Author: Prof. Sanjeev Rastogi State Ayurvedic College and Hospital, Lucknow

1. Sleep Medicine : What Ayurveda Can
Contribute?
Prof. Sanjeev Rastogi
State Ayurvedic College and Hospital, Lucknow

2. When This is Dark
What comes to our mind first
Let’s Sleep………Its time to sleep

3. Sleep Has a Dark Connection
 From evolutionary biological perspectives day light allows us to get
involved in activities essential for survival
 Food Procurement
 Defense
 Observed in plants also
 Heliotropic movements
 Photosynthesis
 Almost every physiological activity in a living cell has a circadian
rhythmicity responding to dark and light cycle of nature

4.  Biological clock works in unison with natural clock
 The trigger for setting of the biological clock in tune to natural clock is Dark and light
 Besides circadian, there are ultradian rhythms too which govern our entire physiology
The Two Guiding Clocks
Biological Clock
Natural Day Night Clock

5. Hormones Status in Day Status in Night Function
Cortisol ↑ ↓ Defense
Insulin ↑ ↓ Glucose
Metabolism
Leptin ↓ ↑ Appetite
suppression
Ghrelin ↑ ↓ Appetite
enhancer
Testosterone ↓ ↑ Sex drive ,
Sperm Quality
Melatonin ↓ ↑ Sleep induction
Tuning of Biological Clock to Natural Clock

6.  Our temporal physiology and behavior is primarily regulated by the circadian pace maker
located in the hypothalamic supra-chiasmatic nucleus (SCN)
 Rhythms are generated in cells by auto-regulatory transcription/translation feedback
loop, composed of several clock genes and their protein products.
 Clock genes produce proteins in rhythm with the planet’s daily rotation from light to dark
 Clocks operating in cells are fundamental to health
 When clocks are disrupted, metabolic disorders can develop
How This All is Regulated?

7. Disharmony of Clocks : The Cause of All Evils ?

8.  ब्राह्मे मुहुर्ते उत्तिष्ठे जीर्ााजीर्े निरूपयि - Get up early in the morning
 कालस्र्तथोचिर्त: निद्रा Timely and adequate sleep
 Ayurveda severely criticizes attempts of creating disharmony between biological and natural clock
 रात्रि जागरर् (Night awakening) - रुक्षं Increases vata
 दिवास्वप्ि ( Day time sleep) - स्स्िग्धं Increases kapha
 रात्रि जागरर् and दिवास्वप्ि are contraindicated
 In general
 In respective dosha predominance people and pathology
 रात्रि जागरर् and दिवास्वप्ि are presumed cause of many diseases related to respective dosha
( including Diabetes)
Ayurvedic Perception of Biological Clock in Tune to the Natural Clock

9.  Protect our selves in dark …. ?
 Give rest to our mind…. ?
 Give rest to our body ……..?
Why Do We Sleep ..?
 यिा र्तु मिसि क्लान्ते कमाात्माि: क्ल्मास्ववर्ता:। त्तवषयेभ्यो निवर्तावर्ते र्तिा स्वत्तपनर्त मािव:॥
ि.िू.२१/३५
 When mind is tired , the sense organs also get fatigued hence fail to receive the stimulus ,
a man then sleeps .
 Sleep is an active process cleaning our brain of all junk though a specific pulsatile
glymphatic mechanism which pumps out toxins from brain to neck lymphatic system.

10.  निद्रा is One of the three fundamental foundations of life called ियोपस्र्तम्भ
 As important as
 आहार
 ब्रह्मिया not the celibacy
निद्रा
ब्रह्मिया
आहार
Life is completely dependent upon these three
and in the absence of any of them, it can not exist
Ayurvedic Wisdom About Sleep

11. निद्रायर्तं िुखं िु:खं पुस्ष्ि कार्शया बलाबलम ।
वृषर्ता क्ललीवर्ता ज्ञािमज्ञािं जीत्तवर्तं ि ि॥ ि.िू.२१/३६
 िुखं िु:खं
 Happiness and Sorrow
 पुस्ष्ि कार्शया
 Nourishment and Emaciation
 बलाबलम
 Strength and Debility
 वृषर्ता क्ललीवर्ता
 Virility and Impotence
 ज्ञािमज्ञािं
 Knowledge and Ignorance
 जीत्तवर्तं ि ि
 Life and No life
A Contrasting combination of
features that are produced in the
presence or absence of good sleep
Systemic Effects of Sleep

12. िुख िंज्ञकम आरोग्यम, त्तवकारो िु:खमेव ि।
 Sleep disturbances are there in most physical and mental diseases
either as a cause or a manifestation
 Sleep is the primary indicator of quality of life
 Sleep is also the primary indicator of healing process.
 Sleep plays an important role in pain perception
Sleep
Pain
Sleep as an Inductor to िुख - िु:ख

13.  Ayurveda believes that sleep promotes nourishment (बृंहर्) and hence promotes
weight gain in general
 Sleep is recommended as a therapy for the emaciated people
 स्वप्िो हषा िुख शय्या.....ि.िू.२१/२९
 Those who wish to gain weight are advised not to remain awake in night
 प्रजागरं व्यवायं ि व्यायामं चिवर्तिानि ि।स्थौ्यम इच्छि पररत्यक्लर्तर्तुं क्रमेर्ासभ प्रवधायेर्त………..ि.िू.२१/२८
 Hypersomnia is considered as one important cause of obesity
 अचिवर्तिाच्ि कायाार्ां ध्रुवं िवर्तपार्ेि ि। स्वप्ि प्रिंगाच्ि िरो वराह इव पुष्यनर्त ॥ ि. िू.२१/३४
Sleep as promoter to Nourishment and Debility (पुस्ष्ि / कार्शया)

