A.  Gandhi, a Chartered Accountant in his early forties looked quite haggard. Reason: for the past three months, he has been finding it increasingly difficult to fall asleep. Even if he could manage to sleep with a great difficulty, within a few hours, he would find himself wide-awake. He tried taking sleeping pills, which he bought over-the-counter, for a few days, but was afraid to be addicted to them if he continued having them for long. He approached us in pursuit of a safer alternative. 

Sleep needs in individuals vary remarkably and changes during the life cycle. For an adult, seven to eight hours of good sound sleep is sufficient. As one gets older, sleep diminishes to an average of five - six hours.

Sleep is the natural periodic suspension of ‘consciousness’ - the totality in psychology of sensations, perceptions, ideas, attitudes, and feelings of which an individual is aware. However, the modern science poorly understands the exact mechanism of sleep. 

Ayurved has explicitly described this process of awareness or wakefulness and sleep.  Atma (soul) is the spiritual principle embodied in human beings, which is the supreme destination of perception or awareness. Mana (mind) is a link between this atma and the senses received through indriya (sensory organs). Dissociation of this mana - atma link, caused by exhaustion and ultimate withdrawal of mana from its duty, impedes the perception attained by the atma, which results in to the sleep. This clearly highlight that the psychological, and not the physical exhaustion, induces sleep. 

Sleeplessness technically called as ‘insomnia’, becomes a serious problem when it affects daytime performance and behavior. Many complex physical and psychological interactions are responsible for 'Disorders of initiating and maintaining sleep', another term used to describe insomnia.

• According to ayurved, faulty increase of vata dosha, which hyper stimulate ‘mana’, is primarily responsible for sleeplessness.
• Medical problems like physical pain from arthritis, ulcers, migraines, angina, breathing disorders like asthma, and respiratory problems such as cold and cough, irregular heartbeat or palpitation, cramps in legs, increased frequency of urination due to diabetes mellitus, etc., may cause insomnia.
• Some medicines, such as stimulants, sedative, antidepressants, drugs acting on thyroid, contraceptives, etc. may cause insomnia.
• Alcohol consumption also causes disturbance in sleep. Both, sleeping pills and alcohol lead to fragmented sleep and frequent early awakening instead of good sound sleep.
• Disturbing environment can profoundly affect sleep. Too noisy, too cold or too hot bedroom can keep one awake.
• Consumption of food in too less or excess quantity at night, may awaken you in the middle of the night.
• Fear of insomnia itself is a main causative factor.

Mr. Gandhi was suffering from insomnia as a result of his anxiety related to the stupendous work pressure. He was recommended “shirodhara”, one of the ancillary procedures of panchakarma, which is very useful to treat insomnia, for three consecutive days.

He was also recommended six sessions of  “abhyanga” - a traditional ayurvedic medicated oil massage, once in a fortnight, to pacify the aggravated vata dosha. Further, Mr. Gandhi was advised 4 teaspoons of ashwagandharishta­- a generic medicine that reduces anxiety along with 250 mg. each of pimpalimoola churna and sarpagandha churna, to be taken after dinner. He continued this treatment for three months.

After the third day of shirodhara, Mr. Gandhi’s anxiety was considerably reduced and he could enjoy sound sleep.  He was recommended to continue taking ashwagandharishta, for further 3 months.       

Dos and Don’ts

• Avoid sleeping during the day.
• Get into the bed at a regular time.
• Avoid alcohol, especially at night.
• Avoid chocolates, coffee, tea, soft drink and smoking, especially in the evening. 
• Avoid eating a large, late-evening meal - and heavy, fatty foods before going to bed
• Take a hot water bath, an hour before bedtime.
• Exercise regularly during the daytime.
• Don't use your bedroom as a place to work
• Try reading, listening to soft music, etc. to ease your mental tension.
• Adopt stress management and relaxation techniques like, yoga and meditation. Shavasana, performed at bedtime ensues good sleep.

Sleep Tips

• Regular abhyanga (traditional massage) with oil, processed with medicinal plants, induces good sleep.
• Apply gogrhita (clarified butter) on soles and massage gently, before retiring to bed.
• Massaging til (sesame) oil processesed with bramhi and jatamansi on head.
• Have a glass of warm milk (especially buffalo’s), an hour before bedtime.
• Shirodhara (pouring of medicated oil continuously, in a stream on forehead, for around 40 minutes) and shirobasti (holding medicated oil, over head, with the help of a specially prepared cap, for around 15 – 30 minutes) are very effective techniques to treat insomnia.
• Nidrodaya vati, ahswagandharista, saraswatarishta, jatamasi churna, sarpagandha ghana, pimpalimoola choorna, etc., are useful in the treatment of insomnia, however they should be taken under medical supervision only. 

