Abstract

Dr. Amrita Kumari*, Dr. (Prof.) Satyendra Kumar Tiwari

ABSTRACT

Background: Nidra is described in Ayurveda as one of the Trayopastambha, essential for maintenance of life, health, strength, happiness and proper functioning of body and mind. Disturbance of Nidra leads to Anidra, which closely resembles primary insomnia in contemporary sleep medicine. Primary insomnia is now understood as a disorder of persistent hyperarousal involving cortical activation, hypothalamic-pituitary-adrenal axis dysregulation, autonomic overactivity, altered neurotransmitter balance and disturbed circadian-sleep homeostatic regulation.[1-4,10-13] Shirodhara is an important Moordhni Taila procedure used in psychosomatic disorders, stress and sleep disturbances. Takradhara and Snehadhara with Jatamansi Taila are traditionally indicated for calming the mind and promoting sleep.[14-18] Aim: To compare the clinical efficacy of Takradhara and Jatamansi Taila Shirodhara in the management of Anidra with special reference to primary insomnia. Materials and Methods: A randomized, double-arm comparative clinical study was conducted on 30 completed patients of Anidra/primary insomnia. Patients were randomly allocated into two groups of 15 each. Group A received Takradhara and Group B received Shirodhara with Jatamansi Taila. The procedure was performed for 30 minutes daily for 14 days, followed by assessment up to Day 28. The Athens Insomnia Scale was used for assessment of sleep induction, awakenings during night, early final awakening, total sleep duration, sleep quality, daytime well-being, daytime functioning and daytime sleepiness.[5,19] Results: Both interventions produced statistically significant improvement in symptoms of insomnia. Takradhara produced 62.86% relief in sleep induction, 61.29% in nocturnal awakenings, 71.43% in total sleep duration and 63.33% in sleep quality. Jatamansi Taila Shirodhara produced 54.55% relief in sleep induction, 58.06% in nocturnal awakenings, 56.25% in total sleep duration and 58.62% in sleep quality. Takradhara showed comparatively better improvement in total sleep duration, while other parameters were broadly comparable.[19] Conclusion: Both Takradhara and Jatamansi Taila Shirodhara are effective and safe non-pharmacological Panchakarma interventions for Anidra/primary insomnia. Takradhara appears more effective in improving total sleep duration, whereas Jatamansi Taila Shirodhara shows broad improvement in sleep-related symptoms. The findings support the Ayurvedic understanding of Anidra as a Vata-Rajas dominant psychosomatic condition and correlate with the modern neurobiological concept of insomnia as a hyperarousal disorder.