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Kamalaxi. M. Angadi
Dissertation submitted to the
Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore
Kayachikitsa
Under the Guidance of
Department of Kayachikitsa
Post Graduate Studies & Research Center
D.G. MELMALAGI AYURVEDIC MEDICAL COLLEGE, GADAG
2005-2008
D.G.M.AYURVEDIC MEDICAL COLLEGE
POST GRADUATE STUDIES AND RESEARCH CENTER
GADAG, 582 103
This is to certify that the dissertation “Management of Anidra with Nidra caps - a
partial fulfillment of the requirement for the post graduation degree of “Ayurveda
Bangalore, Karnataka.
Date: Guide
Place: Gadag
Prof. Dr. Shiva Rama Prasad Kethamakka
M.D. (Ayu) (Osm), C.O.P (German), M.A., [Ph.D] (Jyotish)
Professor in Kayachikitsa
DGMAMC, PGS&RC, Gadag
J.S.V.V. SAMSTHE’S
under the guidance of Prof. Dr. Shiva Rama Prasad Kethamakka, M.D. (Ayu) (Osm),
C.O.P (German), M.A., [Ph.D] (Jyotish), Professor in Kayachikitsa in partial fulfillment of the
requirement for the post graduation degree of “Ayurveda Vachaspati M.D. (Kayachikitsa)”
Nidra caps - a placebo comparative study” is a bonafide and genuine research work carried
out by me under the guidance of Prof. Dr. Shiva Rama Prasad Kethamakka, M.D. (Ayu)
(Osm) M.A. (Jyotish), [Ph.D (Jyotish)], Professor in Kayachikitsa, DGMAMC, PGS&RC, Gadag.
Date
Place Gadag
Kamalaxi. M. Angadi
Copy right
shall have the rights to preserve, use and disseminate this dissertation/ thesis in print or
Date
Place Gadag
Kamalaxi. M. Angadi
the Vata disorder affects the people of all age groups. The study objective is – to evaluate
Simple random sampling technique with comparative clinical trial is adopted here under
two groups to test the significance. Induction of sleep it is said that when the mind gets
exhausted or becomes inactive, the sensory and motor organs become inactive then the
individual gets sleep. Onset of sleep is related to the increases of Tamas always. Here,
tamo-abhava is reticular activity transmission and tamobhava is RATR. When Vata along
with rajas gets increased the above told phenomena will not takes place leading to
Anidra. Here the rational combination Nidra cap is with bhutaghna manasa doshahara
Jatamamsi, vatahara and mastishka shamaka prabhava Tagara, adaptogen and immuno
modulator Ashwagandha and Vata hara and deepaniya Pippali moola are able to act
against the symptoms of Anidra and induces the good sleep. . The parameters show High
significance with Nidra caps as good sedative. Among the subjective and objective
parameters the Nidra cap group shows more High significance than the placebo group
and said to effective. Thus it is fair to conclude the Nidra cap has putative Nidra janaka
prabhava.
Acknowledgement
Any research is not an individual effort. It is a contributory effort of many hearts,
hands and heads. I am very much thankful to the subjects of this study.
I am extremely happy to express my deepest sense of gratitude to my beloved and
respected guide Prof. Dr. K.Shiva Rama Prasad, M.D., C.O.P. (German), M.A., [Ph.D.],
for his guidance and timely help.
I express my gratitude to Dr. V. V. Varadacharyulu Professor and H.O.D for his
advice and encouragement in every step of this work.
I am sincerely grateful to Dr. G. B. Patil, Principal, for his encouragement and
providing all necessary facilities for this research work.
I extend my gratitude to Dr. R. V. Shettar, Dr. G. Purushottamacharyulu, Dr. P.
Shivaramudu, Dr. M. C. Patil, and Late. Dr. Dilip Dr. G. S. Hiremath. Dr. G.
Danappagoudar. Dr. S. H. Doddamani. Dr. Rajashekhar. Dr. S. N. Belawadi. Dr.
Nedugundi, Dr. Samudri, Dr. Kubersankh. Dr. Mulgund. Dr. J. Mitti. Dr. Mulki Patil. Dr.
Yasmin A.P. Dr. B. G .Swami all my U.G. Lecturers for time-to-time help offered.
I express my immense gratitude to my statistician Nandakumar, Tippanagoudar
(Lab), V.B. Mundinamani (librarian) and Shyavi and Kerur for facilitating me in
collection and production of my thesis.
My deep senses of gratification to my inspirations of this study are my husband
Shivanand. B. Manvi and my parents Mallappa. S. Angadi and Neelamma. M. Angadi
who are architects of my career. I am extremely happy to express my deepest sense of
gratitude to my mother-in-law Sharanamma.B.Manvi and my beloved son Bhuvan.
Last but not least I express my deepest thankfulness whose names are not taken
here but helped me a lot along with my kith and kilns to my family members and Dr.
Sanjeevkumar and all my senior and junior friends.
1 Introduction 1 to 7
2 Objectives 8 to 10
3 Literary Review 11 to 59
4 Methods 60 to 71
5 Results 72 to 95
6 Discussion 96 to 108
9 Bibliographic References i to vi
-1-
Tables of
“Management of Anidra with Nidra caps - a placebo
comparative study”
SN TITLE OF TABLE PAGE
1 Stages of sleep in the NREM 30
2 Synonyms of Anidra 38
3 Anidra Ahara Nidana 41
4 Anidra Vihara Nidana 41
5 Chikitsa atiyogajanya Nidana of Anidra 41
6 Anidra Manasika Nidana 41
7 Symptoms of Anidra 42
8 Anidra – Samprapti ghataka 45
9 Bahya Upacharas for Nidranasha 47
10 Aahara Upacharas for Nidranasha 48
11 Manasika Upacharas for Nidranasha 48
12 Anya upachara for Nidranasha 49
13 Single drugs useful for Nidranasha 50
14 Distribution of Patients by Age- Gender in Group A & B 73
15 Gender wise Results in Group – A (Placebo cap) 75
16 Gender wise Results in Group –B (Nidra cap) 75
17 Religion wise Results in Group – A (Placebo cap) 76
18 Religion wise Results in Group – B (Nidra cap) 76
19 Occupation wise Results in Group – A (Placebo cap) 77
20 Occupation wise Results in Group – B (Nidra cap) 78
21 Economical status wise Results in Group – A (Placebo cap) 79
22 Economical status wise Results in Group – B (Nidra cap) 79
23 Diet wise Results in Group – A (Placebo cap) 80
24 Diet wise Results in Group –B (Nidra cap) 81
25 Showing chief complaints of Anidra 82
26 Showing Associated complaints of Anidra 83
-2-
27 Showing Mode of onset in Anidra 84
28 Showing Anidra course in study 84
29 Showing Anidra frequency in study 85
30 Showing Anidra duration in study 85
31 Showing Anidra preceding factors in study 86
32 Showing Anidra change of regularities in study 87
33 Showing Anidra Nidana in study 87
34 Showing Anidra Nidra (sleep) Examination in study 88
35 Showing Anidra Results of the Group A (Placebo caps) in study 89
36 Showing Anidra Results of the Group B (Nidra caps) in study 91
37 Subjective Statistical assessment Group-A 92
38 Objective Statistical assessment Group-A 92
39 Subjective Statistical assessment Group- B 92
40 Objective Statistical assessment Group-B 92
41 Comparative Statistical assessment of Both Groups 93
42 Comparative Statistical assessment of Both Groups in % of 94
comparison
-3-
Chapter – 1
Introduction
Barenked Ladies sung “Who needs sleep?” as -
I count heartbeats,
How the food, water and air are essential for life, like the same sleep i.e. Nidra is also
very much essential. ‘The best bridge between despair and hope is good night’s sleep. Sound
restorative sleep is the foundation of a healthy life. Hence, the Ayurveda explains Nidra as
winding up of the vital clock, a recharging of life’s battery or “Chief nourisher at life’s feast”.
Three sub-pillars are diet, sleep and celibacy. If these three are fulfilled properly, the body is
supported well by these pillars, it continues well endowed with strength, complexion and
developments till the complexion of life span provided one abstains from harmful practices
Ahara, partaking food confers satisfaction and immediate strength supports the
body, increases span of life, radiance, enthusiasm, memory, valiance and digestive
Brahmacharya
The end product of ahara rasa is said as the shukra dhatu. Loss of shukra
causes death on the other hand conservation of sukra promotes life. Thus it is said as
Nidra
Hence, these three trayopasthmbha exhibits their importance in the life and necessity
of the induction or regulation of the Nidra effect to add flavor to the life. As we know that
satisfaction alone is sufficient to have better life thus the satisfaction of the Nidra gives raise
The importance of sleep is well accepted by modern science also, because of its
restorative, recuperative and resting actions to the living organisms. We spend at least 1/3rd of
our lives asleep. Yet little understand why our body requires it or for what reasons nature
often chooses to transform the soothing slumbers of youth into the restless tossing of
maturity. Only for the last half century has this universal subject of human concern or distress
stimulated seriousness and physiologists and neurological physicians to examine its mysteries
and mechanisms.
struggle for existence etc, the (sleeplessness) Anidra (Insomnia) became a major problem.
fall asleep or to stay asleep; A broader definition of insomnia is difficulty initiating sleep,
refreshing sleep. The subject must also suffer some degree of impairment in social
Now a days about 40% women and 30% men and about 25% of elderly people and
15% of the general population suffer from this altered sleep i.e. insomnia 6.
demerits, classification and the management of insomnia are also dealt along with the concept
So far the problem of Nidra, Anidra and the management of Anidra are concerned, it is
surprising, and that research work carried out on this topic is very less 8:
• Dr. Kala Kasliwal (1984), in N.I.A. Jaipur, has carried out the study on Nidra and tried
some Nidra janana drugs to assess their efficacy in inducting the sleep.
• In P.G.T and R.A Jamanagar- Dr.U.D.Joshi (1987) has carried out a study on Anidra,
• Dr. Kavitha Trivedi (1995) has carried out the comparative study of shirodhara and
most commonly available antidepressant drugs, sedatives, tranquillizers and hypnotic drugs.
The drawback with this approach is drug dependence, tolerance towards the drugs and
reoccurrence of the symptoms on withdrawal of the drug. Apart from these internal
medications, counseling, cognitive therapy, physiotherapy and meditation have also been
Ayurveda has a very good approach towards the treatment of Nidranasha/Anidra by both
The main purpose of the study is to evaluate a medication which doesn’t give any drug
dependence along with tolerance. Chiefly the purpose relays on two areas viz. 1) control of
Vata and 2) correction of Manasa vyakula Bhavas which cause the Anidra. Such medicament
under the principles of Ayurveda based upon the theories and concepts are erected as “Nidra
caps”.
Charaka has mentioned that the controller and stimulant of the mind is Vata. The
Vatahara herbs are said to be the best medicines to induce sleep as they are the Kapha
promoters. The Kapha is of “Tamo” guna, thus the dravyas which are of Kapha in nature offer
an important role in causing Anidra. The Nidra cap is designed as cost effective and corrects
the disturbed mental faculties and provoked Vata. Thus pacify all kinds of stressors to achieve
the state of tranquility leading to deep relaxation which helps in the normalization and
extracts have been used with varying degree of success in the management of
When made as a rational combination induces sleep in a better way making the Dosha
samyata in the body. The rationality of the combination is justified by the rasa, guna, veerya,
vipaka and karma prabhava attributed to the individual drugs with Nidrajanakatwa prabhava
embedded in them.
According Ayurveda sleep is induced by the increase of the inert universal attribute
called Tamas. The term Tamas literally means darkness. Satva, Rajas and Tamas are the three
major or universal attributes that pervade the universe. These three attributes play an
important role in the functioning of the mind, of them rajas and Tamas are the vitiators of
specific changes in vegetative and motor systems by the absence of purposeful activity and
sensory interaction with the environment. Sleep is characterized by the inhibition of conscious
mental activity.
Onset of sleep is related to the increase of Tamas and Kapha. Both these principles
effect inertia, sleep usually occurs at night as the surroundings are dark and are predominated
by Tamas. This dark environment naturally increases the Tamas in human beings according to
During night the biological channels are blocked by Kapha. The sensory and motor
faculties are fatigued by day’s work. The fatigued faculties become sluggish in their work and
will loose their activity. Considering the physical plane, the humor Kapha i.e. responsible for
conservation of energy has a role in inducing sleep, Kapha is stable and sluggish. Increase of
They gradually withdraw from their objects. The functions of the mind also are
blocked by the increase of Tamas. Mind gets detached from the faculties and its action of
enjoying the faculties ceases. This stage is called sleep, even in sleep mind maintains its
The hypothesis is made on the basis of Vata shamaka in terms of controlling the mind
through its functions. The present medicine acts as Vata shamaka in terms of regulating the
mind thus sleep is induced by initiating the Tamas. The important factor responsible for
reduction of sleep has been shown to be the fatigue of neuromuscular function which in turn
unable to pass on proprioceptive impulses may be the Tamas. The action of the trial drug is
3. How Vata is responsible for disturbing the inhibition of conscious mental activity i.e.
sleep
The search for the answers are made at this study named as – “MANAGEMENT OF
Technology and the industrial revolution is one of the biggest factors. People live in a fast-
paced, high-tech world that operates 24 hours a day. Working fields like a myriad of
businesses and services are accessible around the clock. Television, radio and movie channels
broadcast day and night. To cope up such conditions occurring around the clock, people work
long hours and something must be sacrificed. Unfortunately sleep is a very common thing to
sacrifice. Consequently, insomnia has spread up very widely like other harassing diseases.
Insomnia has a great impact on social, occupational and other functioning areas of the
individual. The modern medical science is still not having a definite treatment for this disease.
Although, hypnotics and sedatives are there in all the prescriptions of psychiatrists and in
maximum prescriptions of general practitioners their role in curing the disease is very limited
There comes the relevancy of our Ayurvedic principles for the treatment, which
reveals that the medicine or treatment that cures one disease and creates some other is not a
good therapy, but the therapy which cures one disease and does not create any other, is the
13
right treatment . Hence, here a humble attempt had been done to give an effective
the deviations from the normalcy of Dosha are to be considered with due importance.
Vata and Pitta are in increased state, while in case of Kapha, the diminished is
observed usually. As in Anidra, mainly Vata Prakopa occurs due to its Chala and
Laghu Guna vitiate, thus keeps the mind active, causing Anidra.
The ingredients of the Nidra capsules are with Vata Dosha hara action having
snigdha guna, ushna veerya, with the sedative and hypnotic action, otherwise
Nidra caps, it seems to be very much beneficial in the management of Anidra for
obtaining the requisite results, viz. induction of Tamas, initiation of sedation, relaxing
anxious or phobic or even depressive patients, respond to the placebo. Thus the
placebo is responsible for many temporary successes in therapy acting on the mind. As
we know that many times placebo is used to understand the differentiate phenomenon
of the psyche physical disturbances, with good success of specifying the relief of the
problem, for a comparison to understand the Nidra cap efficacy, the placebo sedation
Anidra
of the Nidra caps internally to pacify the Dosha in Anidra and placebo to overcome the
psychosomatic origin of the disease Anidra is not compared. Thus the trial is
compared at the clinical efficacy with respect to the subjective and objective
parameters chosen. At this attempt the group-A and group-B designated with
respective medicaments of Placebo and Nidra caps, are observed for the efficacy of
After this glimpse of Pralaya – man awakens fresh like Srujana. For the living beings in the
world, it is an essential phenomenon for maintenance and restoration of both – body and
mind.
Since the dawn of the civilization the thinkers of the world tried to study the sleep, its
nature and causes. In India, from the Vedic and Upanishad period, the Yogis have studied the
Yogic phenomena pertaining to various stages associated with Atma. They have termed these
state) and Samadhi Avastha (the conscious sleep phase having Detachment from the external
IMPORTANCE OF SLEEP
Ahara, Nidra and Brahmacharya are the three factors, which play an important role in
the maintenance of a living organism. In the Ayurvedic literature, these factors i.e. Ahara,
Nidra and Brahmacharya have been compared with the three legs of sub-support and have
The inclusion of Nidra in the three Upastambha proves its importance. While
discussing about Nidra, the ancient Acharyas have stated that happiness and sorrow, growth
and wasting, strength and weakness, virility and impotence and the knowledge and ignorance
as well as the existence of life and its cessation depend on the sleep 15.
diseases has been recognized intuitively if not scientifically in the modern texts; nearly all
Management of Anidra with Nidra caps – Literary Review 11
doctors recommended that their patients should get plenty of rest and their advice is followed
because that is just what patients want to do whether such sleep does have any adoptive value
is, however, unknown. Many disorders are associated with abnormal patterns of sleep. Some
important findings of sleep are listed below: Sleep is one of the factor upon which the pattern
of GH secretion is dependant. (Factors are stage of development, nutritional state, sleep stage,
stress and exercise.) Secretion is enhanced by sleep with levels highest during slow-wave
sleep and lowest during REM sleep. Oxygen consumption is lower during sleep, facilitating
an anabolic process. Physiological activities (e.g. exercise) and pathological disorders (e.g.
hyperthyroidism), which lead to increased catabolism are associated with increased slow-
wave sleep. Reduced activity and metabolic turnover (e.g. paraplegia and hypothyroidism) are
associated with decreased slow-wave sleep. Hormones that inhibit anabolic processes (e.g.
The word Nidra is feminine formed by the prefix ni+dra+rak+ta. This is a state of
Definition
Ever since modern people are unable to define it accurately from the time it is a
question in every mind that what is sleep, how it occurs and what is its role in health. But the
great sages of India had the perfect knowledge regarding the sleep. The definitions are as
follows -
1. Sleep is the mental operation having the absence of cognition for its grasp. Vyas while
unconsciousness, but the consciousness remains about his own unconsciousness 18.
have any dream or desire for anything and that state is called ‘susupti” 19.
3. Chhandogya upanaishad states that “the state in which the mind is unaware about
surroundings or will not have any dream is termed as sputa or Nidra 20.
4. Nidra is defined as the temporary loss of contact with Jnanendriya and Karmendriya to
5. Charaka affirmed that when the mind (as well as soul) gets exhausted or becomes
inactive and the sensory and motor organs become inactive then the individual gets
sleep 22.
6. Susruta described the sleep occurs when the Hridaya the seat of chetana is covered by
Tamas 23.
7. Dalhana the commentator of Susruta states that Nidra is the state of combination of
8. Astanga sangraha Vagbhata stated that - the manovaha srotas become accumulated
with sleshma and mind is devoid of sense organs because of fatigue, when individual
10. Adhamalla defines that the Nidra is a state in which the tamoguna combines with
Phenomena of Nidra
There is a natural relation of sleeping and waking during 24 hrs. The sleep comes
naturally during the night but it is not necessary consequence of darkness, as is proved by
condition.
