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Dr Suhas
Consultant Physician
Rockholm at the Light House Beach

Introduction


Insomnia, often referred to as the silent epidemic of modern society, is a sleep disorder that affects millions of people worldwide.

Characterised by difficulty falling asleep, staying asleep, or both, insomnia can have profound effects on an individual's physical health, mental well-being, and overall quality of life. In this article, we will delve into the causes, effects, and management strategies for insomnia, shedding light on this often misunderstood condition.

Causes of insomnia:

insomnia can be triggered by a myriad of factors, including stress, anxiety, depression, medical conditions, medications, poor sleep habits, and environmental factors. Stress and anxiety, in particular, are the common culprits, as the incessant rumination and worry can make it challenging to relax and fall asleep.

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Similarly, individuals suffering from depression may experience disrupted sleep patterns due to alterations in neurotransmitter levels and circadian rhythms. Medical conditions such as chronic pain, asthma, and gastrointestinal disorders can also contribute to insomnia, as can certain medications like antidepressants, corticosteroids, and stimulants. Moreover, poor sleep hygiene practices, such as irregular sleep schedules, excessive screen time before bed, and consumption of caffeine or alcohol, can exacerbate sleep difficulties.

Effects of insomnia:

The consequences of chronic insomnia extend far beyond mere fatigue and drowsiness. Sleep deprivation can impair cognitive function, memory consolidation, and decision-making abilities, leading to decreased productivity, impaired academic or occupational performance, and an increased risk of accidents and errors. Furthermore, insomnia has been linked to numerous physical health issues, including obesity, diabetes, cardiovascular disease, and compromised immune function. Mental health is also profoundly impacted, with insomnia being a significant risk factor for the development of mood disorders such as depression and anxiety disorders. Moreover, the relentless cycle of sleeplessness can exacerbate existing mental health conditions, further exacerbating symptoms and reducing overall well-being.

Physiology of Sleep in Ayurveda:

When the mind, including sensory and motor organs, is exhausted and they dissociate themselves from their objects, then the individual sleeps.

We should all become aware of the presence of a sub-conscious mind, where everything, even the tiniest of your momentary thoughts, can get stored forever. Our body and mind are strong enough to suppress the expressions of this sub-conscious mind when we are active. But what happens when our body takes a rest? Our subconscious mind attains the power to get expressed, and it fights out the suppressions. This “resting phase” is what we call “sleep"—the m most gifted phenomenon for almost all organisms. What if you are not able to get a proper rest? It would become even more troublesome to sustain as the world gets busier!

The holistic approach of ancient Indian medical scholars lit up their vision towards the importance of sleep in the normal continuity of our daily lives.

The world’s oldest systematic medical textbook, The Charak Samhita, describes about three sub-pillars of life. They are Āhāra (food), Nidra (sleep), and Brahmacharya (celibacy).

Much importance is given to sleep, as it is told along with food, without which life is impossible! This might be the reason for the increased queue for receiving Ayurvedic treatments in India and many places in Western countries too. Being able to receive a good sleep, and that too, a natural sleep—without any sedative drugs—will be the most sought-after therapy that anyone would love getting!

When to sleep is also properly described in Ayurveda. Sleeping at the wrong time will also cause derangements in the equilibrium of Doshās and thereby lead to diseases in the future. Sleeping is said to be an attribute of the Kapha Dosha. Kapha is one of the Three Doshās, which is able to create Āvarana (coverings) around the other Doshās as well as around certain body parts. When Kapha is able to create a covering over the manas (mind), a person falls into sleep!

The ancient Ayurvedic researchers in India did a lot of work on sleep. It is told that a proper sleep can provide you with Suhka (wellbeing), Pushti (nourishment), Bala (strength), Vrishatha (vigour), Njānam (concentration), and Jeevitham (a pleasant life), whereas improper sleep will just do the opposite! Such effects are possible due to the action of sleep in determining whether to increase or decrease the Doshās (the fundamental functional units of the living body according to Ayurveda).

Management Strategies for insomnia:

Fortunately, there are various strategies and interventions available to manage and alleviate insomnia symptoms. Cognitive-behavioural therapy for insomnia (CBT-I) has emerged as the gold standard treatment, addressing maladaptive thought patterns and behaviours that perpetuate sleep difficulties. This therapeutic approach encompasses techniques such as stimulus control, sleep restriction, relaxation training, and cognitive restructuring, empowering individuals to regain control over their sleep. Additionally, lifestyle modifications, such as establishing a consistent sleep schedule, creating a relaxing bedtime routine, optimising sleep environment conditions, and limiting stimulants and electronic devices before bed, can promote healthy sleep habits. Pharmacological interventions, including prescription sleep medications and over-the-counter sleep aids, may be considered in certain cases, although their long-term efficacy and potential side effects warrant careful consideration and monitoring by a healthcare professional.


Therefore, therapies should be aimed at calming down the Pitha and Vatha doshas in your body. There are many treatment modalities to serve this purpose. Some of them are listed below:
  • Abhyanga:This is the typical Ayurvedic oil massage. It has excellent capacity to reduce Vatha and is specifically indicated to promote sleep according to the ancient Ayurvedic textbook named Ashtanga hridaya. It also has the ability to remove exhaustion, promote excellence of vision, nourishment, longevity, and is good for the skin.
  • Thalam:it is the process of applying medicinal powers or sometimes medical pastes over the vertex of the head. This is a very minor procedure, which is usually done along with other main treatments as a pre-procedure. Even then, it has the ability to manage stress and promote sleep, depending on the medicine that is used for the procedure.
  • Nasyam:this is the procedure of instilling medicated oils or sometimes medicated water drops through the nostrils. Nose is considered the entry level to all the internal structures inside the head. It is found to be the most effective route of administration of medicines that are aimed at treating the brain’s functioning.
  • Padabhyanga:This is specifically the massage given to the feet. Ayurvedic textbooks opine that doing massages under the feet with certain medicated oils can promote sleep even in the worst conditions.
  • Thakradhara:This is the process of pouring medicated buttermilk over the body, especially over the head, when sleep is the targeted effect. Buttermilk for this purpose is processed with many herbs, especially the amla (Indian gooseberry).
  • Sirodhara:This is the process of pouring medicated oils over the head. Sirodhara is one of the most sought-after treatments in Ayurveda for all those who love to get a good sleep. Many people who regularly take Ayurveda treatments often tell that they slept in between the Sirodhara!

Even though these treatments have sleep promotion as their special indication, other treatments may also become necessary to prepare your body so that your body accepts these procedures. Sometimes, a Vasthi (liquid medicine administration through the anal route) may be required if your Vatha is on the higher side. Sometimes a Virechana (induced purgation) may be required if your pitha is on the higher side.

There are all sorts of solutions for this problem, elaborately described in our ancient texts. The only thing is to choose the combinations of therapies and the best sets of medicines that suit each individual while performing these treatments. This is what your Ayurvedic physician will decide for you, depending on several individual traits like the body constitution, age, the imbalanced doshas, the sites or locations of the disequilibrium of doshas, and so on.

Yoga has gained worldwide acceptance for its effectiveness in promoting a healthy mind and body. While Ayurveda pertains more to correcting the body, yoga pertains more to correcting and controlling the mind. Thus, a combination of various modalities derived from the ancient Indian wisdom can help to resolve this problem to a greater extent!