14.  Sleep is an important neuroendocrine
and glucose metabolism modulator
 Sleep loss results in metabolic and
endocrine alterations like : ↓ glucose
tolerance, ↓ insulin sensitivity, ↓ levels
of Leptin, ↑evening level of cortisol, ↑
Ghrelin, and ↑ hunger and appetite.
 sleep loss has ↑ risk of obesity.
This evidence is contrary to the ayurvedic concept
of sleep restriction as a promoter to weight loss
Sleep and Obesity: Current Evidences

15. • Sleeping less or more both
lead to obesity
• Sleep loss is associated with
increased appetite and hunger
• This may be the indirect cause
of increase in weight among
people who sleep less
Sleep: A Double Edged Effect

16. • Sleep is an immune booster.
• Sleep enhances the immune
related memory .
• Sleep promotes production of
undifferentiated T cells and pro-
inflammatory cytokines
बल-अबल
Sleep and Immune Function

17. Sleep as inductor of Virility and Impotence वृषर्ता क्ललीवर्ता

18. • Sleep ↑ the testosterone levels and
waking ↓ it.
• Testosterone and other steroid hormone
levels are linked with sexual drive and
performance .
• Sperm Motility decreases in less sleep
and also in over sleep
• Sperm Count decrease in less sleep and
also in over sleep
∩
Sleep as Inductor of वृषर्ता क्ललीवर्ता

19. Sleep deprivation affects cognitive
functions negatively
Neuropsychiatric Disease and Treatment
2007:3(5) 553–567
Enhanced problem solving skills after sleep are not
merely associated with mitigation of interference
in concentration but is actually related to the
mechanism of spreading activation in neurons
(recruiting more neurons for a set of problems)
Sleep as an Inductor of ज्ञाि - अज्ञाि

20.  अनिद्रा is caused by कु त्तपर्त वायु
 निद्राचधक्लय is the result of कफ वृद्चध
 Management plan for अनिद्रा is to ↓ वार्त and ↑ कफ
1. मदहषी क्षीरं स्वप्ि जििािां श्रेष्ठ: ि.िू. २५/४०
2. निद्रा घार्ते त्तपबेर्त क्षीरं स्वप्याच्िेष्ि कथो िर: िु.उ.र्तं. ५५
3. निद्रात्तवधारर्ार्त र्ति स्वप्िं िंवाहिानि ि॥ ि.िू. ७/२३
Ayurvedic Proposals for Managing Sleep Disorders
Milk specially the buffalo milk and body massage are
considered effective treatment for insomnia

21. • Milk is a rich source of Tryptophan, an
essential amino acid
• Tryptophan is a precursor for serotonin
which in turn converts to melatonin.
• Serotonin and Melatonin both are known
to enhance sleep and to relax the brain.
• Milk is also a direct source of Melatonin
Milk as a Sleep Inducer

22. Milk produced in night time when this is dark is exceptionally
rich in melatonin , the sleep inducer hormone
Night Time Milk or Milk in Night Time ?

23. अभ्यंगोत्िाििं स्िािं ग्राम्यािूपौिका रिा: ।
शा्यविं ििचधक्षीरं स्िेहो मद्यं मि:िुखम॥
मििो अिुगुर्ा गवधा: शब्िा: िंवाहिानि ि।
िक्षुषोस्र्तपार्म लेप: सशरिो वििस्य ि ॥
स्वास्र्तीर्ा शयिं वेर्शम िुखम कालस्र्तथोचिर्त: ।
आियवत्य चिरास्विद्रां प्रिष्िा या निसमत्ि:॥
ि.िू.२१/५२-५४
Ayurvedic Management for Insomnia
The idea is similar to the concept of sleep hygiene
It promotes practices and habits helpful in having a good night
time sleep and full daytime alertness

24.  अभ्यंग Massage
 उत्िािि Rubbing
 स्िाि Bath
 ग्राम्य आिूप औिक रि Kapha promotive food
 शा्यवि ििचध क्षीरं स्िेहो Kapha promotive
 मद्यं मि: िुखम
 मििो अिुगुर्ा गवधा: शब्िा: Good aroma , light music
 िंवाहि Kneading Massage
 िक्षुष र्तपार् covering the eyes
 सशरोलेप Head massage
 काय लेप Body rub and paste
 स्वास्र्तीर्ा शयिं वेर्शम िुखम comfortable bedding and linen
 कालस्र्तथोचिर्त: timely and adequately
Ayurvedic Wisdom of Sleep Induction and Sleep Hygiene

25.  Putting oil on scalp may induce sleep
 निद्रालाभ: िुखं ि स्याि मुस््िा र्तैलनिषेवर्ार्त’ ि.िू.५/८३
 Current evidences are suggestive of beneficial effects of head and body oil massage in
infants resulting in:
 Improved Growth
 Improved Sleep pattern
 Improved Sleep duration
 Improved Sleep Quality
Scalp Massage for Insomnia

26. Increases serum serotonin level
Produces meditation like state
Increases delta waves in brain
Has anti anxiety effect
सशरोधारा for the Management of Insomnia

27.  Ayurveda takes a due cognizance of natural and biological clock and
recommends the person to behave accordingly
 Ayurveda considers sleep as one essential condition of life .
 Ayurveda recognizes the systemic effects of sleep besides its relaxing effects
 Ayurveda criticizes the attempts to disharmonize natural clock and biological
clock and hence it criticizes night awakening and day nap.
 Ayurvedic treatments for insomnia are in tune to the idea of sleep hygiene and
are better than later at many places
 Simple remedies like head massage with oil and oil based shirodhara are
effective in sleep loss.
Key Message