Authors of ancient Hindu literature made crystal clear explanations regarding the
physiology of sleep. They explained it in different ways according to their working field and
conceptualized. These explanations regarding the phenomena of Nidra may be summed and
1. Theories of Upanishad
2. Theories of Yoga
3. Theories of Ayurveda
1) Theories of Upanishad
28
a) Ancient seers of Chandyogyopanishad stated that the Atma moves from
Hridaya through the nadis and gets lodged inside the membranous sac
2) Theories of Yoga
The yogic philosophers have made a clear explanation regarding sleep resembles as
Samadhi state which is entirely different from it. They studied ‘Yoga Nidra’ pertaining to
Svapnavastha – dreaming
and feeling come to an end. In sleep the senses of perception rest in the mind, the mind in the
consciousness and unconsciousness in the being. In deep sleep, the senses of perception cease
3) Theories of Ayurveda
According Susruta 31, the sleep is induced by the increase of the inert universal
attribute called Tamas. The term Tamas literally means darkness. Satva, Rajas and
Tamas are the three major or universal attributes that pervade the universe. These
three attributes or dimensions play an important role in the functioning of the mind
and even body, of them rajas and Tamas are capable to vitiate mind (Manas). Because
of their predominance’s affects and afflicts the mind the mental diseases are resultant.
On the other hand the satva increase can cause the conductive to mental health and
principles affect inertia on general. Sleep usually occurs at night as the surroundings
are dark and are predominated by Tamas. This dark environment naturally increases
32
the Tamas in human beings according to the theory of generality . Apart from this
the bioelectrical cells, which are in the body, sustain the energy for activity in the day
light by getting charged through Sun light. At the night the Human is the only capable
The sensory and motor faculties are fatigued by day’s work. The fatigued
faculties become sluggish in their work and will loose their activity. They gradually
withdraw from their objects. The mind functions are also blocked by the increase and
influence of Tamas. Mind gets detached from the faculties and its action of enjoying
the faculties ceases. This stage is entitled as sleep. But even in the sleep also mind
maintains its connection with the soul, as it is “Ubhayendriya” – dualistic organ 33.
Sleep is a natural function of Tamas where in both satva and rajas acts against
the sleep induction. Apart from sleep Tamas causes of fear, ignorance, depression and
awakening: Nevertheless sleep is included among any natural diseases. Hence, the
Satva is against the ignorant and inert sleep. Rajas on par with satva represent action
and hence, it is also a factor against to sleep induction, where the physical and mental
Kapha is said as the strength of the living being. Such Kapha when obliterates
the channels because of the over activity of the body the mind withdraws from the
sensory activities and induces the sleep as physical rest to the body. Such Nidra also
Sleep remains one of the great mysteries of modern neuroscience. We spend nearly
one-third of our lives asleep, but the function of sleep still is not known. Fortunately, over the
last few years’ researchers have made great headway in understanding some of the brain
circuitry that controls wake-sleep states, but no single explanation can accepted as the final
word for the understanding of physiology of sleep 36. The views regarding the phenomenon of
the sleep throw light upon the phenomenon occurring during the rest and refreshing effect.
1) Vascular Theory:
in the blood supply to the brain or at least to the conscious centers. This
2) Pavlov’s Theory:
proposed a theory for sleep, base upon the cortical inhibition caused by
3) Chemical Theory:
hours which irritates the nerve cells of brain and causes sleep as a
result.
inactive.
5) Oxygen Theory:
Whenever brain utilizes less oxygen, at that time sleep is taking place.
6) Hypothalamus Theory:
parasympathetic function.
9) Serotonin Theory:
natural sleep is the raphe nuclei in the lower half of pons and in the
medulla. Nerve fibers from these nuclei spread widely in the reticular
(the sensory region of the medulla and pons) – also promotes sleep.
These regions perhaps act by exciting the raphe nuclei and serotonin
and
Types of Nidra
Ayurveda has different opinions regarding the types of sleep. Basically Nidra can be
classified into type’s viz. Svabhavika (natural) and Asvabhavika (abnormal). Out of the
former Svabhavika Nidra is regularly every night, which offers beneficial effects for the
living beings, whereas the later Asvabhavika is one can be due to different causes of
pathological in origin.
Charaka classifies the sleep condition into seven folds. He agrees with the ancient
authors who considered the sleep is Bhutadhatri. Sleep comes at night, spontaneously and
regularly as a natural instinct and that the other categories were either due to sin or the
5. Agantuki Nidra
6. Vyadhyanuvartini Nidra
a) Tamobhava Nidra:
Generally the sleep is due to the effect of Tamas, but the Tamobhava Nidra as
particularly due to the excessive Tamas causing sleep. When Satva and Rajasa are
diminished in excess and the seat of Atma and Mana i.e. Hridaya is covered by the
condition described by Charaka, which is the comatose state. The sleep caused by
Tamas always causes excessive sleep. Thus, the individual is unable to perform
Sleshma is the material state of Tamas and as such the Sleshma and the Tamas
are having identical properties. When the Sleshma increases in the body the sleep
The person also gets the sleep as the result of exertion. Due to excessive
mental stress and strain, the mind gets tired and unable to perform its activities; as a
The person also gets the sleep due to physical exertion. When a person
indulges in excess physical activities he feels too much tired. The body and mind
desire to take rest and agitate to work further and the person gets sleep.
e) Agantuki Nidra:
Sometimes the cause of sleep remains obscure and the cause is not explainable.
However, the sleep is followed by the death and as such Chakrapani has termed this
f) Vyadhyanuvartini Nidra:
There are some diseases like Sannipata Jwara where severe weakness of the
patient and follows the condition just similar to coma. This type of sleep is termed as
Vyadhyanuvartini Nidra.
As has been stated earlier the sleep is a natural phenomenon and it comes at a
particular time cyclically in the night. There is no specific or particular reason for this
41
kind sleep and it is termed as Bhutadhatri . It has been observed that even the
individual who has slept during the daytime would also feel sleepiness in the night,
attached to the power of Vishnu Maaya. Here, Maaya is a desire of the Manasa
to get detached from the worldly sensory objects on account of the tiredness of
Manasa; and the seat of Manasa and the Sleshma and Tamas cover Atman.
This mostly happens in the night and individual gets sleep. The Tamoguna
dominant persons may go to sleep at any time i.e. day or night. But a person
having Rajoguna in excess may get sleep sometimes in the day or in the night,
Satva Guna sleeps at the midnight, because, at this time Tamas is excess and
Satva will be decreased (Dalhana). The term Papma has been used to describe
b) Tamasi Nidra:
Kapha induces this due to the blockage of Sanjnavaha Srotasa, and this Nidra
c) Vaikariki Nidra:
and increase of Vata and also due to mental and physical pain, distress etc. the
the names. He also mentioned seven types. The commentator Indu opined that the Tamobhva
is Antya i.e. comes at the time of death and Agantuka means Shastra Praharadina (due to
all seven types in this viz. Akala sevitha, Ati prasangath sevitha, Nacha sevitha and
Nishevitha. The commentator Hemadri considered them as – The properly taken sleep brings
happiness, nourishment, strength, virility, knowledge and life to the individual. The
improperly taken other three types may kill the individual like the Kalaratri, who killed all
demons.
Instead of above seven fold classification we can make three types of classifications in
terms of Tamas. As we seen that sleep is due to manodosha Tamas, but here Tamas means not
45
alone, the other manasika doshas are there i.e. according to Charaka vimansthana Dosha
anubhandhya anubhandha concept the Nidra can be made into mainly three types.
Tamasika nidra
both day & night, Rajayukta tamasika Nidra get sleeps either in the day or night and
There is much evidence to support the theory that sleep is a period of growth and
anabolic activity but little about the role of sleep in recovery from illness. Excessive sleep,
sleepiness fatigue and fever are symptoms of nearly all infections diseases and chronic
inflammatory disorders. Fever probably protects during illness, but the effects of sleep are m
Many processes could contribute to the link be in sleep and immune response. For
example the circadian release of melanotonin during the night is thought to counteract the
Several molecules play a part in the regulation of sleep and immune processes
muranyl peptides that are produced by macrophages from phagocytosed bacterial cell walls
and certain viral products also increase the length of sleep and the production of modifiers of
the immune response, one class of that is called cytokines. Cytokines are concerned with the
known to effect sleep include interleukin L-alpha, interleukin l-beta, tunor necrasis factor and
interferon – alpha.
Though the studies regarding the close association between sleep and immune
regulation are carried out, further elucidation is required to prove this any how rest is part of
Nidra as Rasayana
winding up of the vital clock, a recharging of life’s battery and “Chief nourisher at life’s
sleep patterns induce Rasayana effect. Health is a first muse and sleep is the condition to
produce it. The goal of the Ayurvedic approach is to create more potent individuals through
increased Ojas (immunity), which is the finest end product of digestion & metabolism that
provides energy, enthusiasm, happiness, clarity of thinking, better coordination between the
49
body and mind . Only the sound most restful (stage IV) sleep generates Ojas. A sound
quality sleep provides ultimate rest to the mind and senses, with enhanced capacities of
mental and physical work ability for the next day. On the other hand, lack of sleep vitiates &
The hypothesis is that sleep is a process by which the whole body may be restored.
during slow wave sleep. Though the process of catabolism and anabolism are continuous, the
relative rates vary according to whether the subject is awake or asleep, and it has been shown
Growth hormone is released mainly at night, also in association with slow wave sleep
and also treatment of short stature by growth hormone is more effective if given at night.
It has been postulated that slow wave sleep being more important for macromolecular
synthesis and REM sleep for removing the synthetic products of slow wave sleep to maintain
Disorders) 51.
Some research workers have postulated that it is the brain not the body that
recuperates during sleep and that sleep counteracts the effects of the metabolism of the brain
during the day. They also claim that the exercise included increases in slow wave sleep can be
explained by an increase in brain temperature and metabolism and alter sleep deprivation it is
psychological rather than physiological deficits that are most apparent. This emphasizes that
No one hypothesis completely explains the complexities and vagaries of sleep, but
taken together may form the foundation of the explanation for the indisputable need for sleep.
Individuals vary sleep with the prakriti i.e. personality and vayah (age factor). The
sleep requirement differs with relation to either psychological or somatic personalities. The
person the quality and quantity of sleep varies. An individual of Kapha prakriti gets more
sleep which is sound also, while a person of Vata prakriti gets less sleep is related to the age
or vayah. In balyavastha, Kapha is predominant, so child sleeps more time than the youth. In
vriddhavastha, Vata is predominant, so the old aged gets very less sleep. Apart from the deha
1) Svabhaviki Nidra:
Svabhaviki Nidra is caused due to the Maaya or illusionary effect attached to the
power of Vishnu Maaya. Here, Maaya is a desire of the Manasa to get detached from the
worldly sensory objects on account of the tiredness of Manasa; and the seat of Manasa and the
Sleshma and Tamas cover Atman. This mostly happens in the night and individual gets sleep.
The Tamoguna dominant persons may go to sleep at any time i.e. day or night. But a person
having Rajoguna in excess may get sleep sometimes in the day or in the night, because of
Chalatva of Rajasa. The person having qualities dominated by Satva Guna sleeps at the
midnight. Because, at this time Tamas is excess and Satva will be decreased (Dalhana)
The term Papma has been used to describe the Tamobhava of Nidra and also to
2) Tamasi Nidra:
It is the lack of consciousness preceding the death. Tama dominant Kapha induces this
due to the blockage of Sanjnavaha Srotasa, and this Nidra cannot awaken individual.
3) Vaikariki Nidra:
This is a condition of insufficient sleep due to the decrease of Kapha and increase of
Vayu and also due to mental and physical pain, distress etc. the person doesn’t enjoy the
2,3
sufficient and sound sleep in quantity and quality . Disturbed sleep is also a type or
Vaikarika Nidra.
remarked that the thirty muhurta period (24hours) is divided by the sun into day and night, the
day being intended for the activities and the night designed for the rest and repose.
Naturally the night is described as a proper time for sleep. The person should not
awake at night and should not sleep in day time because both are Dosha prakopaka. It is
advised to take sleep avoiding at the first and last parts of night. As the sleep is one among
56
five varjyas of sandhya kala, if taken the person becomes needy or sparse . As it is well
known concept that early morning awakjening is good for health and also to get Bramhajnana.
By the previous descriptions regarding sleep it is very clear that sleep is having
dominant process, it also maintains the equilibrium between three humors. In Ayurvedic
classics, it is mentioned that in the kaphaja vikaras, Nidra and tandra are commonly seen and
in vataja vikaras sleeplessness occurs and in pittaja vikaras lack of sleep is one of the
symptoms 57.
58
The equilibrium of the dhatus also depends upon the sleep. Charaka and Susruta59
have stated that by means of proper sleep the dhatusamya, the nourishment of the body, the
increase of strength and the stability of life are achieved. When the decrease of Rasa Dhatu
occurs, the sleep is diminished and the dhatus get proper nourishment again only when the
proper sleep is enjoyed. By the proper sleep the digestion power is properly mentioned and
the Agni functions remain normal. The evacuation of the bowel and the emptying of the
During each night, a person goes through stages of two types of sleep that alternate
with each other. The EEG (Electro encephalogram), EOG (Electro occulogram), EMG
(Electro myogram) can be conveniently record during the sleep by fixing small silver
electrodes to the scalp and to the face before the subject goes to sleep. EOG reveals the
eyeball movements while EMG indicates the tension of the muscles. Based on these records
NREM Sleep:
In NREM type of sleep the brain waves are very slow, so it is also called slow-wave
sleep. This sleep is exceedingly restful and is associated with decrease in peripheral vascular
Most sleep during each night is of slow-wave variety and it is deep, restful type of
Table – 1
Stages of sleep in the NREM
Stage I Stage II Stage III Stage IV
NREM sleep is a peaceful state relative to waking. Because the decrease of pulse rate,
respiratory rate, blood pressure, basal metabolic rate is seen in this state.
The deepest portion of NREM sleep (stage III & IV) is sometimes associated with
unusual arousal characteristics. The organization during arousal during stage III or IV
NREM sleep is frequently called ‘dreamless sleep’, but dreams do occur during it.
These dreams are not usually remembered whereas those of REM sleep are likely to
be remembered 60.
brain activity and physiological activity levels similar to those in wakefulness. In a normal
night of sleep, bouts of REM sleep lasting 5 to 30 minutes usually appear on the average
every 90 minutes, the first such period occurring 80 to 100 minutes after the person falls
asleep. When the person is extremely sleepy, the duration of each bout of REM sleep is short
The person is even more difficult to arouse by sensory stimuli than during deep slow-
wave sleep and yet people usually awaken in the morning during an episode of REM
The muscle tone throughout the body is exceedingly depressed, indicating strong
inhibition of the spinal projections from the excitatory areas of the brain stem.
Probably the most distinctive feature of REM sleep is dreaming. The heart rate and the
respiratory rate usually become irregular, which is characteristic of the dream state.
The brain is highly active in REM sleep and the overall brain metabolism may be
increased as much as 20%. This type of sleep is also called paradoxical sleep because
it is a paradox that a person can still be asleep despite marked activity in the brain.
However, the brain activity is not channeled in the proper direction for people to be
wakefulness is usually associated with α waves. Slow-wave sleep is divided into four stages.
In the first stage of slow-wave sleep, the voltage of the EEG waves becomes very low; this is
broken by “sleep spindles”, that is, short spindle-shaped bursts of α waves that occur
periodically. In stages II, III and IV of slow-wave sleep, the frequency of the EEG becomes
It is often difficult to a difference between REM sleep brain wave pattern and that of
alert awake person. The waves are irregular high frequency β waves which are suggestive of
excess but desynchronized nervous activity as found in the awaken state. Therefore, REM
PHYSIOLOGY OF SLEEP
When Manas is exhausted then sleep occurs this phenomenon can be understood in
this manner. According to Howell, sleep is due to cerebral ischaemia. Cerebral cortex is the
seat of higher centers like pre and post central gyrus, association area etc., which have the
correlation with mental activities described in Ayurveda. So due to the reduction in cerebral
Further, during sleep, Indriyas (both Jnanendriya and Karmendriya) become inactive
by the detachment from their sense organs or from their work. Kleitman explains that due to
reduction of muscle tone and discharge of less afferent impulses, the cerebral cortex remains
inactive. This can be interpreted in the terms of ‘Guru’ and ‘Varanaka’ properties (according
transmission of afferent impulses to the cerebral cortex and thereby keeping it inactive seems
During wakefulness, the brain is kept in an alert state by the interactions of two major
systems of nerve cells, in the upper part of the pons and in the midbrain, which makes
acetylcholine as their neurotransmitter, sends inputs to the thalamus, to activate it. It in turn
sleep the cholinergic nerve cells and the thalamus and the cortex are in a condition similar to
wakefulness but the brain is in REM sleep. The difference is supplied by three sets of nerve
cells in the upper part of the brain stem: nerve cells that contain the neurotransmitter a)
norepinephrine b) serotonin and c) histamine. These monoamine neurons fire most rapidly
during wakefulness, but they slow down during slow wave sleep, and they stop during REM
sleep.
The brain stem cell groups that control arousal are in turn regulated by two groups of
nerve cells in the hypothalamus. One group of nerve cells, in the ventrolateral preoptic
venterolateral pre-optic neurons fire, they are thought to turn off the arousal system, causing
sleep, damage to the ventrolateral preoptic nucleus produces irreversible insomnia (Anidra). A
second group in the lateral hypothalamus acts as an activating switch. They contain the NT
orexin and dynorphin, which provide an excitatory signal to the arousal system, particularly to
the monoamine neurons. Recent studies show that in humans with narcolepsy, the orexin
levels in the brain and spinal fluids are abnormally low. Two main signals control this
circuitry. First, there is homeostasis. There is an intrinsic need for a certain amount of sleep
each day. Some people think that a chemical called adenosine may accumulate in the brain
during prolonged wakefulness, and that it may drive sleep homeostasis. The other major
influence on sleep cycle is the body’s circadian clock, the suprachiasmatic nucleus. These
nerve cells in the hypothalamus contain clock genes, which go through a biochemical cycle of
almost exactly 24 hours, sleep, hormones and other bodily functions. The suprachiasmatic
neurons 67.
The depth of sleep is not constant throughout the sleeping period, but varies from hour
to hour. Experiments upon man in which auditory stimuli were employed to arouse the subject
at different time or in the movements of the sleeper were recorded indicate that the depth of
sleep follows a characteristic curve. In most adults sleep deepens rapidly to the end of the first
hour, after which it lessens sharply for a time, and then more slowly till the time of waking.
Generally, sleep taken during the daytime is lighter than that during the night. Deep sleep is
dreamless, dreams occur only during light sleep and chiefly in the period, which just precede
waking. In sleep, unconsciousness is not uniform for all senses; the depth of sleep is greatest
for the sensations of smell and least for those of pain, hearing and touch. The sleep
requirement of different persons varies widely; it also alters with age. The following are
average figures for the hours of sleep required at different periods of life:
• Adults 7 – 9 hours
During sleep most bodily functions are reduced their basal levels.
The blood pressure is lower, the systolic pressure showing a decline of from 10 to 30
mmHg. If the sleep is disturbed by exciting dreams the blood pressure might be
The metabolic rate is reduced by from 10 to 15% below the basal level and the rectal
The respirations are slowed as a rule they also tend to become irregular or periodic.
Muscle tone is minimal, the knee jerk is abolished and a positive Bebinski may be
present.
Vasomotor reflexes, however, are more active. The pupils are usually constricted, the
light reflect is retained. The eyeballs are turned upwards and outwards.
Charaka explains that in the night, the Hridaya (heart) gets contracted and the Srotasa
(the channels of circulation) as well as the Koshtha (the gastro-intestinal tract) are contracted,
According to modern view, sleep causes two major types of physiological effects.
nervous system at any point below the brain cause neither harms to the body organs nor any
deranged function.
