra can be considered as difficulty in initiation of sleep, reduction in duration of sleep and disturbances during sleep. Acharya  Charaka defines that, if mind gets tired or becomes sedentary then the sensory and motor organs become lazy then one deep into sleep. It means that if mind  draw its attention from its work and whole body get tired due to work and it leads to the Nidra. The Nidra is the one which provide complete relaxation to the body and mind. Many patients suffered from disorders  about Nidra and Nidranasha, but have been unable to find relief due to a lack of extensive studies and treatment.

KEYWORDS: Anidra, Sleep, Ahara, Indriya, Trayoupastambha.

Introduction

Acharya Charaka mentioned the Ahara, Nidra and Brahmacharya as a Trayoupastambha. These three factors which play an important role in the maintenance of health of a living organism thus are termed as Upastambhas.¹  The Nidra is the one which provide complete relaxation to the body and mind and thereby it restores the potentials of the individual.The Ahara is mainly concerned with the energy production and maintenance of living tissues (Pitta). The Brahmacharya is concerned with disciplined mode of sexual life and reproduction (Vata).

Nirukti:
The term “Nidra” is feminine gender. Derived from the root “Dra‟ with suffix “Ni” and the root ‘Dra’ means undesired ‘Gatu’ to lead, it is a state which is hated, therefore, it is termed as “Nidra”. Nidra is formed by Sutra ‘Ataschopasarge’ “Nindyate Iti Nidra”.

Definition Nidra(sleep):

1. Nidra is defined as the temporary loss of contact with Gnanendriya and Karmendriya to the Manas.
2. Nidra is considered by Charaka is a condition of mind if tired or becomes sedentary then one deep into sleep. Due to the Karma, Mana and Indriya klantata it further leads to Nidra. Therefore, when mana and indriya withdraw from their vishaya leads to sleep. Nidra is nothing but acombined stage of tired mind and body.
3.  Susruta described the sleep occurs Chetana is vitiated by Tama gunas.²
4.  According Acharya Vagbhata  if  Manovaha Srotas become hoarded with Sleshma and mind because of exhaustion, when individual fell asleep.
5. Sharangadhara mentions that Nidra is a state where predominance of Kapha and Tamas is witnessed.

According to Yog Darsanas, there are four Avasthas related to Nidra:³

They are:-

1) Jaagradavastha

2) Svapnavastha

3) Sushuptiavastha

4) Tureeyavastha

1. Jaagradavastha- In this phase the person is able to perceive subject via Panchendriyas.

2. Svapnavastha- This is the phase of sleep in which the person experiences some feelings depending upon what he has done or perceived during the Jaagradavastha.

3. Sushuptiavastha- This also is a phase of sleep but nothing is experienced by the person. Only the life sustaining vital functions (like respiration, circulation etc) happen.

4. Tureeyavastha- Due to increase in Satva Guna the person can control over the  Nidra and there is no effect of Tamoguna on this phase. According to Yoga Sastra, the Nidra is a type of Chittavrtti and it is Abhaava of Manovishaya.

Different types of sleep disordered  in Ayurveda  :

The word Ratrojagarana is explained in various Ayurvedic texts. Various words used to denote Ratrojagarana are presented in the table.

Table no. 1 Showing Synonyms of sleep Disordered in ayurveda

• Alpa Nidra: ‘Alpa’ means small quantity, which refers to reduction in sleep time.

• Jagarana: ‘Jagarana’means awakening or waking , Nidra Rahita, Nidra Abhava , which refers to the loss of sleep or no sleep.
• Nidra Kshaya: ‘Kshaya’ means Hrasa, Adarshana, reduction in sleep time.
• Nidra Bhanga: The word ‘Bhanga’means breaking, splitting, dividing which means disturbances of sleep.

By considering all these synonyms, Anidra can be considered as difficulty in initiation of sleep, reduction in duration of sleep and disturbances during sleep. In the classical texts the term Anidra and Anidra is used frequently as synonymous to one another.

