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Year : 2022  |  Volume : 10  |  Issue : 1  |  Page : 27-32

Understanding the pathophysiology of insomnia (Anidra) with special reference to primary insomnia using neurotransmitter sleep theories: a narrative review

1 Department of PG Studies in Kayachikitsa, Sri Sri College of Ayurvedic Science and Research, Bengaluru, Karnataka, India
2 Department of Integrative Medicine, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India

Correspondence Address:
Dr. Shruti Jhawar
Sri Sri College of Ayurvedic Research, 21st km, Kanakapura Road, Udayapalya P.O., Bengaluru 560082, Karnataka.
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/JISM.JISM_75_21

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Sleep is a primordial requirement for human sustenance and its role in health is inevitable. Despite its importance, inadequate sleep is one of the most common complaints across the globe. Ayurveda identifies Nidra (sleep) as one of the three supporting pillars of life and attributes its maintenance not only to health but also to longevity and prosperity; in contrast, Anidra (disturbed sleep) is one of the contributing factors for disease. Ayurveda clearly identifies the factors in Anidra which are vitiation of Pitta or Vata (fundamental humors of the body), Manasantapa (psycho-social stress), Kshaya (debilitating factors), or Abhighata (injury/trauma). Insomnia is characterized by reduced quality or quantity of sleep and has effects on the quality of life of the affected individual. It can be the difficulty of sleep initiation, sleep maintenance, or early morning awakening, which can have a significant impact on the daily activity of the individual. The contemporary science is yet to give a definite theory for the physiology of sleep and the pathophysiology of insomnia. The most widely accepted and researched concept is the role of neurotransmitters such as gamma-aminobutyric acid, serotonin, acetylcholine, dopamine, norepinephrine, melatonin and their effects in the regulation of sleep–wake cycle. These neurotransmitters and their effect on sleep physiology and pathology of insomnia need to be further explored in order to improve its management strategies. Hence, this review aims to determine the possible relation between the concepts of Nidra (sleep) and Anidra (disturbed sleep) mentioned in Ayurveda and these neurotransmitter sleep theories. This will help in improving the understanding of the pathophysiology of insomnia, developing Ayurveda management protocols for insomnia, and also in explaining the pharmacodynamics of Ayurveda drugs better. The method used for review is by sourcing and analyzing the available data from Ayurveda and contemporary literature on the topic in discussion.

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