On the other hand, lack of sleep certainly does affect the functions of the central
the mind and sometimes even causes abnormal behavioral activities of the nervous system.
So, in the absence of any definitely demonstrated functional value of sleep, we might
postulate that the principle value of sleep is to restore the natural balance among the neuronal
centers 70.
Sleep does have moderate physiological effects on the peripheral body. For instance,
during wakefulness, there is enhanced sympathetic activity and hence increases the muscle
parasympathetic activity increases. Therefore, a ‘restful’ sleep ensues – fall in blood pressure,
respiratory rate and pulse rate, and skin vessels dilate, activity of GIT sometimes increases,
muscles fall into a mainly relaxed state, and the overall basal metabolic rate of the body falls
by 10 to 30 percent.
Sleep at the nighttime makes for the balance of the body constituents (Dhatusamya),
alertness, good vision, and good complexion and fired digestive power.
Susruta described that, those who takes proper sleep in proper time will not suffer
from disease, the mind of them will be peaceful, they gain strength and good complexion,
good virility, their body will be attractive, they won’t be lean or fatty and they live good
physiology of sleep, its precise nature and functions are not exactly known to the modern
physiology. A number of theories have been proposed, which include the hypothesis that
thermoregulatory evolution, for conservation of energy. The most widely held theory about
the function of sleep is that its senses as a period of recuperation or restoration. There are two
ways in which this hypothesis is interpreted; total body restoration and neurological
restoration.
Disease review
By going through the previous description, it is quite evident that Nidra is not only an
important but an essential phenomenon of life, which affects the body and mind equally in a
favorable way when it is enjoyed in a rightful manner. Otherwise the inadequate Nidra
(Anidra) leads to various problems like dukha, karshya, abala, klibata, ajnana at last leads to
Charaka 75 explains Nidra and Nidranasha in context of ninditi purusha at sutra sthana
76.
which is included in 80 nanatmaja Vata vikaras But has no explanation of management at
Nidra plays a role in nutrition and development of the body. He also describes vaikarika Nidra
Vruddha Vagbhata 78 of Astanga sangraha mentions Nidra and Nidra vikara along with
Chikitsa in viruddha annavijnaniya adhyaya and in Vagbhata 79 of Astanga hridaya dicuss the
Deprivation of Anidra
It is composed of two words ‘A’+’Nidra’. The suffix ‘A’ provides negative meaning
to the act of Nidra 81. Anidra means less or no sleep. Ayurveda Vishwakosha part I 82 explains
Anidra as Nidranasha. In Ayurvedic texts the term ‘Anidra’ is used indicating a pathological
Synonyms of Anidra
Table – 2
Synonyms of Anidra
Sno Synonyms CS SS AH AS YR MN HS BS DN RN
1 Anidra + + + + + + + +
2 Alpa Nidra + + +
3 Aswapna + + + +
4 Jagarana + + +
5 Nidranasha + + + + + +
6 Nidra vighata + +
7 Nasta Nidra + + + + + +
8 Nidra dourbalya +
9 Nidra bhramsha +
10 Nidra kshaya + +
11 Nidra bhanga +
12 Nidra vinasha +
13 Nidra cheda +
14 Nishi jagarana + +
15 Nidra viparyaya +
16 Prajagarana + + + +
17 Veatanidra + +
Jagarana:
84 85
Jagarana means awake or waking Nidra rahita, Nidra abhava which refers to the
Nidra kshaya:
Kshaya means harsa, adarshana, bhanga 86 so, this term refers to disturbances in sleep
Nidra bhanga;
87
The word bhanga means breaking splitting, dividing, this shows disturbances of
sleep.
Nidra chheda:
Chheda 88 means cutting off, a section, apiece which shows disturbances during sleep,
Nidra bhramsha:
89
The term ‘bhramsha’ means to drop, fall down, cessation, loss which refers to
Vigata Nidra:
90
The term ‘vigata’ means gone, disappear, ceased which can be correlated with loss
Nasta Nidra:
91
Nasta means lost, disappeared deprived which convey the meaning of loss of sleep.
By seeing all these synonyms Nidranasha can be considered as difficulty in initiation of sleep
reduction in sleep time and disturbances during sleep either one or more (icd-10) 92.
Nidana
Charaka mentions the causes for Anidra as – eva eva cha vigneyo nidranashasya
hetavaha 93 the factors are Atiyoga of vamana, Atiyoga of virechana, Atiyoga of nasyakarma,
Atiyoga of rakta mokshana and Atiyoga of dhoomapana. Due to the excess use of these
factors makes the Vata vitiation and Anidra is inducted. Ati vyayama, Ati upavasa and
Asukha shayaa are the causatives of Vata vitiation, thus the Anidra is induced.
Ati chinta, Ati krodha and Ati bhaya are the manasika karana leading to tama kshaya
Along with these, some others Chikitsa procedures of Atinidra advised by Charaka can
also are considered as causative factors for Anidra, which are as follows.
work), Kala (old age), Vikara (disease), Prakriti (personalities such as Vata) and Vayu (Vata
Further Susruta has mentioned some extra Nidana factors which may cause Anidra;
these factors are Vata vridhi, Pita vridhi, Manastapa, Kshaya and Abhighata 96.
Astanga sangraha Vagbhata mentions Nidana which may cause the Anidra are as
follows. Lobha, Harsha, Vyatha, Atimaithuna, Ati kshudha, Rukshanna sevana, Yavanna
sevana and Anjana are said to cause Anidra with their individualized qualities embedded 98.
At consideration of all these Nidana factors, the sharirika doshas such as Vata, Pitta,
and manasika Dosha raja are the principal causative factors for Anidra /Nidranasha.
Purvarupa
Rupa
Table – 7
Symptoms of Anidra
Rupa CS 100 SS 101 AH 102 AS 103
Jrumbha + + + +
Angamarda + + + +
Tandra + + + +
Shiroroga + - - -
Shirogourava - + + +
Akshigaurava + + - -
Jadya - - + +
Glani - - + +
Bhrama - - + +
Apakti - - + +
Vataroga - - + +
Charaka has described the symptoms are suppression of sleep; yawning, body ache,
drowsiness, head disorders and heaviness in eyes are caused. Susruta has described following
symptoms due to restraint of sleep. Yawning, body aches, stiffness in the body, head and eyes
drowsiness are the symptoms caused by restraint of sleep. Vagbhata has mentioned that due to
Anidra – malaise, heaviness in head, yawning, laziness, languor, giddiness, indigestion, stupor
emphasized. Anidra is mentioned as Vata vikara with pita vriddhi associated with some other
Figure – 1
Schematic diagram of Anidra Samprapti
Nidana
Vata Vruddhi (Chala, Rooksha & Laghu) Rajo Vruddhi (Chala, Rooksha & Laghu)
Pitta Vruddhi (Ushna & Teekshna) Tama Kshaya (Snigdha, Guru & Manda)
Kapha Kshaya (Snigdha, Guru & Manda)
Anidra
At the description of Nidra it is mentioned that Kapha, Tamas, Hridaya and sanjavaha
104
srotas are responsible for it . But yogic concept defines Nidra as - when Atma having
is any changes appear in this physiological process or path it causes the Anidra 105. Hence it is
evidential that the Vata Pitta, raja, Hridaya and sanjnavaha srotas play an important role in the
Samprapti of Anidra. Thus it is concluded that the vitiation of involved factors leads to the
Types of Samprapti
Sankhya: According to Ayurveda, Asvapna/ Anidra is of two types viz., either due to
Vikalpa: In Anidra, mainly Vata Prakopa occurs and it’s Chala and Laghu Guna vitiates,
which keeps the mind active, causing Anidra. Thus the Dosha amshamsha kalpana is
essential.
Nanatmaja Vyadhi, vitiation of Vata takes place, and Pitta dominance is not ruled out. Thus
Bala: Bala of Anidra i.e. Vyadhi can be distinguished by the strength of manifestation of
Kala: Kala is an important factor, while considering Nidra as well Anidra. Charaka107
mentioned the Nishi Kala cause Nidra naturally. Sleeping at day time is contra indicated. Not
sleeping at night indicates that Kala interferences to cause the Anidra – thus the time factor
Table - 8
Anidra – Samprapti ghataka
Dosha Vata & Pitta (Vriddhi), Kapha (Kshaya)
Dushya Rasa
Srotas Manovaha, Rasavaha
Srotodushti Prakara Atipravritti (Over indulgence)
Adhisthana Hridaya
Agni Jatharagn
Dosha: Dosha involvement in Anidra is said as Vata, Pitta and Kapha. But the deviation from
the normalcy is to be considered with due importance. Vata and Pitta are in Vruddhi state,
in due course the Dhatu involvement occurs to give rise associated symptoms and conditions
of Anidra viz. Glani, Aruchi, Apakti etc, which are the symptoms of Annavaha srotas and
Rasa Dhatu, do has their role in Samprapti of Anidra, as they provide Tushti, Preenana for the
entire body.
Srotas: The role of Manovaha Srotasa is understood without any controversy in Anidra as the
mind psychologically and body physically takes rest voiding the external stimuli. In this
context, Rasavaha Srotas too have a pivotal role in the pathogenesis of Anidra. Seat of
Manovaha and Rasavaha is Hridaya where the functions of different levels originate from the
same. Moreover, the etiological factors responsible for Rasa Dushti are said to be psycho
disturbing, such as Chintyanam Chatichintanat, where the chetana and stawa are disturbed.
to the Manovaha sroto Atipravritti. But the sanga of Rasavaha srotas can not be ruled out, as
Adhisthana: Hridaya is the abode for Rasa and Mana. It is the platform where the whole
Samprapti process is supposed to be observed. As earlier stated, Hridaya is the bed rock for
Agni: Here, vitiation of Jatharagni takes place, because proper Nidra is said to enhance the
Agni 108. Apakti and Aruchi are the symptoms of Anidra, indicates the vitiation of Agni.
UPADRAVA
Kapha kshaya. The decreased and dried Kapha sticks in Dhamanis walls and cause
Srotorodha. This, results in so much exhaustion that eyes of the patient remain wide open and
watery secretion from eyes. This dangerous exhaustion is Sadhya up to three days then
As upashaya and anupashaya are not available in texts, they can be evolved. Mamsa
sevana, madya, ksheera and ksheera vikaras, abhyanga, utsadana, tarpana and sneha sevana
There is no specific line of treatment mentioned for Anidra in our texts. Depending
upon the Chikitsa mentioned is in different contexts, for Anidra can be broadly divided into 2
types 1. Bahya Chikitsa 2. Abhyantara Chikitsa. Abhyantara Chikitsa can be again sub
divided into (a) ahara pradhana Chikitsa (b) aushadha pradhana Chikitsa.
Our acharyas have given more importance to bahya upacharas such as moordhni taila,
abhyanga etc. and manasika upacharas such as manonukula vatavarana manonukula vishaya
grahana etc., along with these therapeutic measures are also described along with some
specific aharas for patients of Anidra. All these therapeutic measures in the different contexts
may be classified into the following groups’ viz. Bahya upachara, Manasika upachara,
Table – 9
Bahya Upacharas for Nidranasha
Bahya CS SS AH AS YR BP KS HS BS BR
Upachara
Abhyanga + + + + + + - - + -
Utsadana + - - - - - - - - -
Samvahana + + - + + + - - - +
shitarpana + - + + - + - - - -
Moordhni Taila + + - - - - - - - -
Udvartana - + + + - + + - - -
Shirobasti - - + + - - - - - -
Shirastarpana - - + - - - - - - -
Karnapoorana - - - + - - - - - -
Padabhyanga - - - + + - - - - -
Angamardhana - - - - - - - - - -
Mardana - - - - - - - + - -
Shirolepa + - - - - - - - - -
Vadana lepa + - - - - - - - - -
Management of Anidra with Nidra caps – Literary Review 47
Table No. - 10
Aahara Upacharas for Nidranasha
Ahara Upacharas CS SS AH YR BP KS HS BR RV DN RN
Gramya mamsa rasa + - - - - - - - - - -
Anupa mamsa rasa + - - - - - - - - - -
Jaleeya mamsa rasa + - - - - - - - - - -
Mahisha ksheera + - + + - - + + + + +
Peeyusha + - + + - - - - - - -
Morata + - - + - - - - - - -
Goodhooma - + - - + + - - - - -
Varahamamsa - - - - - - - - - + +
Guda - - - - - + - + - - -
Matsya - - - - + + - + - - -
Dadhi - - - - - + - - - - -
Koorchika - - - + - - - - - - -
Masha - - - - + - - + - - -
Sita - + - - - - - - - - -
Yoosha - - - - + - - - - - -
Sneha - - - - + - - - - - -
Kilata + - + + - - - - - + +
Madhya - - + - - - - - - - -
Table No. - 11
Manasika Upacharas for Nidranasha
Manasika Upachara CS SS AH AS HS BP
Manonukula Vishaya grahana + - - - - -
Manonukula Sabda grahana + - - - - -
Manonukula Gandha grahana + - - - - +
Mrudu shayya - + - - - -
Sukha shayya - - - + - -
Sukha sparsh - - - + - -
Nischinta - - + - - -
Nityatrupti - - + - - -
Bhaya tyaga - - - - + -
Chintatyaga - - - - + -
Lobha tyaga - - - - + -
Swasteerna Sayana + - - - - -
Sukhavartalapa - - - - + -
Santosha - - - - - +
a) 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. - 13
Single drugs useful for Nidranasha
Ekamoolika BP KS HS DN RN BR
Palandu + - - + + -
Ikshurasa + - - - - -
Potaki + - - - - +
Tila + - - - - -
Trikatu - + - + - -
Ketaki - - + - - -
Vartaka - - + - - -
Kakamachi - - + - - -
Asuri - - - + + -
Interests on sleep disorders started in the early 1970’s when obstructive sleep apnea
becomes established as a common and often life threatening condition. A number of survey’s
carried out in different countries indicates that sleep related complaints are most commonly
encountered in modern medicine. The disturbances of sleep are also very common complaints
in psychiatry. Sleep is disturbed in several ways in its pattern, quality and duration. As age
advances the average sleeping time decreases which is normal phenomenon. In some
pathological problems like mania, insomnia may be total. Delay in falling asleep (early
and the sleep is usually non-refreshing. The sleep wake pattern is disturbed in certain organic
conditions like delirium and dementia. As sleep is interrupted in several conditions, it has
Disorders Centers (ASDC) which has been widely accepted. It consists of 4 major types
of sleep disorders.
1. Dyssomnias
2. Parasomnias
3. Sleep disorders related to another mental disorders
4. Others sleep disorders
Dyssomnias:
Sleep-wake schedule (DOSWS) and Insomnia (DIMS). Out of insomnia (DIMS) are
Insomnia (DIMS) –
synonym also gives for insomnia which shows its clinical features i.e. DIMS (Disorders of
Diagnosis of Insomnia:
People are varying in their amount of sleep they require and some of those who
Usually the diagnosis of Insomnia can be based on the account given by the patient.
EEG recordings are occasionally helpful whether there is continuing doubt about the extent
and nature of the insomnia. So diagnosis of insomnia made on the basis of following points:
awakening)
- Non restorative sleep (i.e. despite adequate duration of sleep, feeling of not having
• It causes either marked distress or interferes with social and occupational functioning.
Above sleep disturbances (either one or more) if occurs at least 3 times in a week for
Types of Insomnia:
sleep.
About 15% of all the insomnia is primary origin. They are rare in childhood and
adolescences but become more prevalent as age advances. Females are more affected.
- Individual shows excessive worry during the day about not being able to fall
asleep.
- In evening the person shows intense efforts to fall asleep but becomes
unsuccessful.
- Also occur secondary to substance abuse like alcohol, amphetamine, steroids and
several others
worsening.
The investigations are not only for Insomnia but also can be applied for other sleep
1. Clinical evaluation:
A detailed sleep history is the most informative diagnostic tool. A thorough sleep
history can help for deciding whether the sleepiness or sleeplessness is normal or
pathological.
mandatory in a patient before using long term treatment with CNS stimulants initiated. MSLT
3. Polysomnography:
- Several changes of EEG to distinguish wakefulness from sleep and for sleep
staging.
- Eye movements
- Electro cardiogram
behaviour treatment and pharmacological treatment. General sleep measures include some
activities like regular exercise, avoidance of nicotine, alcohol and heavy meals close to
bedtime, etc. behaviour therapy includes relaxation, sleep restriction, stimulus control and
cognitive therapy. Pharmacological treatment includes several hypnotics and sedative drugs.
All these modalities of management are not capable enough to meet the challenges of Anidra.
Vata plays the most important role in the pathogenesis of the Anidra. Thus, the main aim
behind the management of the Anidra is directed towards pacification of Vata. In the present
The above Rational combination has been formulated based on the pharmacological
properties and pharmacokinetics of individual drugs included in Nidra cap are individually
scrutinised for its Nidra janakatwam and Nidra prabhava from the classical texts. To check the
suitableness of this combination through information of these herbs which are included in
Nidra cap are discussed on the basis of Rasa, guna, veerya, vipaka is as under.
Prayojyanga Moola
Rasa Madhura, Tikta, Katu
Guna Ushna
Veerya Ushna
Vipaka Katu
Prabhava Sedative, Hypnotic
Doshagnata Kapha Vata shamana
Rogaghnata Agnimandya, Unmada, Apasmara
Chemical consttiuents Volatile oil of Estates, Valerianic acid
Prepared Medicines useful at Vataraja vati-2
Manovaha Srotas
Prayojyanga Moola
Rasa Tikta, Kashaya
Guna Laghu, Snigdha
Veerya Sheeta
Vipaka Katu
Prabhava Bhootaghna, sedative
Doshagnata Tridosha shamaka
Rogaghnata Shira shoola, Anidra
Chemical consttiuents Oleum Jatamamsi, Resin, Sugar, Starch
Prepared Medicines useful at Vatarajavati -2
Manovaha Srotas
Prayojyanga Mooola
Rasa Tikta, Kashaya
Guna Ushna, Snigdha,Laghu
Veerya Ushna
Vipaka Katu
Prabhava Sedative, Hypnotic
Doshagnata Kapha vata shamaka
Rogaghnata Bhrma, Moorcha, Anidra
Chemical consttiuents Somniferen,
Prepared Medicines useful at Ashwagandhavalehyam
Manovaha Srotas
Pippalimoola - Piper longum 137 to 140
Prayojyanga Moola
Rasa Katu
Guna Laghu, Snigdha, Teekshna
Veerya Sheeta
Vipaka Madhura
Prabhava Rasayana, Yogavahi, srotoshodhaka
Doshagnata Kapha vata shamaka
Rogaghnata Aruchi, Ajeerna, Dourbalya
Chemical consttiuents Piperine, Piplartine, Piperlongumirin, Steroids,
Glycosoids
Prepared Medicines useful at Sudarshana choorna
Manovaha Srotas
new things, which will, helpful for his better living, since time immemorial. Now-a-days
many varieties of diseases are coming up, out of which some are challenging to medical
sciences and some affects the health and longevity of human life. One of such symptom and
disease is insomnia, which is a challenge to the physician as well as adversely, affects the
patients in all the sphere of their life. Cause and diagnosis of Insomnia is difficult, because the
kind of sleep patterns and degree of daytime fatigue differs to that of people considering the
indications of insomnia for other people is normal. Ayurveda considers Anidra (Aswapna) is
141
one out of 80 Nanatmaja Vata Vikaras described by Charaka . However its detail
description is not available may be due to low prevalence of the disease in the society at that
time. Now days due to fast mechanical sleep patterns style makes prevalence to increase.