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The Itchy Hives

By - Dr. Prashant Sawant, M.D (Ayu.)

Article Published in “The Times Of India” on Saturday, January 9, 2004

Prajakta, in her early twenties, was irritated because of the intensely itchy rash on her forearms and stomach. The rash would flare up during any time of the day, last for a few minutes to an hour and disappear without a trace. It was becoming embarrassingly difficult for her to carry out her normal duties as a Public Relations Executive in a bank. The ordeal continued for more than six months during which she had to take anti-histaminic medicines on several occasions, which provided temporary relief from the annoying itch.  

Urticaria, commonly known as the “hives” or "wheals, are pale red swellings of skin that occur in groups on any part of the skin. Each such hive lasts for a few hours, before fading without a trace. New areas may develop as old areas fade. They can vary in size from as small as a small button to as large as a CD ROM. Hives usually are intensely itchy, but may also burn or sting.

Hives are very common. Around 10 to 20 percent of the population has at least one episode in their lifetime. Most episodes of hives disappear quickly in a few days to a few weeks. Occasionally, a person will continue to have hives for many years. Hives lasting less than six weeks are called "acute urticaria."  The most common causes are foods, drugs, insect bites, pressure, cold, sunlight or infections. Hives lasting more than six weeks are called "chronic urticaria". The cause of this type of hives is usually much more difficult to identify than that of an acute urticaria.

Almost any medication can cause hives. Some of those drugs include antibiotics, pain medications, sedatives, tranquilizers, and diuretics. Diet supplements, antacids, arthritis medication, vitamins, eye and eardrops, laxatives, vaginal douches, etc., can be a potential cause of hives.

Although the best treatment for hives is to find and remove the cause, it is often not possible. Antihistamines or steroids are usually prescribed to provide relief.

According to ayurved, such intensely itchy rash is called “sheeta pitta”. The disease is common during the winter season. Vitiation of all the three body humors (dosha), kapha dosha causing intense itching, pitta dosha causing burning or stinging and vata dosha causing rapid flare-ups, is responsible for the sheeta pitta (hives).

Prajakta was advised “Vamana”, one of the Panchakarma procedures, in which controlled therapeutic vomiting is induced, which cleanses toxins related with kapha dasha. She was also recommended to take a teaspoon of Haridra khanda, and tablet Arogyavardhini rasa, in a 2-is-2 dosage, to be taken after the break fast and dinner. Immediately after the vamana, itching and the eruptions were markedly reduced. The symptoms disappeared completely after a week. As a prophylaxis, she was advised to continue with the medicines for two more months.  

Dos & Don’t:

• Avoid viruddha ahara  (incompatible food combinations like fruit salad with milk or ice cream, milk with fish, etc.)

• Avoid nuts, chocolate, fish, shellfish, tomatoes, eggs, curd, and milk. Raw foods cause hives more often than cooked foods.

• Avoid too spicy, salty or oily food.

• Eat plenty of fruits and vegetables.

• Avoid exposure to allergens like molds, dust, fumes, chemicals, etc.

• Avoid exposure to cold air

• Avoid cold-water bath.

• Have cow’s milk, cow’s ghee, grapes, ginger, bitter gourd, serpent gourd, gourd, cucumber, lemon juice, wheat, lentils, green gram, honey, etc.

Useful Tips:

• Have 1/2 teaspoon of turmeric powder mixed with a teaspoon of honey after breakfast and dinner.

• Have 1/2 tsp. of black pepper with a teaspoon of ghee and half a teaspoon of honey after breakfast and dinner.

• Have half a teaspoon of dry ginger with a glass of warm water

• Apply sour buttermilk on the affected skin.

• Apply coconut oil, mixed with a little camphor on the affected skin.

• Have a glass of lemon juice mixed with a teaspoon of honey.

• The juice of coriander with candy sugar is useful.

• Soak overnight, a teaspoonful of fennel seeds in a glass of water mixed with a teaspoon of candy sugar (khadisakhar), strain the mixture and have it before breakfast.

• Generic medicines like kamdudha rasa, avipattikar churna, sarivasav, haridra khanda, maha manjishtadiquath,maha tikta gruta, etc., are useful to treat urticaria. However, these should be taken under medical supervision.

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