Paper Details

Background: Nidra (sleep) is enumerated among the Trayopasthambha — the three sub-pillars that sustain the body — and its derangement, Anidra or Nidranasha, is a Vata-Pitta predominant Manasika-Sharirika vyadhi. Contemporary insomnia affects an estimated 10–30% of adults globally, and conventional hypnotics carry well-documented risks of tolerance, dependence and rebound insomnia. Tagara (Valeriana wallichii DC.) is a classically documented Nidrajanana and Medhya dravya whose use in Anidra has preliminary clinical support. Case presentation: A 38-year-old male information-technology professional presented to the outpatient department with an eight-month history of difficulty in initiating sleep, three to four nocturnal awakenings, non-restorative sleep, morning Shirogaurava, Jrimbha, Angamarda, Tandra and reduced work concentration. He had discontinued zolpidem four weeks earlier because of morning sedation and apprehension about dependence. Secondary causes were excluded by clinical assessment and laboratory investigation. He was diagnosed as a case of Anidra (Vata-Pittaja) corresponding to chronic insomnia disorder. Intervention and outcome: Tagara Churna 3 g twice daily with 100 mL lukewarm cow’s milk as Anupana was administered for 30 days, together with Nidana Parivarjana and structured sleep hygiene; no other Ayurvedic medicine or procedure was given. Sleep-onset latency fell from 105 to 18 minutes, total sleep time rose from 3.8 to 6.9 hours and sleep efficiency from 48% to 86%. The Pittsburgh Sleep Quality Index improved from 15 to 5, the Insomnia Severity Index from 20 to 7 and the Athens Insomnia Scale from 17 to 5. The composite Ayurvedic symptom score improved by 68.18%. Gains were largely maintained at the 30-day drug-free follow-up, with no rebound insomnia and no adverse event. Conclusion: Tagara Churna with Godugdha Anupana produced a clinically meaningful, well-tolerated and sustained improvement in chronic Anidra in this patient. The observation is consistent with the GABAergic and adenosinergic pharmacology of valerenic acid and valepotriates, and supports the conduct of adequately powered randomised controlled trials employing objective sleep measurement.

Anidra, Nidranasha, Tagara, Valeriana wallichii, primary insomnia, Nidrajanana, case report, Ayurveda, Pittsburgh Sleep Quality Index.