A) Study Design:
B) Sample:
inclusion/ exclusion criteria. Selected patients are distributed randomly and equally in two
groups, viz. Nidra caps and placebo. 15 patients are treated in each group for the stipulated
period.
C) Grouping:
21 days of study with every 7th day drug distribution where patients under went
periodical checkups.
E) Follow up:
F) Exclusive criteria:
3. Pregnant women are excluded because - even though the drug composition is
herbal and safe still may be placental barrier and affect the foetus.
4. Lactating mothers are excluded because - even though the drug composition is
herbal and safe still may have effect over food (milk) of infant.
5. Associated with any other systemic and metabolic disorders are excluded
G) Inclusive criteria:
a) Patients complaining of reduction in sleep time are included because they are the
b) Difficulties in initiating sleep are included because they are the prime objective
parameters of assessment.
parameters of assessment.
glani, bhrama and apakti will be included because they are the prime subjective parameters
of assessment.
3) Patients already diagnosed for primary insomnia with the duration of 1 month to 5 years
will be included because, the disease said as kasta sadhya from the Ayurvedic classics
4) Patients those who are in between 18 to 70 years of the age are included
H) Posology:
2 caps of 500mg or 15mg /kg body weight/24 hours, 1 hour before to retiring with
buffalo milk as Anupana. Charka mentioned that the buffalo milk is the best for inducing
sleep, thus the Buffalo milk is selected as Anupana to enhance the effect of the medicament.
For diagnosis, a detailed medical history is taken and physical examination also
undertaken in detail according to Ayurvedic and contemporary clinical methods. Patients are
diagnosed according to diagnostic criteria given for insomnia in DSM – IV 142. A special case
level of daytime sleepiness. If the problem is grave patient may be suggested to spend a night
at a sleep disorders center for evaluation. A team of people at the center can monitor and
record a variety of body activities during the night, including brain waves, breathing,
heartbeat, eye movements and body movements. But for most people whose main complaint
Doctor may ask patient many questions about sleep patterns; such as 143–
1) Demographic data
The patient identity is prime in diagnosing the disease as Ayurveda specifies the
Sadhya and Asadhya based on age and relative factors such as desha, Kala etc. thus Name,
Age, Gender, Occupation, Economical status, Birth place and Food habits are recorded in the
demographic data of the case sheet along with the consent signed.
contemporary systems are detailed for the studies are noticed with chronological order and
duration is as follows. The chief complaints of the possible are tabulated and rest are added to
the main list in the clinical trial to understand the complaints of an Anidra patient. The listed
Difficulty in initiating sleep is a gradual process which changes from person to person.
For proper assessment of the sleep quality and to measure the quantity, the following
Since the sleeping state and the waking state are both integral components of a 24 hour
continuum. The quality of the patients waking state is equally relevant. How does the patient
feel upon awakening in the morning? How does the person function during the day? Does the
patient feel tired and / or involuntarily fall asleep during the day? A few patients awaken
refreshed and function perfectly well despite sleeping much less than expected. Except for
brevity their sleeping appears to be normal. These so called short sleepers regularly have a
daily sleep total that is less than 75% of that usually expected for their age. Hence it is
necessary to measure the reduction of sleep time in hours with respect to the patients
complained of Anidra. The units of measurements here are hours and minutes.
In the proper context sleep disturbance may constitute strong evidence for diagnosis of
uni-polar depression. How patient is sleeping? A frequent response is not good. In what way
Body ache is common symptom of the Anidra patients as they are subjected for
increased muscle tone with enhanced sympathetic activity. Thus the compliant of Angamarda
5) Yawning (Jrumba)
Yawning is the expression of the sleep and lack of sleep, seen in Anidra. It may or
may not be present in all patients. The intensity of the yawning is necessary to measure to
evaluate the sleep patterns. Thus the following grades are inducted.
Associated Complaints
Associated complaints are the symptoms associated with the main complaint or
seldom may lead to Anidra. The listings of the Anidra associated symptoms observed in the
helplessly amazed state with dazed where the intense urge for the sleep is noticed. It is caused
by the increase of the Tamas, Vata and Kapha. This is observed as present or absent with
duration.
Jadya (heaviness in eyes), Deha Jadya (Body heaviness), Glani, Bhrama (Giddiness), Apakti
(Indigestion) and Aruchi (Anorexia) are associative symptoms of Anidra are commonly seen
Anidra, Duration of Anidra, and Preceded by what factors & Change of Regularities are
4) History of sleep
Taking history of the patient with due importance of the bed habits as the questioner is
the technique followed here. The answer obtained from the patient is in the form of yes/no to
rule out the bias in the research. The questioner is of St. Joseph Hospital Sleep Disorders
Center, 1310 West Stewart Drive (Suite 403), Orange, CA 92868, is followed as under 144.
5) Personal history
The personal history is discussed as - Food habits with reference to taste, Taste
preferred, Agni, Kosta, Nidra, Addictions, Bowel habits, Menstrual History, Family history –
Specify if any has the same disease, Treatment history and History of past illness, along with
6) Sleep examination
Patient is examined for the sleep with sleep questionnaires having the following
grades set for the respective answers. The questioner is from St. Joseph Hospital Sleep
Disorders Center, 1310 West Stewart Drive (Suite 403), Orange, CA 92868, is followed as
under.
As sleep is the basis of our day to day activity to determine the sleep questioner is
inquired from patient to get absolute information of his sleep patterns. The detailed questioner
is shown here under with the marks awarded for each possible answer.
0 = Never,
2 = Moderate Chance
3 = High Chance
3. Do you have diabetes, hypertension or another health problem that affects your sleep?
5. Do you wake up with a dry mouth, sore throat or headache in the morning?
8. Does your snoring bother you or your spouse enough for you to consider treatment?
12. Doze off or fall asleep as a passenger for 1 hour without a break
13. Doze off or fall asleep in Lying down to rest in the afternoon
15. Doze off or fall asleep while sitting quietly after lunch without alcohol
16. Doze off or fall asleep while stopping for a few minutes in traffic
7) Ayurvedic examination
reference to the symptoms affirmed in Ayurvedic texts. The Dasha vidha pareeksha and
Astastana pareeksha were also included to understand the pathogenesis under the lime light of
Ayurvedic pathology. The special emphasis of the Agni is made as the Chikitsa is to regulate
The pancha lakshana Nidana i.e. Nidana, Lakshana along with the Upashaya and
anupashaya are examined according to the classical references as detailed in the annex-1.
Subjective parameters
Apart from the mentioned chief complaints the following are taken as the subjective
The objectivity of the sleep is difficult to establish but as the researchers have
evaluated sleep measurements in mathematical way through a tabulator work sheet shown
3. Number of awakenings
– (Daw + SL)
Going to Bed
TST = TTSR
S.No
Awakenings
Completion
Duration of
Awakening
Number of
Latency
Falling
asleep
TTSR
Sleep
Sleep
1
before
1
After
1
Follow up
The above shown work table is used to calculate the objective parameters in the study.
9) Investigations
The following routine investigations are undertaken to estimate the patient general
Haemoglobin %
Differential count
Subjective and objective parameters of base line data (subjective and objective
parameters) to the after treatment data comparison are done for the assessment of results.
the study. Out of Subjective parameters, Difficulty in initiating sleep, Body ache
(Angamarda), Yawning (Jrumba), Vitality after morning awakening and Performance of daily
activities were considered. At the objective parameters Total sleep time (hrs), Sleep onset
latency (min) Number of awakens, Efficiency of sleep (TST/TTSR * 100) and Sleep
Fragmental Time (TST/ # Awk) are considered. The Result is declared as Well Responded,
Moderately Responded, Poorly Responded and Not Responded categories. The discontinued
J) Statistical analysis:
parameters. The paired T – test is used for the objective parameter assessment and non
parametric tests are used for the testing subjective parameters. If the test hypothesis p value is
patients were discontinued and 5 patients not fulfilled the inclusion criteria hence their data
has not been included in the assessment. The remaining 30 patients of Anidra viz. Insomnia
which patient is reactive. Patients fulfilling the criteria of diagnosis and inclusive criteria were
included in the study, fewer than two groups as discussed in the Methodology, distributed
patients in Group-A are 15 (Placebo) and Group-B (Nidra caps) are 15.
All the patients were examined before and after the trial, according to the case sheet
format given in the annex. Both the subjective and objective criteria were recorded. The data
A. Demographic data
D. Statistical assessment
The details of Age, Gender, Religion, and Occupation etc. of the 15 patients in each
Table- 14
Distribution of Patients by Age- Gender in Group A & B
Age Group-A (Placebo cap) Group –B (Nidra cap) Total Patients
Number
Female
Female
Male
Male
%
%
20-30 3 20 2 13.3 1 6.66 2 13.3 8 26.7
30-40 3 20 1 6.66 0 0 0 0 4 13.3
40-50 1 6.66 1 6.66 2 13.3 3 20 7 23.3
50-60 3 20 1 6.66 2 13.3 2 13.3 8 26.7
60-70 0 0 0 0 3 20 0 0 3 10
Total 10 66.6 5 33.4 8 53.4 7 46.6 30 100
Figure – 3
Distribution of Patients by Age- Gender in Group A & B
3
2.5
2 Group A Male
1.5 roup A Female
1 Group B Male
0.5 Group B Female
0
20-30 30-40 40-50 50-60 60-70
that the Anidra is much identified at the ages progressing from the 40 years till to the upper
age limit of the study as 70 years. This is an evidence for the Vata implications with Anidra
induction. Apart from this observation an alarming 26.7% of the youngsters of 20 to 30 years
of age group are in the study with Anidra. This strongly suggests that the present trends of
In the Group A (placebo), out of 15 patients, the over all results declared are 1 well
responded, 7 each in Poor responded and not responded. The patient who is well responded is
of 30-40 age group. On the other hand the result in the group –B declared as 4 well responded
And 11 moderately responded. No poor or not responded patients recorded. Out of the well-
responded 4 patients 2 patients are of 50-60 age groups and 1 in 40-50 years of age and 1 in
A2) Gender
The gender distribution in the trial with the result is tabulated as under. This trial
reveals that the distribution of the male community is more. The ratio in the group A is 1:3 of
the female to male and in the group B it is as almost 1:1. The results declared in the group A
(placebo) suggests that the 1 male as well responded and 4 poorly responded. The percentage
of the not responded in the male group are 33.33% i.e. 5 patients. The females has poor
response at the treatment are 3 and not responded as 2. In the group B (Nidra caps) out of 8
males 3 well responded and 5 moderately responded. Out of 7 females 1 well responded and 6
moderately responded. The reasons of obtaining these results are discussed in the next
chapter. The tabular forms and pictorial forms are shown below.
Moderately
Total no of
Responded
responded
responded
responded
patients
Poor
Well
Not
%
%
Male 10 66.6 1 13.3 0 0 4 26.6 5 33.3
Figure - 4
Table- 16
Gender wise Results in Group –B (Nidra cap)
Gender
Moderately
Total no of
Responded
responded
responded
responded
patients
Poor
Well
Not
%
A3) Religion
Table- 17
Religion wise Results in Group – A (Placebo cap)
Religion
Moderately
Total no of
Responded
responded
responded
responded
patients
Poor
Well
Not
%
%
Hindu 12 80 1 6.66 0 0 5 33.34 6 40
Responded
responded
responded
responded
patients
Poor
Well
Not
%
of the condition related exploration. But as a routine the data is collected here and presented
in tabular form for the Group A and B separately with results obtained. The over all
Figure -6
Christian , 1 Others , 1
Muslim , 7
Hindu, 21
A4) Occupation
Table-19
Occupation wise Results in Group – A (Placebo cap)
Occupation
Moderately
Total no of
Responded
responded
responded
responded
patients
Poor
Well
Not
%
Moderately
Total no of
Responded
responded
responded
responded
patients
Poor
Well
Not
%
%
Sedentary 1 6.66 0 0 1 6.66 0 0 0 0
The occupation level of this study refers with three groups’ viz. sedentary, active and
labor. The study reveals that the active group people are prone to get the problem of
sleeplessness i.e. Anidra. In the study 73.3% of group A and 80% of group B are active
Figure - 7
8
6
3
4 2
2 1 1
0
Sedentary Active Labor
The sedentary group patient in group A poorly responded and where in group B
moderately responded. The labor group patients in group A poorly responded and in B
responded and 8 moderately responded are recorded. The graphical representation is as above.
Moderately
Total no of
Responded
responded
responded
responded
patients
Status
Poor
Well
Not
%
%
Poor 4 26.66 1 6.66 0 0 3 20 0 0
Responded
responded
responded
responded
patients
Status Poor
Well
Not
%
%
Poor 3 20 0 0 3 20 0 0 0 0
The class mass to differentiae is difficult in this small study. But certainly a target of
middle class is observed in the study with Anidra. The percentages of the cumulative groups
are expressed here as 18 (60%) patients of middle 7 (23.33%) of poor and 5 (16.66%) of
higher middle are recorded. The tabulations above with graphical representations below are
shown.
10
10 Group A
8 Group B
8
6
4 4
4 3
2 1
0 0
0
Poor Middle Higher Higher
Middle
A6) Diet
Table- 23
Diet wise Results in Group – A (Placebo cap)
Diet
Moderately
Total no of
Responded
responded
responded
responded
patients
Poor
Well
Not
%
%
Vegetarian 11 73.33 0 0 0 0 5 33.33 6 40
Diet
The food has always influence over the Tridosha and also on mano bhava. The
vegetarian food consumers are supposed to be comfortable always but in the study it is found
that much of the patients are of vegetarians as 11 and 10 patients respectively in group A & B.
on the other hand the mixed diet practitioners are only 4 and 5 in group A & B. well response
distributions are shown in pie diagram as below along with group B distributions.
Table- 24
Diet wise Results in Group –B (Nidra cap)
Diet
Moderately
Total no of
Responded
responded
responded
responded
patients
Poor
Well
Not
%
%
Vegetarian 10 66.66 4 26.66 6 40 0 0 0 0
Figure - 9
Mixed Diet , 9
Vegetarian , 21
Table – 25
Showing chief complaints of Anidra
SN Chief complaint Group –A Group –B Total
(Placebo) (Nidra cap)
Patient % Patient % Patient %
s s s
1 Difficulty in initiating 15 100 14 93.33 29 96.66
sleep
2 Reduction in sleep time 15 100 14 93.33 29 96.66
The study includes with the 30 patients in two groups. The prime complaint Difficulty
in initiating sleep and Reduction in sleep time is observed with 96.66% of patients. The
second common presenting complaint is Wakefulness during sleep with 80% of patients
involved. Body ache with 16 (53.33%) patients and yawing with 8 (26.66%) patients are
The trial observes 70% of patients with the shirogourava, Shirasoola and Deha jadya.
Out of 30 patients 66.66% of patients reported withAkshi jadya. The rest of the features of the
associated complaints are minimal and expressed in the tabulation and also in graph below.
Figure 10
Associated compliant in the study
Glani , 5
Deha Jadya
Shirogourava
(Body Akshi Jadya
Shirasoola (Head
heaviness), 21 (heaviness in
(Headache), 21 Heaviness), 21
eyes), 20
Table -27
Showing Mode of onset in Anidra
SN Group –A (Placebo) Group –B (Nidra Total
cap)
The mode of onset observed in the study revels that the Anidra is a gradual in onset for
a population of 63.33% and 7 patients are of insidious. Very few of 4 patients went in to
Table – 28
Showing Anidra course in study
SN Group –A Group –B (Nidra Total
(Placebo) cap)
course is for 17 (56.66%) and the rest of patients i.e. 13 (43.33%) are at the transient course of
Anidra.
Table -29
Showing Anidra frequency in study
SN Group –A (Placebo) Group –B (Nidra Total
cap)
Anidra frequency is calculated in days and weeks. Few weeks of frequency is shown
by 56.66% of patients and rest 43.34% of the patients show the few days’ frequency. More or
Table -30
Showing Anidra duration in study
SN Group –A (Placebo) Group –B (Nidra Total
cap)
the study 46.66% of the patients’ exhibit the continuous patterns and 43.33% show
intermittent duration. Very few of 10% patients are reported with medication usage for
achieving sleep.
Table 31
Showing Anidra preceding factors in study
SN Group –A (Placebo) Group –B (Nidra Total
cap)
Preceding Patients % Patients % Patients %
factors Number Number Number
1 Anxiety 11 73.33 9 60 20 66.66
Sleep and psychology are hand in hand to give rise sleep. Here an attempt is made to
understand the sleep in relation with psychological factors. To disturb sleep anxiety has major
role i.e. 66.66%. Later to it 43.33% express fear. 36.66% of patients expressed pain either
physical or psychological. In the present study along with the above said psychological
In the study 56.66% of patients were observed with Anidra due to change of place and
40% with bed. 26.66% of patients expressed that the environmental changes cause Anidra.
Table -33
Showing Anidra Nidana in study
Group –A (Placebo) Group –B Total
(Nidra cap)
Pts % Pts % Pts %
Ahara
Yavanna 0 0 0 0 0 0
Rookshanna 2 13.33 3 20 5 16.66
Dhooma 0 0 0 0 0 0
Vyayama 0 0 0 0 0 0
Vihara
Shirovirechana 0 0 0 0 0 0
Raktamokshana 0 0 0 0 0 0
Kshaya 0 0 0 0 0 0
Abhighata 0 0 0 0 0 0
In the present study manasika Nidana are major factors for Anidra showing
89%patients of chinta, 70% patients of bhaya, 50% patients of vyatha and 46.66% patients of
contributory.
The examination of the Anidra patient is a Herculean task. Here the help of questioner
is taken to understand the patient before and after. The sum of the patients in both groups
suggests that inclination to the susceptibility of Anidra has reduced in later study of
questioner. The tabulation is as follows. The group A initially shows the 8 points mean later
reduced to 3.33. The group B mean initially is 7.53 which reduced to the 1.2 at later stage.
The mean difference observed at both groups suggests that the efficiency of the Nidra caps
Table – 34
Showing Anidra Nidra (sleep) Examination in study
Questioner Group –A (Placebo) Group –B (Nidra cap) Total
Points Mean Points Mean Points Mean
obtained obtained obtained
Before 120 8 113 7.53 233 7.76
As it is described in the methods the baseline data to the after trial final data was
compared to get the results of the trial. Here all the parameters are individually compared to
get percentage of the result in terms of individual. The percentages are cumulated and mean
percentage is drawn. Above 75% of cumulative percentage achieved patients are considered
as the well responded in the study. The patients between 50 to 75% recognized as moderately
responded for the study and less than 50 and above 25 percentages are considered as poorly
The results as discussed in the methods were classified under 4 groups viz. well
responded, moderately responded, poorly responded and not responded. The group A placebo
study doesn’t show any well and moderate response except one patient of well responded in
general. The result is mainly poor responded with 7 patients and 7 patients of not responded.