Table No.2: Associate symptoms related with Sleep disorders in ayurveda

Management of sleep disorders in Ayurveda

Dietary items for the management of sleep disorders: There are many dietary items mentioned in Ayurveda classics, which helpful inducing sound sleep.^4,5 Dadhi (curd), Cow milk (Godugdha), Madya (alcohol), Mahish Kshira (buffalo’s milk), Mamsa Rasa.

Sleep disorders and psychological factors: Due to current scenario of competition  everyone has   tension, sometimes unpleasant environment etc., interrupts our healthy sleep pattern. So, in order to avoid and havening good sleep it is very vital to avoid all such psychological factors, especially during sleep time.⁶ Chintatyaga (removing worry), Nityatrupti, Santosha, Bhaya tyaga (fear), ideal shayya, Manonukula Sabda granaha , Manonukula Vishaya grahana, Sukha Shayya (comfortable bedding), Nischinta, Sukha Sparsh (pleasant touch), Sukhavartalapa (pleasant talk), Swasteerna Shayana.

External therapies for sleep disorders:⁷ Abhyanga (oil massage), Padabhyanga (foot massage), Karnapoorana, Mardana (massage) Akshitarpana, Moordhnitaila, Shirobasti, Snana (bath), Utsadana (body anointment).

Table No.3 : External therapies in sleep disorders

Single drug therapy: A good number of single drugs are described in Ayurvedic literatures which gives relief from Nidranasha. These single drugs are:

Table No.4: Sowing Single drugs useful for Sleep disorders

Discussion

Healthy Sleep guidelines from Ayurveda which can help in the management of sleep disorders): 8, 9 Ayurveda texts have provided detailed guidelines to enhance good sleep. Lying down in an easy posture on a comfortable bed removes the sense of fatigue, pacifies or soothes Vata Dosha, brings sleep and Dhriti.

Conclusion

 Ayurveda has given importance to  Nidra (sleep) as it  one of the most important components in living a good among Ahar, Nidra and Brahmacharya. If the duration of Nidra and sound sleep is not occurring due to vitiation of various dosha or illnesses, it is called as Nidranasha. Good-quality sleep is both necessary and beneficial to one's quality of life. During sleep, a variety of important physiological changes take place that help people stay healthy and perform at their best.  

References

1. Srimad Amarasimha, Amarakosha; Pradhama Bhaga/NatyaVarga/7/36;Pg.no.140.
2. Sushruta, Sushruta Samhita, Edited with Ayurveda Tattva  Sandipika; Commentary by Kaviraj Ambikadutta Shastri; edited by Dr. Pranajivana Manekchanda Mehta; Chaukambha Sanskrit Sanstan Varanasi; 1987 edition; Sarira Sthana4/34; Pg.no. 34.
3. Brian dana Akers, editor, The Hatayogapradipikaof Svatmarama. 1st Edition,Yogavidya Publication USA,  pg 342
4. Acharya YT, editor. Charaka Samhita of Agnivesha, Chaukamba Sanskrit Orientalia; Varanasi, 2007. Pg 453
5. Acharya YT, editor. Sushruta Samhita of Sushruta, Varanasi: Chaukhambha Surabharati Prakashana; Varanasi, 2008. 432
6. Shastri Paradakara HS, Asthanga Hridaya of Vagbhata, Chaukhambha ]Surabharati Prakashana, Varanasi, 2010
7. Shetty M., Babu S.,Yoga Ratnakara; Vol I. Varanasi; Chowkambha Krishnadas [22]Academy; 2005
8. Acharya YT, Charaka Samhita, repr., Sutrasthana, Chapter 8, Verse19-21, Chaukhamba Orientalia, Varanasi, 2007, P.-59-60.
9. Sharma P.V. and Sharma G., Kaiyadev Nighantu (Pathyapathya-Vibodhaka), Viharavarga, Sutra 340-345 Chaukhambha Orientalia, Varanasi. 2009, Pp.- 537-538

Source of Support : None declared
Conflict of interest : Nil