Thus it is a clear and evidential that the placebo doesn’t induce sleep. The placebo
psychological effect of inducting sleep is mere chance i.e., One in 15 patients of the study.
Table 35
Showing Anidra Results of the Group A (Placebo caps) in study
Result Number of patients Percentage
Moderately Responded 0 0
Total 15 100
Poorly
responded
46.67%
The results as discussed in the methods were classified under 4 groups viz. well
responded, moderately responded, poorly responded and not responded. The group B Nidra
caps study show well and moderate response only but not of either poor or no response
categories. The result is mainly moderate responded with 11 (73.33%) patients and 4
(26.66%) patients of well responded. Thus it is a clear and evidential that the Nidra caps has
induced sleep. The Nidra caps effect is not only psychological but also has drug effect in
inducting sleep is not mere a chance. The detailed tabulation along with pictorial presentation
is as follows.
Poorly responded 0 0
Not Responded 0 0
Total 15 100
Figure - 12
Moderately
Responded
73.33%
To compare the effectiveness of drugs in two different groups, here statistical analysis
is done by using un-paired t-test, the conclusion is done as highly significant if P <0.05 by
assuming that the mean effect of two if among subjective parameters all groups is same. The
parameters show High Significant in both the groups. There is High Significant in body ache,
yawning, and performance of daily activities but in the parameter difficulty in initiating sleep
Among the objective parameters all the parameters shows non significant is both the
groups, (i.e. the mean effect of the two groups is not same groups). To know the effectiveness
of drug on individual group the Statistical analysis is done by using paired t test by assuming
Management of Anidra with Nidra caps – Results 94
that drug is not responsible for changes in grading before and after the therapy. The
conclusion is drawn as High Significant if P<0.05. Among the subjective parameters the
Nidra cap group shows High Significant, than the placebo group in all the parameters (by
comparing P values) in the placebo group except the parameter difficulty is initiating sleep all
Among the objective parameters the Nidra cap group shows High Significant than the
The parameter efficiency of sleep is more High Significant in Nidra cap group than
placebo group with more mean effect and less variation, (by comparing t-value, mean and
S.D). The % improvement in subjective parameter in group placebo is 17.65% is yawning and
improvement in body ache (83.33%). Among objective parameters is group placebo the least
time (66.51%)
In the group B the least % improvement in total sleep time (40.16%) and more than
From birth to death almost half of the lives we spend for sleep. Insomnia became a
major problem now-a-days, by stress, anxiety etc., which play a key role in causing the
Anidra. It is for all religions and economical people who are under the sky. But it is more with
Adequate sleep is critical to good health, yet many adults have sleep related problems
that prevent them from getting adequate sleep. Many Foundations working for sleep disorders
say that at least 1/3rd people of the world suffer from sleep disorders. Additionally,
sleeplessness has been associated with a broad range of complications, including depression,
heart disease, lost productivity and an increased risk of high-way and work related accidents.
In majority of the people, various mental factors causing insomnia cause numerous mental
disorders too. The present study intended to evaluate the Anidra with Nidra cap a rational
combination made from the various Nidra janaka, pravartaka prabhava herbs cited at the
Ayurvedic treasure. The comparison of the test drug Nidra cap is compared with the placebo
to rule out the psychoneural involvement in the study. The discussion is made under the
Nidra is inversely proportional to the age, as age advances the sleep decreases, i.e.
sleep often becomes less restful as age progresses. But, a lack of restful sleep is not normal
consequence of aging. With age, people’s bio clock often alters, that means, they get tired
early than normal and seek rest and consequently wakeup early in the morning. It is
physiological; often it results as Anidra with reduction in sleep time and associated
symptoms of Anidra.
Here in the study, out of the 30 patients of Anidra studied exhibits each 26.7%
patients belong to 50 to 60 and 20 to 30 years age group. 50 to 60 age group data denotes
the age stage of Vata. On the contrary the early ages of 20 to 30 years suggests that the
psychological and insecurities of life style mainly related to Rajas which ultimately
influence the Vata. This observation strongly suggests that the present trends of
environmental and social disturbances influences over the causative factors of Anidra and
In placebo group one male patient of 32 years responded well, where as all others
show either not responded or poor responded. At the counseling it is reveled that the patient
is unmarried and workaholic not consuming the food at proper time. The patient is at the
early insomnia responded well with placebo up to 70% of symptom variance. In this patient
added stress led to have Anidra with associations of deleterious effect on day time
functioning. Increased efforts to obtain sleep can it self induce sleep with timely
suggestions and placebo. Thus the patient achieved result apart from others in the same
group of study.
vitiates excessively. In this disorder Anidra, both of the above are seems to be vitiated.
psychic disorder is a difficult task. Proper counseling, relaxation techniques applied along
Thus the Manaha Sukham, Manonukula Vishaya etc. of pleasing techniques of mind is
module consisting herbal formulation by name Nidra caps is planned for the study. The
result of the Nidra caps on the ages strata are discussed here under.
Generally insomnia is seen on higher side in females than males. It is said in texts as
sukrabahulya (Soma) in male and rajo (Agni) bahulya in females is usual physiologically.
Thus the reason behind influence of the drug could be understood as the Agni predominance
in females helps to assimilate the drug faster and safer. In this study maximum number of 60
% male patients and 40% female patients were observed. This observation is at this
geographical area not to be considered as standard due to variances. The result of the Nidra
cap on this part of the study show more inclination over the male community.
Religion is not a marker of the sleep disturbances. The Anidra at communal riots are
may be claimed to insecurity, but the area of study is free of any disturbances the religion
relation is not existing. Thus the Maximum patients of 70% Hindus are recorded in Hindu
and leads ultimately to Anidra. Here in the study middle class people are found more. The
results as already told that the placebo doesn’t have any better effect and Nidra caps exhibited
its excellence.
Occupation has a good role in the induction of sleep naturally. People who are well
tired gets sleep well. Even the same is observed with the mentally active too. But when it
crosses the threshold level the same induce the Anidra. Thus the study has a many either
mentally tired or physically people as 23 patients out of 30. Businessmen, labor or service
persons suffer from excessive mental tension and worry, which may lead to Anidra. The
Nidra cap result implication over these exhibited 80% success. The reason behind could be
that Nidra cap is Vata and Rajodosha pacifier to release the neuron chemical action at the time
In the Ahara Nidana and of people food consumption methods as observed that the
vegetarian food takers are usually less unctuous and non vegetarians with more unctuous food
intake. The former makes the Vata vitiation and the later to Kapha. Even though Kapha
involvement is not justified at the installation of Anidra, the other factors suggesting
influential over the Vata is a marker here. The Vata and Kapha predominant food takers are
not away from the involvement of Rajas, thus the Maximum 70% patients of Niramisha
(vegetarian) food are observed with Anidra along with 30% patients Samisha. The result of
Nidra cap has nodding effect over the Niramisha takers with 66%.
Anger and intolerance are the twin enemies of correct understanding – Mahatma
Gandhi; with increasing industrialization and a faster pace of life developing countries like
India are also following the pattern set by western nations. A stressful life style resulting from
day to day problems of finance, education, family and inter personal relationships; as also the
demands of work, travel, insecurity of job and business; and an urge to exceed and
accomplish more than what already a person possess. All these lead to a degree of stress,
Mans best escape from the stress of life is provided by sleep and rest, recuperation
which it affords. Sleep occupies 1/3 of our lives and turns out to involve the basic biological
states of the brain and body. But sleep and getting enough of it is not a simple problem.
Chief Complaints:
patients having Difficulty in initiating sleep and Reduction in sleep time. Out of 80% were
of Vata and Rajo Dosha – sleeplessness/ disturbed sleep might be seen due to their Chala
Associated Complaints:
These associated complaints are due to Vata, Pitta and Rajo guna. Though some of
the symptoms like Akshi Gaurava, Shiro Gaurava etc. are seen as in Kapha Prakopa, even in
Nidranasha also they are witnessed, is due to Vata alone. It is observed that the Anidra
apakti, tandra and other Vata rogas, which may fall under different areas.
We have seen that proper sleep does have moderate physiological effects on the
peripheral body, for instance during wakefulness, there is enhanced sympathetic activity and
hence increases the muscle tone, conversely, during slow wave sleep sympathetic activity
decreases while parasympathetic activity increases. Therefore a restful sleep ensues fall in
blood pressure, respiratory rate and pulse rate and skin vessels dilate, activity of GIT
sometimes increases, muscles fall into a mainly relaxed state, and the over all basal metabolic
On the other hand, lack of sleep certainly does affect the functions of the central
the mind causing the above said symptoms. It is not necessary to have all symptoms in Anidra
patient, sometimes without these symptoms only there is disturbed sleep or sleeplessness.
A sound mind in a sound body has been recognized as a social ideal for many
centuries. In present study both the physical and psychological etiology are noticed. Majority
of patients are having the psychological implications are declared at results are of 89% of
Stress
Concerns about work, school, health or family can keep many patients mind too
active, making them unable to relax. Excessive boredom, such as after retirement or
during a long illness, may occur and also can create stress and keep patient awake.
Everyday anxieties as well as severe anxiety disorders may keep patients mind too
Depression
Patients may either sleep too much or have trouble sleeping if they're depressed. This
may be due to chemical imbalances in their brain or because worries that accompany
Stimulants
initially make the patients groggy, but they can worsen urinary problems, causing
Travel or working a late or early shift can disrupt patients’ body's circadian rhythms,
making them unable to get to sleep when they want to. The word "circadian" comes
from two Latin words: "circa" for "about" and "dia" for "day." Their circadian
rhythms act as internal clocks, guiding such things as there wake-sleep cycle,
Behavioral insomnia
This may occur when patients worry excessively about not being able to sleep well
and try too hard to fall asleep. Most people with this condition sleep better when
Having a light snack before bedtime is OK, but eating too much may cause patients
to feel physically uncomfortable while lying down, making it difficult to get to sleep.
Many people also experience heartburn, a backflow of acid and food from the
stomach to the esophagus after eating. This uncomfortable feeling may keep them
awake.
A change in activity
Patients may be less physically or socially active. Activity helps promote a good
night's sleep. Some patients may also have more free time and, because of this, drink
more caffeine or alcohol or take a daily nap. These things can also interfere with
sleep at night.
A change in health
depression, anxiety and stress can interfere with sleep. Older men often develop
can cause the need to urinate frequently, interrupting sleep. In women, hot flashes
Ayurveda lays down the hypothesis that physical life depends largely on the psychic
life. The development of all the limbs of human body merely follow the mind which under the
control of Vata. Charaka say’s that “Sarvaangnaam hi asya hrudayam moolam” (Ch.Sa 6/30).
limbs to rest physically at sleep. Sleep occurs during the sensory and motor faculties are
fatigued by day work. The fatigue faculties become sluggish in their work and will lose their
objects and the functions of the mind also blocked by the increase of Tamas. Mind gets
detached from the faculties and its action of engaging the faculties ceases. When there is over
Now to discuss how Vata and Tamas are involved in causing Anidra. Jean Martin
Charcot says that – disease is very old and nothing about it has changed, it is we who change,
as we learn to recognize what was formerly imperceptible. There are many theories are
explained to understand the induction of sleep which are mentioned in the earlier while
explaining the contemporary concepts. By observing all these the conclusion can be drawn
that, there are some centers in the brain which are responsible for causing induction of sleep.
The theories are going on changing as the science and technologies advances. There is
no end for the science which is like flowing river stagnant water goes and new water comes.
Here, I tried my level best to record all the up date knowledge in my dissertation. According
to Ayurveda Vata vriddhi is the main cause for the Anidra, after proper analyzing we see that
mastishka and vatavahasrotases (brain and nervous system) are the important seats of Vata in
respect to its two functions viz., gati and gandhana i.e., motor and sensory functions.
Even though the mastishka is the main seat of Vata, to execute the two main functions
viz., gati and gandhana, the Vata has to move through the vatavaha srotasses to reach the
target organs throughout the body. These vatavaha srotases can be divided into two varieties
according to the function viz. 1) Chestravaha srotases – to conduct motor function and 2)
So Manas is stated as ubhayatmaka. While describing the Anidra Samprapti, we have seen
that both daihika and manasika nidanas leads to Vata vriddhi and tama kshaya i.e., kshaya of
Kapha and tama avarana to the chetana hrudaya/sanjnavaha srotas. Vatavriddhi indicates the
involvement of mashtishka. Even the modern theories say the involvement of sleep centers at
brain.
When we go through Sensory functions of Vata as Vata stimulates all sensations. The
information about the artha from sense organ is carried to the Manas and Buddhi (cortical
centers) for nischayatmikajnana. The receptive impression of the artha on the sense organs is
transformed into the nerve impulse in the organ and carried through the sanjnavaha srotas via
In Charaka Samhita for induction of sleep it is said that when the mind gets exhausted
or becomes inactive, the sensory and motor organs become inactive then the individual gets
sleep. When Vata gets increased the above told phenomena will not takes place leading to
Anidra.
Somnus Rasayana
Previously it was believed that reticular activating system (RAS) located in upper
brain stem is the main area responsible for sleep. When the person remains active the area
within RAS remains excited and long continued excitation produces fatigability in that area,
when the RAS becomes fatigued, at the same time it becomes inactive and sleep manifests.
But it has been proved that an active inhibitory process causes sleep and stimulation of some
specific areas of brain can produce sleep with characteristics near to those of natural sleep.
mechanism of sleep and catecholamines are considered to be responsible for wakefulness. The
blood concentration of serotonin becomes lower during sleep than awakefullness cholinergic
neurotrasmitters also play an important role in REM sleep generation. A variety of sleeps
promoting substances have been identified. They are prostaglandin D2 delta sleep inducing
peptide, maramyl dipeptide interleukin -1, fatty and primary amides and melatonin. The
peptide increases the REM sleep, the prostaglandin D2 and interlukin -1 acts immunologically
to induce sleep. This fact suggests a link between immune function and sleep wake state.
The ancient Greeks endorsed the sleep to God Hypnos (sleep), the child of darkness
and night and the brother of death, whose power as he swept across humanity was so great
that even the gods succumbed to him. Even in our mythology we found the “Nidra Devata” as
As we understand, the Sleep is a periodic functional state of man and higher animals,
purposeful activity and sensory interaction with the environment and the Sleep is
Satva, Rajas and Tamas are the three major or universal attributes that pervade the
universe. Onset of sleep is related to the increases of Tamas always. These said principles
predominated by Tamas. This dark environment naturally increases the Tamas in human
muscles, the need for which recurs periodically. The stages of sleep have been variously
defined in terms of depth (light, deep), EEG characteristics (delta waves, synchronization),
that, the satvika purusha with less tamas, who wants achievement in life, thinks that “If I
sleep, the world will move front, leaving me behind”. But dear, friends to maintain both
person spends approximately 1/3 of his life in sleep. Adequate sleep is a necessity of life. A
significant number of individuals complain of lack of sleep, insomnia; and the use of
the availability of large number of such preparations in the market and the high incidence of
Chikitsa i.e., which acts over both mind and body such a medicament has to be involved. Both
abhyantara and bahya Chikitsa and the manasika upacharas play an important role.
withanolides are believed to account for the multiple medicinal applications, stimulates the
immune system and also been shown to inhibit inflammation and to improve memory.
Pippalimoola is a Vata hara and deepaniya. Thus the four rational drugs made combination
(Nidra cap) is able to subside the symptoms of Anidra and induces the good sleep.
The parameters show High Significance in both the groups. Among the subjective
parameters the Nidra cap group shows more High Significance than the placebo group.
Among the objective parameters the Nidra cap group shows High Significance than the
placebo group in all the parameters by comparing the t-values. The parameter efficiency of
sleep is High Significant in Nidra cap group than placebo group with more mean effect and
Ayurvedic herbal alkaloid extractions require Animal experiments for sleep patterns
On the basis of the study “Management of Anidra with Nidra caps - a placebo
Nidra is an essential phenomenon for maintenance and restoration of the life, which is
considered under Trayopastambha. Adequate sleep is critical to good health, yet many adults
have sleep related problems that prevent them from getting adequate sleep. Many Foundations
working for sleep disorders say that at least 1/3rd people of the world suffer from sleep
Nidra is inversely proportional to the age, as age advances the sleep decreases, i.e.
sleep often becomes less restful as age progresses. But, a lack of restful sleep is not normal
time and associated symptoms of Anidra. Some simple changes in your daily routine and
How much sleep is enough varies from person to person. Although 7 1/2 hours of
sleep is about average, some people do well on four to five hours of sleep. Other people need
nine to 10 hours of sleep each night. Nearly everyone has occasional sleepless nights, perhaps
Patients may either sleep too much or have trouble sleeping if they're depressed.
Prescription drugs, including some antidepressants, high blood pressure and corticosteroid
medications, can interfere with sleep. Most people with this condition sleep better when
Activity helps to promote a good night's sleep. Sleep occurs during the sensory and
motor faculties are fatigued by day work. Even the modern theories say the involvement of
sleep centers at brain. Proper sleep provides balance of the body constituents, alertness, good
vision, good complexion, fired digestive power as well as happiness, vigor, virility, nutrition
and long life. According to modern science, sleep is said to nourish and repair the damages to
When we go through Sensory functions of Vata as Vata stimulates all sensations. The
blood concentration of serotonin becomes lower during sleep than wakefulness’ cholinergic
neuron-transmitters also play an important role in REM sleep generation. A variety of sleep
promoting substances has been identified. The peptide increases the REM sleep, the
prostaglandin D2 and interlukin -1 acts immunologically to induce sleep. This fact suggests a
Insomnia can affect not only patients’ energy level and mood, but also patient’s health
as well because sleep helps bolster patient’s immune system. Fatigue, at any age, leads to
Here in the study, out of the 30 patients of Anidra studied exhibits each 26.7%
patients belong to 50 to 60 and 20 to 30 years age group. 50 to 60 age group data denotes
the age stage of Vata. Increased efforts to obtain sleep can it self induce sleep with timely
management of Anidra. Religion is not a marker of the sleep disturbances. Occupation has a
good role in the induction of sleep naturally. People who are well tired gets sleep well. The
role in the pathogenesis of Anidra. Manasika Nidanas as well as Psychic stress are the main
patients having Difficulty in initiating sleep and Reduction in sleep time. Out of 80% were
having Wakefulness during sleep as complaint. It is not necessary to have all associated
symptoms in Anidra patient, sometimes without these symptoms only there is disturbed
sleep or sleeplessness.
the drugs having tranquilo-sedative and muscle relaxant effects provided added beneficial
Onset of sleep is related to the increases of Tamas always. A normal person spends
approximately 1/3 of his life in sleep. Adequate sleep is a necessity of life. Among the
subjective parameters the Nidra cap group shows High Significance than the placebo group.
The present study is entitled “Management of Anidra with Nidra caps - a placebo
Who needs sleep?” every body! I won’t sleep is a complaint of many patients at
clinics. Adequate sleep is a necessity of life. Sound restorative sleep is the foundation of a
healthy life among three sub-pillars diet, sleep and celibacy. According Ayurveda sleep is
induced by the increase of the inert universal attribute called Tamas. Sleep is characterized by
the inhibition of conscious mental activity. Onset of sleep is related to the increase of Tamas
and Kapha. This stage is called sleep, even in sleep mind maintains its connection with the
soul. Achara Rasayana gives rise regularized sound sleep and vice versa the regularized sleep
Naturally the night is described as a proper time for sleep. During sleep most bodily
functions are reduced their basal levels. Sleep does have moderate physiological effects on the
peripheral body. Gastric secretion is increased or little altered during sleep. Many disorders
are associated with abnormal patterns of sleep. Sleep depends upon the utilization of oxygen.
Theories state that there is a sleep center in the hypothalamus, the stimulation of which is
responsible for sleep. According to Howell, sleep is due to cerebral ischemia. NREM sleep is
a peaceful state relative to waking state. In NREM type of sleep the brain waves are very
slow, so it is also called slow-wave sleep. Most sleep during each night is of slow-wave
variety and it is deep, restful type of sleep. Deep sleep is dreamless, dreams occur only during
light sleep and chiefly in the period, which just precede waking. The consumption of oxygen
is lowest during slow wave sleep. It has been postulated that slow wave sleep being more
of slow wave sleep to maintain synaptic connections which is necessary to maintain cognitive
parasympathetic activity increases. Probably the most distinctive feature of REM sleep is
dreaming. The depth of sleep is not constant throughout the sleeping period, but varies from
hour to hour.
Nidra is inversely proportional to the age, as age advances the sleep decreases, i.e.
sleep often becomes less restful as age progresses. Although 7 1/2 hours of sleep is about
average, some people do well on four to five hours of sleep. Patients may either sleep too
much or have trouble sleeping if they're depressed. Activity helps to promote a good night's
sleep. The peptide increases the REM sleep, the prostaglandin D2 and interlukin -1 acts
Any derangement of above can cause Anidra. Present study Anidra compared to
comparative clinical Trial of sleep inductive effect of the Nidra caps (trial drug) internally to
pacify the Dosha in Anidra and placebo to overcome the psychosomatic origin of the disease
The results in group A placebo study doesn’t show any well and moderate response
except one patient of well responded in general. The result is mainly poor responded with 7
(46.66%) patients and 7 (46.66%) patients of not responded. Increased efforts to obtain sleep
that the placebo doesn’t induce sleep. The placebo psychological effect of inducting sleep is
The group B Nidra caps study results are well and moderate response only but not of
either poor or no response categories. The result is mainly moderate responded with 11
(73.33%) patients and 4 (26.66%) patients of well responded. Thus it is a clear and evidential
that the Nidra caps has induced sleep. The Nidra caps effect is not only psychological but also
To compare the effectiveness of drugs in two different groups, with statistical analysis
is highly significant as P value <0.05. In the placebo group except the parameter difficulty is
initiating sleep all parameters are not significant. The parameter efficiency of sleep is highly
significant in Nidra cap group than placebo group with more mean effect and less variation.
All subjective parameters of the Nidra cap group shows high significance than the placebo
group in all the parameters. All objective parameters of Nidra cap group show highly
significance than the placebo group in all the parameters by comparing the t-values.
1) Kashinatha Sastri ed, Charaka Samhita, vol-1, sutra 11/35, Vidyotini Hindi
commentary, 18th ed, 2004, Choukhambha Sanskrit Samsthan, Varanasi, pp 160
2) Srikantha Murthy KR ed, Susruta Samhita, vol -2, Chikitsa 24/68, 2nd ed, 2005,
Choukhambha Orientalia, Varanasi, pp 235
3) Kashinatha Sastri ed, Charaka Samhita, vol-1, Nidana 6/9, Vidyotini Hindi
commentary, 18th ed, 2004, Choukhambha Sanskrit Samsthan, Varanasi, pp 652
4) Srikantha Murthy KR ed, Susruta Samhita, vol -2, Chikitsa 24/88, 2nd ed, 2005,
Choukhambha Orientalia, Varanasi, pp 234
5) http://www.holosticonline.com/her_home.htm
6) http://www.printgoogle.co.in/print%3Fq%3Dprimary%2Binsomnia%260i%3DprintG
sig=QaxNvyEgrDQMVssbgb
7) Kashinatha Sastri ed, Charaka Samhita, vol-1, sutra 20/11, Vidyotini Hindi
commentary, 18th ed, 2004, Choukhambha Sanskrit Samsthan, Varanasi, pp 399
8) Vaidya Baghel MS, Researches in Ayurveda, 2005, Mridu Ayurvedic Publication and
Sales, Jamnagar, pp 117, 20, 46, 43
9) P. V. Sharma, Dravyaguna Vijana, Vol-II, 16th ed, 1995, Chaukhambha Bharati
Academy, Varanasi, pp-64
10) Ibid, pp 31
11) Ibid pp 763
12) Ibid, pp 275
13) Kashinatha Sastri ed, Charaka Samhita, vol-1, Nidana 8/23, Vidyotini Hindi
commentary, 18th ed, 2004, Choukhambha Sanskrit Samsthan, Varanasi, pp 541
14) Ibid, Sutra, 11/35, pp 160
15) Ibid, 21/36, pp 283
16) Satyapal Bhishagacharya, Kashyapa Samhita Khila, 5/7, 2nd ed. 1976, Choukhambha
Sanskrit Samsthan, Varanasi, pp 256
17) Bhanoji Dikshit ed, Amarakosha, 1/7/36, 1st ed. Reprint, 2006, Choukhambha Sanskrit
Samsthan, Varanasi, pp 110
18) Brahmalinamuni ed, Patanjali Yoga Darshan, Samadhi pada, 10, 6th ed. 2003,
Choukhambha Sanskrit Samsthan, Varanasi, pp 40
19) Srirama Sharma ed, 108 Upanishad, jnanakhanda, Mandukyopanishat, 5, 4th ed.
2005, Parimala Publication, New Delhi, pp 362
20) Ibid, Chandyogyopanishad, 8/6/3, pp 188
21) Srikantha Murthy KR ed, Susruta Samhita, vol -1, shareera 4/33, 2nd ed, 2005,
Choukhambha Orientalia, Varanasi, pp 63
22) Kashinatha Sastri ed, Charaka Samhita, vol-1, Sutra 21/35, Vidyotini Hindi
commentary, 18th ed, 2004, Choukhambha Sanskrit Samsthan, Varanasi, pp 283
23) Srikantha Murthy KR ed, Susruta Samhita, vol -1, Shareera 4/34, 2nd ed, 2005,
Choukhambha Orientalia, Varanasi, pp 63
24) Yadavji Trikamji Acharya ed, Susruta Samhita, Dalhana Nibandha Sangraha, Sutra,
1/25, 4th ed, 1980, Chaukhambha Orientalia, Varanasi, pp 7
Management of Anidra with Nidra caps – Bibliographic References i
25) Ravidutt Trippathi ed, Astanga Sangraha, Sutra, 9/39, 1st ed. Reprint 2001,
Choukhambha Sanskrit Pratistan, Varanasi, pp 197
26) Srikanta Murthy KR ed, Sharangadhara Samhita, Poorva, 6/24, 1st ed. 1984,
Chaukhambha Orientalia, Varanasi, pp-30
27) Parashurama sastri ed, Sharangadhara Samhita, Poorva, Adhamalla, 6/24, 3rd ed.
1983, Chaukhambha Orientalia, Varanasi, pp-74-75
28) Srirama Sharma ed, 108 Upanishad, jnanakhanda, Chandyogyopanishad, 6/8/1, 7th
ed. Parimala Publication, New Delhi, pp 162
29) Ibid, Bruhadaranyakopanishad, 2/1/17, pp 268
30) Brahmalinamuni ed, Patanjali Yoga Darshan, Samadhi pada, 10, 6th ed. 2003,
Choukhambha Sanskrit Samsthan, Varanasi, pp 40
31) Srikantha Murthy KR ed, Susruta Samhita, vol -1, Shareera 4/34-5, 2nd ed, 2005,
Choukhambha Orientalia, Varanasi, pp 63
32) Srikanta Murthy KR ed, Astanga Hridaya, Sutra, 7/65 3rd ed. 1996, Chaukhambha
Krishnadas Academy, Varanasi, pp-121
33) Kashinatha Sastri ed, Charaka Samhita, vol-1, Sutra 21/36, Vidyotini Hindi
commentary, 18th ed, 2004, Choukhambha Sanskrit Samsthan, Varanasi, pp 283
34) Srikantha Murthy KR ed, Susruta Samhita, vol -1, Shareera 4/33, 2nd ed, 2005,
Choukhambha Orientalia, Varanasi, pp 63
35) Ibid, pp 63
36) Chatterjee CC, Human Physiology, Vol 2, 9th ed. 1983, Medical allied Agency,
Calcutta, pp 5-267-68
37) Arthur C gyton & John E Hall, Medical Physiology, 10th ed. 2001, Harcourt Asia PTE
Ltd, Singapore, pp 690
38) Ibid, pp 690
39) Kashinatha Sastri ed, Charaka Samhita, vol-1, Sutra 21/58, Vidyotini Hindi
commentary, 18th ed, 2004, Choukhambha Sanskrit Samsthan, Varanasi, pp 287
40) Yadavji Trikamji Acharya ed, Charaka Samhita, Chakrapani Ayurveda Deepika,
Sutra, 21/58, 1st ed. Reprint, 2004, Chaukhambha Sanskrit Samsthan, Varanasi, pp
119
41) Kashinatha Sastri ed, Charaka Samhita, vol-1, Sutra 21/37, Vidyotini Hindi
commentary, 18th ed, 2004, Choukhambha Sanskrit Samsthan, Varanasi, pp 284
42) Srikantha Murthy KR ed, Susruta Samhita, vol -1, Shareera 4/33, 2nd ed, 2005,
Choukhambha Orientalia, Varanasi, pp 63
43) Ravidutt Trippathi ed, Astanga Sangraha, Sutra, 9/68, 1st ed. Reprint 2001,
Choukhambha Sanskrit Pratistan, Varanasi, pp 201
44) Harishastri Paradkar ed, astanga Hrudayam, Sutra, 7/54, 7th ed, 1982,
Choukhambha Orientalia, Varanasi, pp 141
45) Kashinatha Sastri ed, Charaka Samhita, vol-1, Vimana 6/11, Vidyotini Hindi
commentary, 18th ed, 2004, Choukhambha Sanskrit Samsthan, Varanasi, pp 602
46) Srikantha Murthy KR ed, Susruta Samhita, vol -1, Shareera 4/33, 2nd ed, 2005,
Choukhambha Orientalia, Varanasi, pp 63
47) Dhamini Nirmal, Role of Manasa bhavas in Anidra and its management with certain
Indigenous drugs and shiro dhara, 2004, Manasa Roga Vibhaga, Jamnagar (L-2930
Baghel), pp 35
V/Mx
Food
Age
No Condition
M F H M C O S A L P Md Hg Hc
1 2534 + 28 V + + + NR
2 2656 + 30 V + + + PR
3 2676 + 52 V + + + PR
4 2757 + 23 MX + + + PR
5 2821 + 58 V + + + PR
6 2869 + 32 MX + + + WR
7 2874 + 22 V + + + PR
8 3933 + 43 MX + + + PR
9 3842 + 27 MX + + + NR
10 3866 + 59 V + + + NR
11 3865 + 34 V + + + NR
12 3863 + 33 V + + + NR
13 5038 + 50 V + + + PR
14 2509 + 29 V + + + NR
15 2812 + 45 V + + + NR
10 5 V=11 12 2 0 1 1 11 3 4 10 1 0 NR=7
Total MX=4 PR=7
WR=1
No Condition
M F H M C O S A L P Md Hg Hc
1 2210 + 69 V + + + MR
2 2515 + 65 V + + + MR
3 2368 + 55 V + + + MR
4 2472 + 40 MX + + + MR
5 2843 + 43 V + + + MR
6 3125 + 62 MX + + + MR
7 3001 + 28 MX + + + MR
8 2568 + 40 V + + + MR
9 3864 + 28 MX + + + MR
10 3882 + 50 MX + + + MR
11 4624 + 58 V + + + WR
12 4812 + 56 V + + + WR
13 5027 + 45 V + + + WR
14 2618 + 40 V + + + MR
15 2853 + 28 V + + + WR
8 7 V=10 9 5 1 0 1 12 2 3 8 4 0 MR=11
Total MX=5 WR=4
Management of Anidra with Nidra caps – Master Charts data of Trial- Annex-1 1
Subjective Statistical Assessment Data of Group – Placebo
S.No OPD Difficulty in Body ache Yawning Vitality after Performance of
initiating sleep (Angamarda) (Jrumba) morning daily activities
awakening
B A B A B A B A B A
1 2534 2 2 1 1 2 2 0 0 0 0
2 2656 1 0 3 3 1 1 1 1 1 1
3 2676 2 0 2 0 1 1 1 1 1 1
4 2757 2 1 1 1 1 1 1 0 1 0
5 2821 2 0 1 1 1 1 2 1 2 1
6 2869 3 0 1 0 2 0 2 0 2 0
7 2874 1 0 0 0 0 0 2 0 2 0
8 3933 3 2 2 1 2 1 1 1 1 1
9 3842 2 2 1 1 1 1 1 1 1 1
10 3866 1 1 1 1 1 1 1 1 1 1
11 3865 2 2 0 0 1 1 0 0 0 0
12 3863 2 2 1 1 1 1 0 0 0 0
13 5038 2 2 1 1 1 1 1 1 1 1
14 2509 2 2 1 1 1 1 1 1 1 1
15 2812 2 2 0 0 1 1 1 1 1 1
Total 29 18 16 12 17 14 15 9 15 9
Management of Anidra with Nidra caps – Master Charts data of Trial- Annex-1 2
Objective Statistical Assessment Data of Group – Placebo
S.No OPD Total sleep Sleep onset Number of Efficiency of sleep Sleep
time (hrs) latency (min) awakens (TST/TTSR * 100) Fragmental
Time (TST/ #
Awk)
B A B A B A B A B A
1 2534 6.5 6.5 120 120 2 2 70.2 70.2 3.25 3.25
2 2656 6 7.5 60 30 2 2 75 93.75 3 3.75
3 2676 3.75 5.5 120 30 3 1 62.5 91.66 1.25 5.5
4 2757 4 6 120 30 3 1 50 75 1.33 6
5 2821 4.25 6 120 60 3 1 60.71 85.71 1.41 6
6 2869 5.5 8 150 30 3 1 64.7 94.11 1.83 8
7 2874 5.75 6.5 60 30 3 2 82.14 92.85 1.91 3.25
8 3933 5.25 6.25 180 120 3 3 61.76 73.52 1.75 2.08
9 3842 5 5 120 120 2 2 62.5 62.5 2.5 2.5
10 3866 4.75 4.75 60 60 2 2 79.16 79.16 2.37 2.37
11 3865 5.25 5.25 120 120 3 3 65.62 65.62 1.75 1.75
12 3863 5 5 120 120 0 0 71.42 71.42 5 5
13 5038 4.5 5.5 120 60 3 3 64.28 78.57 1.5 1.83
14 2509 5 5 120 120 2 2 62.5 62.5 2.5 2.5
15 2812 4.75 4.75 60 60 2 2 79.16 79.16 2.37 2.37
Total 75.25 87.5 1650 1110 36 27 1011.65 1175.73 33.72 56.15
Management of Anidra with Nidra caps – Master Charts data of Trial- Annex-1 3
Chief & Associated complaints of Placebo
Complaints 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 T
8 Bhrama (Giddiness) + + + + +
9 Apakti (Indigestion) + + + +
10 Aruchi (Anorexia) + + + +
Management of Anidra with Nidra caps – Master Charts data of Trial- Annex-1 4
Examination of Sleep Data of Group – Placebo caps
S.No OPD History of sleep Sleep Bahya Manasika
Upashaya
points (11) Examination Karana karana
points (48) (Ahara-
Vihara)
B A B A B A B A B A
1 2534 1 1 5 0 5 1 2 2 0 2
2 2656 1 1 14 6 3 1 2 2 0 2
3 2676 1 1 5 0 5 1 2 2 0 2
4 2757 2 2 8 3 0 0 4 1 0 2
5 2821 1 1 3 0 0 0 3 1 0 2
6 2869 1 1 11 0 4 0 1 0 0 4
7 2874 1 1 22 0 0 0 5 2 0 2
8 3933 1 1 13 10 0 0 4 2 0 3
9 3842 1 1 4 4 0 0 4 4 0 2
10 3866 2 2 7 5 0 0 2 2 0 5
11 3865 2 2 4 4 1 1 3 3 0 3
12 3863 2 2 3 3 3 1 3 1 0 2
13 5038 2 2 5 5 0 0 3 3 0 2
14 2509 2 2 13 10 0 0 4 2 0 1
15 2812 1 1 3 0 0 0 3 1 0 2
Total 21 21 120 50 21 5 45 28 0 36
Mode of onset = 1-sudden /2- Gradual / 3- Insidious; Course of Anidra = 1-Transient / 2-continuous/; Frequency of Anidra
= 1-few days / 2- few weeks; Duration of Anidra = 1-continuous / 2- intermittent / 3- sleeps with medication; Preceded by=
1-Anxiety / 2-Anger / 3-Fear /4- restlessness / 5-pain / ; Change of Regularities = 1-Place / 2-Bed / 3-Environmental
Management of Anidra with Nidra caps – Master Charts data of Trial- Annex-1 6
Group –A (Placebo caps)
SN OPD.No Difficulty Body ache Yawning Vitality Performance Total Sleep Number Efficiency Sleep Total
in (Angamarda) (Jrumba) after of daily sleep onset of of sleep Fragmental mean %
initiating % % morning activities % time latency awakens (TST/TTSR Time (TST/
sleep % awakening (hrs (min % * 100) % # Awk) %
%) %)
%
1 2534 0 0 0 0 0 0 0 0 0 0 0
2 2656 100 0 0 0 0 20 50 0 10.8 21.5 21.05
3 2676 100 100 0 0 0 31.9 75 66.7 29.2 77.3 48
4 2757 50 0 0 100 100 33.4 75 66.7 25 76.7 40.2
5 2821 100 0 0 50 50 29.2 50 66.7 25 76.5 44.8
6 2869 100 100 100 100 100 31.3 80 66.7 29.5 77.5 78.5
7 2874 100 0 0 100 100 11.6 50 33.4 10.8 41.2 44.7
8 3933 33.4 50 50 0 0 16 33.4 0 11.8 14.3 20.9
9 3842 0 0 0 0 0 0 0 0 0 0 0
10 3866 0 0 0 0 0 0 0 0 0 0 0
11 3865 0 0 0 0 0 0 0 0 0 0 0
12 3863 0 0 0 0 0 0 0 0 0 0 0
13 5038 0 0 0 0 0 18.2 50 0 14.3 18 19.2
14 2509 0 0 0 0 0 0 0 0 0 0 0
15 2812 0 0 0 0 0 0 0 0 0 0 0
Total 583.4 250 150 350 350 191. 463.4 300.2 156.4 403 317.35
6
Mean 12.7 30.893 20.0133
38.89333 16.66667 10 23.33333 23.33333 7333 33 3 10.42667 26.86667 21.15667
Management of Anidra with Nidra caps – Master Charts data of Trial- Annex-1
7
Group –B (Nidra caps)
SN OPD.No Difficulty Body ache Yawning Vitality Performance Total Sleep Number Efficiency Sleep Total
in (Angamarda) (Jrumba) after of daily sleep onset of of sleep Fragmental mean %
initiating % % morning activities % time latency awakens (TST/TTSR Time (TST/
sleep % awakening (hrs (min % * 100) % # Awk) %
%) %)
%
1 2210 66.7 100 50 66.7 50 83.4 50 100 35.8 96.7 67.95
2 2515 50 100 100 100 100 16.7 66.7 33.4 11.1 46.7 62.5
3 2368 50 50 50 100 100 17.8 50 66.7 15.7 72.9 57.35
4 2472 100 66.7 66.7 66.7 66.7 25 83.4 100 21.9 75 67.25
5 2843 50 0 100 100 100 23 50 33.4 18.8 50.8 52.6
6 3125 100 0 0 100 100 27.3 80 100 18.8 63.7 59.3
7 3001 100 100 100 100 100 31.3 50 60 25 72.5 73.9
8 2568 50 0 0 100 100 28.6 50 75 25 82.1 51.05
9 3864 100 100 100 100 100 16.7 66.7 33.4 11.1 44.7 67.3
10 3882 100 100 100 100 100 31.2 50 60 25 72.5 73.9
11 4624 100 100 100 100 100 31.9 75 50 29.2 66 75.25
12 4812 100 100 100 100 100 28.6 80 50 26.7 64.3 74.55
13 5027 100 100 100 100 100 33.4 75 50 25 66.7 75
14 2618 100 100 100 100 100 38.5 50 33.4 31.2 60 71.35
15 2853 100 100 100 100 100 25 75 66.7 21.9 75 76.4
Management of Anidra with Nidra caps – Master Charts data of Trial- Annex-1
8
Special case sheet for “Management of Anidra with Nidra caps
- a placebo comparative study”
POST GRADUATE STUDIES AND RESEARCH CENTER (KAYACHIKITSA)
D.G.M.AYURVEDIC MEDICAL COLLEGE, GADAG
Guide: Scholar:
Dr. K. Shiva Rama Prasad Kamalaxi. M. Angadi
1) Name of the Patient Sl.No
7) Address
Pin
AM
Date Month Year Time
Hours Minutes PM
1 Tandra (Stupor)
2 Klama (Fatigue)
b) Examination of sleep
B A
1. Do you wake frequently during the night and feel un-refreshed in the morning?
2. Do you have difficulty staying awake during the day?
3. Do you have diabetes, hypertension or another health problem that affects your sleep?
4. Are you overweight? Do you find it difficult to lose weight?
5. Do you wake up with a dry mouth, sore throat or headache in the morning?
6. Do you have difficulty concentrating during the day?
7. Do you need to take naps during the day?
8. Does your snoring bother you or your spouse enough for you to consider treatment?
9. Doze off or fall asleep in Sitting and reading position
10. Doze off or fall asleep while Watching TV
11. Doze off or fall asleep in Sitting inactive in a public place
12. Doze off or fall asleep as a passenger for 1 hour without a break
13. Doze off or fall asleep in Lying down to rest in the afternoon
14. Doze off or fall asleep in Sitting & talking to someone
15. Doze off or fall asleep while Sitting quietly after lunch without alcohol
16. Doze off or fall asleep while stopping for a few minutes in traffic
0 = Never, 1= .Slight Chance 2 = Moderate Chance 3 = High Chance
B a l ab hr m s h a S l at h an ga t a
Nidrabhr a ms ha S was a
Pralapa K as a
B h r am a At i ni dr a
(b) Dosha Vata B A Pitta B A Kapha B A
Kshaya
Angasada Mandagni Bhrama
Alpabhashite Shareera Urah
ahitam sheetatwam shoonyata
Shira
Chesta heenata Prabha hani
soonyata
Vyamoha Hridrava
Sandhi
Sleshma vruddhi
saidhilya
Nadi V P K VP VK PK VPK
Prakruti V P K VP VK PK VPK
Sara Pravara Avara Madhyama
Samhanana Susamhita Asamhita Madhyma samhita
Pramana Height in Cms Weight in Kgs
Satmya Ekarasa Sarvarasa Ruksha Sneha
Satwa Pravara Avara Madhyama
Ahara Shakti Abhyavaharana Jarana
Vyayam Shakti Pravara Avara Madhyama
Vaya Balya Yauvana Vardhakya
Nadi Dosha Mutra
Pravrutti
Gati
Varna
Astasthana
Purnata
Gandha
Spandana
Kathinya
Jihwa Ardra Sushka Mala Sama Nirama
Lepa Nirlepa
Shabda Sparsha Sheeta Ushna
Drik Akruti
3 Yawning (Jrumba)
TST = TTSR
Compleation
Awakenings
Duration of
Awakening
Number of
– (Daw +
Going to
Latency
Falling
asleep
TTSR
Sleep
Sleep
Bed
SL)
1
before
2
3
1
After
2
3
1
Follow up
2
3
Investigators Note:
OPP. J. T. KALLYANAMANTAPA,
GADAG.
KAYACHIKITSA
How the food, water and air are essential for life, like that Nidra is also very much
essential. Sound restorative sleep is the foundation of a healthy life. A good night’s sleep is
undoubtedly one of the most precious gifts we can enjoy. It provides rest our needs. Rest is
the basis of activity. Hence, the Ayurvedic Acharya’s explained Nidra one of the
trayopasthambhas1. As health is the first muse and sleep is the condition to produce it.
insomnia is usually in young adulthood and middle age. It tends to increase with age and
affects about 40% of women and30% men 2 and about 25% of elderly people and 15 % of
3.
the general population suffer from this complaint This Nidranasha became a major
problem nowadays, due to altered life styles, busy schedule and stressful living conditions,
commonly available antidepressant drugs, sedatives, tranquillisers and hypnotic drugs. The
drawback with this approach is drug dependence, tolerance towards the drugs and
reoccurrence of the symptoms on withdrawal of the drug. Apart from these internal
medication, counselling, cognitive therapy, physiotherapy and meditation have also been
advised. Still we find no satisfactory and safe measures for Nidranasha in contemporary
medical science.
and ideal remedy from Ayurvedic treasure of therapeutics. A several herbs have been
study an attempt will be made to evaluate the efficacy of this drug preparation in Nidranasha
with a view to find out a therapeutically efficacious, safer, cost effective and easily available
drug 16,17,18.19,20.
2
6.2Review of literature
classical texts, only referred as one among the 80 types of vatavyadhi, 5,6 and mentioned as
a symptom in many diseases7. They have mentioned the relation of the doshas to Nidra. .
. Classical text mentioned the symptoms angamarda, shirogourava, jrumbha, jadya, glani,
While telling about merits and demerits of Nidra carak has mentioned, Happiness
and misery, obesity and leanness, strength and weakness, sexual vigour and impotence,
consciousness and loss of sensory activity, even life and death depend on the quantity of
A number of herbal preparations and plant extracts have been used with varying
Pippalimoola (Piper longum), when taken in combination induces sleep. Which are taken on
basis of rasa, guna, veerya, and vipak, and karma and their Nidrajanakatwa prabhav16,
17,18,19,20.
Vangasen has mentioned to give pippalimoola in Nidranasha due to jwara21.
3
6.2 Objectives of the study
c) To compare the Nidrajanaka prabhava (sedation) of placebo and Nidra cap in Anidra
a. Patients : Patients suffering from Nidranasha are selected from P.G.S and R.C
b. Literary : Literary aspects of the study will be collected from classical Ayurvedic
and modern texts, medical journals and information regarding the study will be
c. Trial drug: the trial drugs will be collected from the area where it is available
texts. To check the appropriativeness of rational combination limited no. of herbs are
included in Nidracap. Based on rasa, guna, veerya, vipak the rational combination is
formed16,17,18,19,20,21.
4
7.2 METHOD OF COLLECTION OF DATA
f) Exclusive criteria:
2 caps of 500mg or 15mg /kg body weight/24 hours, 1 hour before to retiring
5
i) Assessment of results:
Subjective and objective parameters of base line data to the after treatment data
j) Subjective parameters:
1. Angamarda
2. Shirogourava
3. Jrumbha
4. Jadya
5. Glani
6. Bhrama
7. Apakti
k) Objective parameters
parameters). The paired and unpaired T – test and non parametric test used for the
8. References:
1. Satyanarayan shastri ed, carak samhita, volume 1 sutra 11/35, vidyotini hindi
commentary, 22nd ed, Choukamba Bharati Academy, Varanasi, 1996, page no.227.
2. http://www.printgoogle.co.in/print%3Fq%3Dprimary%2Binsomnia%260i%3Dprint
Gsig=QaxNvyEgrDQMVssbgb
3. http://www.holistic-online.com/Remedies/Sleep/Sleep insomnia-herbs.htm
6
4. Guyton, Human physiology and mechanism of disease, 5th ed, W. B. Saunders
Company, Tokyo, 1992,page no.453.
5. Satyapal Bhishagacharya, ed, Kashyap samhita, sutra 27/28, Chaukambha Sanskrit
Samsthan , Varanasi, page no. 42.
6. Prof. K. R Shrikanta Murthy etd,Sharangdhara samhita, 7/112, 1st ed, Chaukambha
Orientalia ,Varanasi, 1984, page no. 40.
7. Kavivar Shri Shali Gramoji Vaishya ed, Vangasen hindi tika samhita 1/718,
Khenraj Krishnaadas prakashan, Bombay, 1996, page no. 64
8. Vaidya Jadavaji Trikamji Acharya ed, Susruta samhita ,sutra 1/25, 4th ed,
Chaukambha Orientalia, Varanasi,1980, page no.
9. Kaviraja Ambikadutta shastri, ed, Susruta samhita, sharira 4/32, part 1, 11th ed ,
Chaukamba Sanskrit Samsthan,Varanasi, 1996, pag no.34.
10. Prof. K.R Shrikanta Murthy ed,Sharangdhara samhita, 6/24, , 1st ed, Chaukambha
Orientalia ,Varanasi, 1984, page no. 30
11. P.V. Sharma ed, Astanghridayam, sutra 7/52, Sarvangsundara commentaryand
Vidyotini hindi commentary, 1st ed, Chaukambha Orientalia, Varanasi,1978 page
no. 116
12. Ravidutta Tripathi ed, Astang sangraha sutra 9/56, Saroj hindi commentary, 6th ed,
Chaukambha Bharati Academy, Varanasi, 2001 page no.200
13. Satyanarayan shastri ed, carak samhita, sutra 21/36, vidyotini hindi commentary
22nd ed, Choukamba Bharati Academy, Varanasi, 1996, page no. 418
14. Christopher Haslett ed, Davidson’s Principles and Practice of Medicine 18th ed,
Livingstone International, page no. 1093.
15. htpp//www.google.com/primary insomnia.
16. Dr. G. S. Pandey ed, Bhavaprakash Nighantu, Dr. K.C. Chunekar commentary,
Chaukambha Bharati Academy, Varanasi 2004 page no. 200, 240, 393, 16.
17. Dr. K. M. Nadakarni, Indian Metria Medica, volume 1, 3rd ed, Popular Prakashan,
Bombay, 1982, page no. 1260, 840, 1292, 965.
18. Bapalal .G. Vaidya, Nighantu Adarsha, volume 1, 1st ed, Chaukambha Bharati
Academy, Varanasi, 1985, page no. 737, 731.
19. Bapalal .G. Vaidya, Nighantu Adarsha, volume 2, 1st ed , Chaukambha Bharati
Academy, Varanasi, 1985, page no. 134, 345.
20. P.V Sharma, Dravyaguna Vijnana. Volume 2, 16th ed, Chaukambha Vishvabharati,
1995, page no.31,64,275,763.
21. Kavivar Shri Shali Gramoji Vaishya ed, Vangasen hindi tika samhita, 1/718, Shri
Khenraj Krishnadasa Prakashan, Bombay,1996, page no. 64.
22. Kaplon and Sadock’s , Synopsis of Psychiatry, 8th ed, 1998, B.I Waverly Pvt. Ltd,
New Delhi,page no.737 for sleep and its disorders.`
7
External application :
Kushtha, being exhibited through the skin, external application
are also advocated. For the external application drug should be applied
after elimination of the Doshas from the body by Shodhana Karma and
Raktamokshana. Various forms of local application are prescribed like
Udvartana, Pralepa, Parisheka, Abhyanga, etc. Kshara Karma and Agada
Karma are also prescribed in special condition of Kushtha.
1. SOMNUS RASAYANA
(NIDRA EFFECT IN INDUCTING THE RASAYANA EFFECT)
Author: Dr. K. Shiva Rama Prasad, M.D.(Ay), C.O.P.(German), M.A, Ph.D (Jyotish) 1
Co-Author & Presentation: Dr. Kamalaxi. M. Angadi2
Rasayana (Achara) gives rise regularized sound sleep and vice versa the regularized
sleep patterns induce Rasayana effect. Health is a first muse and sleep is the condition to
produce it. The goal of the Ayurvedic approach is to create more potent individuals through
increased Ojas (immunity), which is the finest end product of digestion & metabolism that
provides energy, enthusiasm, happiness, clarity of thinking, better coordination between the
body and mind. Only the sound most restful (stage IV) sleep generates Ojas. A sound quality
sleep provides ultimate rest to the mind and senses, with enhanced capacities of mental and
physical work ability forthe next day. On the other hand, lack of sleep vitiates & initiates Vata,
Ama (endo toxins), etc in the body.
Human requires the three fundamental objective fulfillments in his entire lifetime, “Trayo
Upasthambha” (Trayo upasthambha iti swapnoahara brahmacharyamiti) viz. Ahara (Food),
Brahmacharya (regularized sex act) and Nidra (Sleep) (cha.su11/35). Sleep is function of all
living beings. It is definite to say that “The best bridge between despair and hope is a good
night’s sleep”. As like the all essentials of life it is evidential that the Nidra is also very much
needed to attain the fulfillments of the individuals. Sound restorative sleep is the foundation for
healthy living, there by to construct a progressive society. A good night’s sleep is undoubtedly
one of the most precious gifts of the nature ever we are enjoying to give rise next days energy
boosted levels. Sleep is the basis of our day-to-day activity, hence, the Ayurveda explains
physiological and pathological Nidra in detail.
1
Professor, Department of Kayachikitsa (PG), Postgraduate Studies and Research Center, DGM Ayurvedic Medical
College, Gadag, BOS member, Calicut University, Kerala (+91-9448746450), doctorksrprasad@gmail.com
2
Final PG scholar, Department of Kayachikitsa (PG), Postgraduate Studies and Research Center, DGM Ayurvedic
Medical College, Gadag
1
In Shakespeare’s words the sleep is - indeed a positive thing, a reactive process, a
winding up of the vital clock, a recharging of life’s battery and “Chief nourisher at life’s feast”.
Three sub-pillars are diet, sleep and celibacy. If these three are fulfilled properly, the body is
supported well by these pillars, it continues well endowed with strength, complexion and
developments till the complexion of life span provided one abstains from harmful practices
which will be explained here itself (Cha. Su. 11/35)
Ahara
Ahara, partaking food confers satisfaction and immediate strength supports the body,
increases span of life, radiance, enthusiasm, memory, valiance and digestive capacity. (Su.Chi
24/38)
Nidra
Sleep enjoyed at the proper time bestows nourishment, good color (Complexion), and
strength, enthusiasm, keenness of digestive power, wakefulness and maintains normalcy of
tissues (Su.Chi 24/88).
Brahmacharya
The end product of ahara rasa is said as the shukra dhatu. Loss of shukra cause
marana i.e. death on the other hand dharana of sukra gives life. So the shukra is the bala
(strength) for purusha (human) (Su.Chi 24).
Hence, these three trayopasthmbha exhibits the importance of life and necessity of the
induction of the Rasayana effect in to the life. As we know that satisfaction alone is the cause of
Rasayana and the satisfaction of the Nidra gives raise the Rasayana effect.
Rasayana
Rasayana is the food, medicine or therapy, which nourishes Rasa and other Dhatu or
the medicine with the effect of its taste, potency or special properties bestows long life, strength
and retards ageing.
Charaka has opined the ‘Nidra’ (Ch. Su. 11/35) along with Chakrapani as ‘Upastambha’
as sub-post, which promotes the Rasayana. Posts mainly support a house, but sub posts add to
the supporting strength of such posts. In the same way, body is mainly supported by the acts
performed in the previous life, which determined the intake of food, sleep and Bramhacharya.
So they are known as secondary supports of life. It is observed that all the living creatures must
enjoy the sleep in quality and quantity to keep them fit. From the very birth the amount in hours
of sleep of newborn is maximum, it is because at sleep the baby grows. Bhavamishra has
mentioned that during the pregnancy, when the mother sleeps, the baby in womb enjoys better
rest and comfort - (B. P. 1st part, S.No. 317).
2
Susruta commenter Dalhana classifies Rasayana is as follows. Mainly Rasayana into
two folds as –
1. Kutipravesika Rasayana – residing in a specially built house and undergoing therapy.
2. Vatatapika Rasayana - undergoing therapy while moving about in wind and sunlight.
Further it is again of three kinds as-
1.Kamya Rasayana – desiring benefits such as long life, great intelligence, wealth etc
2.Naimittika Rasayana – consequent to diseases (either for treatment or for resuscitation)
Such as, use of recipes of Shilajatu, Bhalltaka, Tuvaraka etc in diseases like diabetes piles,
leprosy etc
3.Ajasrika Rasayana – habitual to be consumed daily such as milk, ghee etc.
Again it is of two kinds- Samshodhana (purification)-producing vomiting, purgation etc and
Samsamana- mitigates/alleviating the aggravated doshas or diseases.
NIDRA
In fact, Nidra looks like a glimpse of Pralaya, which carries peace but in darkness. After
this glimpse of Pralaya – man awakens fresh like Srujana. For the living beings in the world, it is
an essential phenomenon for maintenance and restoration of both – body and mind.
Since the dawn of the civilization the thinker of various countries in the world have tried
to study the sleep, its nature and causes. In India, from the Vedic and Upanishad period, the
Yogis have studied the Yogic phenomena pertaining to various stages associated with Atma.
They have termed these stages as Jagritavastha (waking state), Svapnavastha (dream state),
Sushuptavastha (sleep state) and Samadhi Avastha (the conscious sleep phase having
Detachment from the external world in different degrees).
In the Patanjali Yoga Sutra, the physiology of Nidra has been described as: Sleep is the
non-deliberate absence of thought waves or knowledge. Dreamless sleep is an inert state of
consciousness in which the sense of existence is not felt. In sleep, the senses of perception rest
in the mind, the mind in the consciousness and the consciousness in the being in the deep
sleep, the senses of perception cease of function because their king, the mind, is at the rest.
This is Abhava, a state of void, a feeling of emptiness (Samadhi Pada – 10 Yogasutras of
Patanjali).
The onset and progress of sleep as described in Brahmanopanishad, pertaining to Yoga
sutra runs as under: when the Chitta becomes exhausted, it goes inward the sense impulses
from worldly objects; hence the sleep is a resting phase of mind. At that time, there is absence
of the knowledge about the orientation of time and place. In this condition, it is believed that the
Chitta resides in the Medhya Nadi. When a person awakens from the deep sleep, it is the sense
3
of pleasure and sense of satisfaction. In Mandala Brahmanopanishad, the sleep is considered
as one of the five unwanted activities (Ma.Br.Up.pp274).
According to Lord Swaminarayana, Nidra is made for the rest of physical and mental
bodies, which get tired after the whole day’s work. Lord Shri Krishna have explained the
importance of proper sleep for a Dhyana Yogi in Bhagwadgita. According to him, excessive
sleep and ceaselessly awakening are also not good. (Shrimad Bhagvadgita).
Sleeping for six hours in the middle of the night and keeping awake during the first and
last quarters as well as during daytime, are generally considered as regulated sleep and
wakefulness. In the Ayurvedic classics and the later literature, the usefulness of sleep and its
role in the maintenance of health is elaborately discussed.
Similarly the botanists have observed that not only animals but plants also enjoy
recreation in the night by attracting the petals and leaves and flowers etc., at the time of sunset
and in the next morning relaxing and reopening (Sa. Ni. Page1142). The sleep is an indicator of
good health because it brings the normalcy in body tissue and relaxes the person. (B. P. Pu.
5/315; Y.R. Pu. 88). Untoward effects of various pathogenic conditions do not harass persons
residing in unhygienic locality but obeying the rules of diet, sleep and exercises. (Ka. Sam. Khi.
5/7).
Generally, the sleep comes during the night and at about the same time for a particular
duration everyday and as such in Ayurveda Nidra has been said to be Ratrisvabhava Prabhava
(Ch. Su. 21/58). According to Susruta, Nidra is provoked due to nature and considered as
Svabhavika Roga (Su. Su.24/8). Therefore, Ayurvedic authors have advised that a man should
not suppress this natural urge (Ch. Su. 7/4).
According to Charaka, the sleep occurring at night, as a natural phenomenon is a
nourishing phenomenon so it is termed as Bhutadhatri – that nurses all the living beings (Ch.
Su. 21/59). It is also called the ‘Vaishnavi Maya’ in a metaphoric language, which means that
Nidra provides the nutrition to the living body and maintains the health like Lord Vishnu, who is
the nourisher and maintainer of the world (Su. Sha. 4/32).
Though, the role and importance of sleep are very wider accepted even then if the sleep
is not taken appropriately and in appropriate quantity and irregularly, it may have adverse
effects on the body. Therefore, sleep should be watchfully enjoyed because the excessive sleep
causes various sins (Papma).
The control over sleep and wakening for the meditation is useful for the uplift of Atma.
The saints always prefer to keep awake at night for meditation, conversely person having
4
antisocial attachment do sleep during the daytime, which considered as one of the root causes
of many evils (Su. Sha.4/32).
Natural Instincts of life
In Shaligram Nighantu, four natural instincts of the living organisms are mentioned,
which are as under –
1) Desire to take the food
2) Desire to take the water
3) Desire to take the sleep and
4) Desire to take the sexual contact for pleasure.
These four are considered as the pioneers of the health (Bri.Ni.Ra.pp2&164).
Independently but an all-round rest for the entire organism is possible only when it goes to
sleep. The ancient seers of India have not only recognized the natural constructive power of
sleep, but have also attributed to it, a super natural power which beneficial for the health,
happiness and longevity. The modern science also confirming the function and physiology etc.
told by our ancient sages but still not come for any conclusion as sleep is concerned.
Finally, Manu, the great lawmaker of the world has ever produced, after describing the
small divisions of time, remarks that 30 Muhurta period (24 hours), are divided by the sun into
day and night; the day time is intended the activities and the night time is designed for the rest
and repose. The daily (Bio) rhythm of the life is thus a natural instinct related to the rhythm of
night and day existing in nature (Manu Smriti). By all above explanation it is said that proper
sleep induces the effect of Rasayana.
Proper sleep
Proper agni
Proper nourishment
Ojus
Hence, here it shows the effect of Nidra in inducting the effect of the Rasayana. In this
paper an attempt is made to evaluate the effect of Nidra in inducting the effect of Rasayana.
5
Many researchers claim that the sleep is psychosomatic in origin, thus a simple randomized
placebo clinical trial is studied. The results are as follows-
Rasayana effect assessment by Dhatu karma Lakshana
Dhatu karma Lakshana as told by Charaka emphasises the effect any drug involvement
over the dhatu. The lakshana with the effect of Nidra as Rasayana is as follows.
1 55.5 55.5
2 82.14 82.14
3 85.71 85.71
4 62.5 62.5
6
5 73.52 73.52
6 53.33 53.33
7 42.85 42.85
8 53.33 53.33
9 62.5 62.5
10 53.1 53.1
Total 624.48 624.48
Mean 62.43 62.43
Nidra – an essential phenomenon for maintenance and restoration of the life, which is
considered under Trayopastambha. Proper sleep provides balance of the body constituents,
alertness, good vision, good complexion, fired digestive power as well as happiness, vigor,
virility, nutrition and long life. According to modern science, sleep is said to nourish and repair
the damages to the tissues caused by various catabolic activities of the body.
7
Evaluation of Tamas in terms of RATR (Reticular Activity
Transmission Retardation) in Sleep patterns
Author: Dr. K. Shiva Rama Prasad, M.D.(Ay), C.O.P.(German), M.A, Ph.D (Jyotish) 1
Co-Author & Presentation: Dr. Kamalaxi. M. Angadi2
Introduction
biorhythms. Human requires the three fundamental objective fulfillments in his entire life
span, “Trayo Upasthambha” (§ÉrÉ EmÉxiÉqpÉÉ CÌiÉ AÉWûÉUÈ xuÉmlÉÉå oÉë¼cÉrÉïÍqÉÌiÉ|) viz. Ahara (Food),
It is definite to say that “The best bridge between despair and hope is a good night’s
sleep”. As like the all essentials of life, even the Nidra is also very much, and that is evidential
even. Sound restorative sleep is the foundation of a healthy life, there by to have a
constructive and progressive society. A good night’s sleep is undoubtedly one of the most
precious gifts of the nature we are enjoying freely. Sleep provides rest there by the energy for
our needs. Sleep is the basis of our day-to-day activity, hence, the Ayurveda explained
physiological and pathological Nidra in detail. As the health is a first muse and sleep is the
condition to produce it. Improper sleep leads to disease both physical and mental. Such sleep
is not emphasized on par with the present day available knowledge for better understanding
1
Professor, Department of Kayachikitsa (PG), Postgraduate Studies and Research Center, DGM Ayurvedic
Medical College, Gadag (+91-9448746450)
2
Final PG scholar, Department of Kayachikitsa (PG), Postgraduate Studies and Research Center, DGM
Ayurvedic Medical College, Gadag
What is Nidra (sleep)?
The ancient Greeks endorsed the sleep to God Hypnos (sleep), the child of darkness
and night and the brother of death, whose power as he swept across humanity was so great
that even the gods succumbed to him. Even in our mythology we found the “Nidra Devata” as
relative quiescence and by a great increase in the threshold of response to external stimuli
relative to the waking state. The definition is still far from being satisfactory; an absolute
definition is not yet available it is very much need of the hour to evaluate the facts related to
the sleep under the lime light of available science. Sleep is defined as unconsciousness from
which the person can be aroused by sensory or other stimuli. (Guyton). Sleep is a state of
altered consciousness or partial unconsciousness from which the person can be aroused.
(Tortora).
As we understand, the Sleep is a periodic functional state of man and higher animals,
purposeful activity and sensory interaction with the environment and the Sleep is
muscles, the need for which recurs periodically. The stages of sleep have been variously
defined in terms of depth (light, deep), EEG characteristics (delta waves, synchronization),
attribute called Tamas. The term Tamas literally means darkness. Satva, Rajas and Tamas are
the three major or universal attributes that pervade the universe. These three attributes or
dimensions play an important role in the functioning of the mind and even body, of them rajas
and Tamas are capable to vitiate mind (Manas). Because of their predominance’s affects and
afflicts the mind the mental diseases are resultant. On the other hand the satva increase cause
Onset of sleep is related to the increases of Tamas always. These said principles affect
inertia on general. Sleep usually occurs at night as the surroundings are dark and are
predominated by Tamas. This dark environment naturally increases the Tamas in human
beings according to the theory of generality. Apart from this the bioelectrical cells, which are
in the body, sustain the energy for activity in the day light by getting charged through Sun
light. At the night the Human is the only capable to generate Bioelectricity through the
activity of digestion (Jatharagni). At the darkness the person reserves the energy and wish to
retire as the activities are restricted and energy levels are inhibited.
The sensory and motor faculties are fatigued by day’s work. The fatigued faculties
become sluggish in their work and will loose their activity. They gradually withdraw from
their objects 1. The functions of the mind also blocked by the increase and influence of
Tamas. Mind gets detached from the faculties and its action of enjoying the faculties ceases.
This stage is entitled as sleep. But even in the sleep also mind maintains its connection with
Sleep is a natural function of Tamas where in both satva and rajas acts against the
sleep induction. Apart from sleep Tamas causes of fear, ignorance, depression and laziness
also. Satva represents cognition and enlightenment. It is the cause of awakening; Nevertheless
sleep is included among any natural diseases 3. Hence, the Satva is against the ignorant and
inert sleep. Rajas on par with satva represent action and hence, it is also a factor against to
sleep induction, where the physical and mental activities are subdued or restrained.
Ayurveda has different opinions regarding the types of sleep. Basically Nidra can be
classified into types viz. Svabhavika (natural) and Asvabhavika (abnormal). Out of the former
Svabhavika Nidra is regularly every night, which offers beneficial effects for the living
beings, whereas the later Asvabhavika is one can be due to different causes of pathological in
origin.
Charaka classifies the sleep condition into seven folds. He agrees with the ancient
authors who considered the sleep is Bhutadhatri. Sleep comes at night, spontaneously and
regularly as a natural instinct and that the other categories were either due to sin or the
1. Tamobhava Nidra
5. Agantuki Nidra
6. Vyadhyanuvartini Nidra
Generally the sleep is due to the effect of Tamas, but the Tamobhava Nidra as
particularly due to the excessive Tamas causing sleep. When Satva and Rajasa are diminished
in excess and the seat of Atma and Mana i.e. Hridaya is covered by the vitiated Tamas, then
the organization become inert or inactive. According to some scholars, the Tamodbhava Nidra
resembles with Sanyasa condition described by Charaka, which is the comatose state. The
sleep caused by Tamas is also the root cause for all sinful acts. Tamas always causes
excessive sleep. Thus, the individual is unable to perform the virtuous files and so he subjects
Sleshma is the material state of Tamas and as such the Sleshma and the Tamas are
having identical properties. When the Sleshma increases in the body the sleep ensues.
The person also gets the sleep as the result of exertion. Due to excessive mental stress
and strain, the mind gets tired and unable to perform its activities, as a result the animal gets
sleep.
The person also gets the sleep due to physical exertion. When a person indulges in
excess physical activities he feels too much tired. The body and mind desire to take rest and
5) Agantuki Nidra:
Sometimes the cause of sleep remains obscure and the cause is not explainable.
However, the sleep is followed by the death and as such Chakrapani has termed this sleep as a
6) Vyadhyanuvartini Nidra:
There are some diseases like Sannipata Jwara where severe weakness of the patient
and follows the condition just similar to coma. This type of sleep is termed as
Vyadhyanuvartini Nidra.
As has been stated earlier the sleep is a natural phenomenon and it comes at a
particular time in the night. There is no particular reason for this sleep and it is also termed as
Bhutadhatri. It has been observed that even the individual who has slept during the daytime
would also feel sleepiness in the night, which is quite a natural phenomenon.
Astanga Sangraha Vagbhata followed the Charaka’s view with a slight change in the
names. He also mentioned seven types. The commentator Indu opined that the Tamobhva is
Antya i.e. comes at the time of death and Agantuka means Shastra Praharadina (due to injury)
Astanga Hridaya Vagbhata considered only four types of Nidra and included the all
seven types in these viz. Akale sevitha , Ati prasangath sevitha, Nacha sevitha and Nishevitha.
The commentator Hemadri considered them as – The properly taken sleep brings happiness,
nourishment, strength, virility, knowledge and life to the individual. The improperly taken
other three types may kill the individual like the Kalaratri, who killed all demons. Acharya
Vaikariki Nidra.
1) Svabhaviki Nidra:
Svabhaviki Nidra is caused due to the Maaya or illusionary effect attached to the
power of Vishnu Maaya. Here, Maaya is a desire of the Manasa to get detached from the
worldly sensory objects on account of the tiredness of Manasa; and the seat of Manasa and the
Sleshma and Tamas cover Atman. This mostly happens in the night and individual gets sleep.
The Tamoguna dominant persons may go to sleep at any time i.e. day or night. But a person
having Rajoguna in excess may get sleep sometimes in the day or in the night, because of
Chalatva of Rajasa. The person having qualities dominated by Satva Guna sleeps at the
midnight. Because, at this time Tamas is excess and Satva will be decreased (Dalhana)
The term Papma has been used to describe the Tamobhava of Nidra and also to
2) Tamasi Nidra:
It is the lack of consciousness preceding the death. Tama dominant Kapha induces this
due to the blockage of Sanjnavaha Srotasa, and this Nidra cannot awaken individual.
3) Vaikariki Nidra:
This is a condition of insufficient sleep due to the decrease of Kapha and increase of
Vayu and also due to mental and physical pain, distress etc. the person doesn’t enjoy the
2,3
sufficient and sound sleep in quantity and quality . Disturbed sleep is also a type or
Vaikarika Nidra.
Instead of above seven fold classification we can make three types of classifications in
terms of tamas. As we seen that sleep is due to manodosha tamas, but here tamas means not
alone, the other manasika doshas are there i.e. according to Charaka vimansthana Dosha
anubhandhya anubhandha concept the nidra can be made into mainly three types.
Tamasika nidra
According to Susruta (shareera 4/32) another sets of Nidra viz. Tamasika Nidra is sleeps
both day & night, Rajayukta tamasika Nidra get sleeps either in the day or night and
Until some time back, it was held that the condition of a sleeping man (or animal) may
be compared to an individual deprived of cerebral hemispheres and capable only of the most
elementary sensory motor acts. This view has since been shown to be inaccurate largely
because the decorticated animal exhibits sleep wake rhythm. In addition there is also evidence
that in sleep several areas of the nervous system are in a quiescent state and such functions as
still are carried out on in a modified manner. The question is if certain parts of the nervous
system exercise a control over sleep awake rhythm or does the nervous system, as a whole,
respond merely to some outside influence, such as a toxin on to be reduced blood flow, has
been sought to be answered thus; there are neural structure in the tagmentum of the mid brain
which maintains a state of wakefulness, somnolence lasting several weeks has been produced
in monkeys by causing lesions between the posterior hypothalamus and the mid brain. The
structure in the tagmentum of the mid brain has been shown to be activated by collaterals of
afferent sensory neurons which in turn excite a wide spread effect on the cerebral cortex. The
existence of a corticofugal influence on the mid brain, by which afferent valleys of nerve
impulses may be prevented from having there influence on the cortex is considered to be a
possibility.
No satisfactory answer has, as yet been found to the question if assuming that, this or
neighboring parts of the nervous system is essential to the sleep-wake rhythm by what means
it periodically subsides into tranquity? In the view of authorities entitled to an opinion there is
a growing measure of support to the view postulated by parkinjee that sleep represents “a
that the cerebral blood flow does not appear to be reduced during sleep. This observation
should clear the prevalent notion that sleep is the outcome of cerebral ischaemia.
concerned with sleep, in the hypothalamus, which is also the center for the sympathetic and
parasympathetic. It has been shown that drugs, which suspend the activity of the sympathetic
center, caused apreponderance of parasympathetic effects including sleep. The view that sleep
The validity of this view, apart, which according to other authorities needs further
experimental corroboration the evidence for the participation of the hypothalamus, is the
causation of sleep is seen to be very strong. Nonetheless, contrary to the view, that sleep is
caused by the excitation of some part of the hypothalamus, some authorities hold that it
results from the depression of the hypothalamus. Thus the hypothalamus is considered to
Reticular activating system (RAS) is a physiological term denoting that part of the
brainstem reticular formation that plays a central role in the organism's bodily and behavioral
alertness; it extends as a diffusely organized neural apparatus through the central region of the
brainstem into the sub-thalamus and the intra-laminar nuclei of the thalamus; by its ascending
connections it affects the function of the cerebral cortex in the sense of behavioral
Yet another theory, the one advanced by Kleitman- holds that sleep is due to the
inactivity of the cerebral cortex, which arises from the reduction in the number of affarent
impulses, especially from the muscles, reaching the sensory areas. The factor which is
considered to bring about the reduction in the number of afferent impulses, especially from
the muscles due to fatigue of the neuromuscular mechanism which latter mediates muscle
tone & the consequential suppression of impulses from the proprioceptors of the muscles is
stated to be important.
Secondly, the exclusion of stimuli from the visual auditory and cutaneous receptors is
also an important factor, which is stated to lead to sleep. Not withstanding the above, it has
been recognized that cortical activity due to psychic causes viz. anxiety, worry, excitement
review of the concept of Nidra is essential. None of them are truly sufficient to explain their
phenomenon undoubtedly. However each one of them has contributed some facts, based on
either experimental or clinical observations. These are of values added studies along with the
concept of Nidra vividly described by Charaka, Susruta and Dalhana. The concepts of sleep
are –
1) Initially, in view of the fact finding the portion of Mastiska that is known as
the cerebra cortex is essential for sensory appreciation and voluntary movements in
the body. As both these capacities are reduced during sleep, recent investigators
looked in to the cortex for an explanation of sleep. Sleep results from a decrease in the
for impulses reduction has been attributed to the fatigue of the neuromuscular
support klama of Charaka, reference to fatigue of the mind. The klama or the fatigue
of body and senses leading especially to divorce of the sense objects from the senses
by implication. The affarent pathways are unable to conduct different kinds of external
agents such as light and sound, which also reduces the sensory barrage to the cerebral
3) Anxiety, fear, worry and elation of spirits, which tends to excite the cerebral
the Tamas.” This is proved with the sleep efficiency and sleep fragmented time calculations of
10 patients who underwent the insomnia and sleep pattern disturbances. The data is as
follows.
In this paper an attempt is made to evaluate the quantity and quality of Tamas in terms of
sleep efficiency and the Tamo-abhava (vitiation of tamas ) in terms of sleep fragmented
100
10 80 2
60
Sleep 40
9 3
efficiency 20
Sleep 0
fragmented
time 8 4
Conclusion:
Sleep is considered as one of the supporting pillars of life. Hence, Ayurveda offers
importance to proper sleep at the most. Its importance is equal to that of food and daily
routines along with regulated sexual act. Food and sex may mainly require maintaining one’s
own health and pleasure satisfaction but the sleep imparts both at once with relaxation. as
sex is essential for the continuity of human race. Ayurvedic treatises advocate various norms
for practicing sleep in proper manner. Acharyas (A.H.Su 7/53 & C.S.Su 21/36) even told that
sleep is the root cause of pleasure, pain, proper nutritional status, emaciation, strength,
weakness, sexual power, impotency, knowledge, ignorance, life and death. It is interesting to
note that sleep can produce favorable and unfavorable results even. Favorable results are
practice of sleep. One should sleep in time for the required period, lest he may fall victim to
diseases (C.Su.21/37). So, one should not indulge excessive sleep and should resort to
untimely sleep.
that, the satvika purusha with less tamas, who wants achievement in life, thinks that “If I
sleep, the world will move front, leaving me behind”. But dear, friends to maintain both
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