Efficacy of Mahanarayana Taila Matra Basti in Primary Insomnia (Anidra)-An Analytical Review

Introduction

Sleep is a naturally recurring state of mind and body. Insomnia is a sleep disorder that regularly affects millions of people worldwide. Insomnia disorder is defined as a subjective perception or complaint of inadequate or poor quality sleep due to a number of factors such as difficulty in falling asleep, waking up frequently during the night with difficulty in returning to sleep, waking up too early in the morning or unrefreshing sleep [3]. Insomnia is not defined by the numbers of hours of sleep a person gets. Insomnia is widely associated with medical and psychiatric conditions as well as with impaired quality of life and emotional functioning. It has also been associated with higher risk of developing chronic disorders [3].

Insomnia is the most commonly encountered sleep disorder and occurs 10-50% of the population [4]. Worldwide epidemiological studies assessed the prevalence of insomnia without restrictive criteria as 33% in general population [5]. When frequency was used to determine the presence of insomnia around countries, it was 17-34% [6]. On the basis of severity it was 18% [7]. According to the symptoms with daytime consequence, it is around 16%. Approximately 40% of adults with insomnia also have a diagnosable psychiatric disorder, most notably stress [8]. It is more common in women and in the people who work in shifts. Insomnia is less prevalent in Asians but increasing day by day due to stressful nature of work. Individuals with anxiety prone personality and depression are more susceptible for insomnia.

Management of insomnia, so far, is not up to the mark because medications available for insomnia are sleep inducing rather than treating the underlying cause. Benzodiazepines, Barbiturate, SARI are potent sleep inducing agents commonly used for insomnia has several adverse drug effects such as drug dependence, mood disorders, GIT disorders and sometimes depression. Many non- pharmacological remedies such as cognitive behavioral therapy are also used to overcome the adverse drug effects of insomnia but unfortunately incidences are increasing day by day.

Ayurveda has a very good approach towards the treatment of insomnia by both internal and external medications. In external treatment of insomnia most of researches were conducted on Shirodhara, Shiropichu, etc... Those effective in insomnia but that is costly and time taking process. Mahanarayana Taila is beneficial in condition of insomnia and it should be used in form of Abhyanga, Basti, Pana and Nasya. Proper administration of Basti enhances sound sleep, so Basti with Mahanarayana Taila is the appropriate therapy for this disease.

Drug Review

Mahanarayana Taila- Mahanarayana oil is a classical oil formulation which was formulated in SAR SANGRAH and BHAISHAJ RATNAVALI, CHAPTER 26, VATAVYADHI ROGADHIKARA, Verse: 343 to 354 & BHAVAPRAKASHA CHIKITSA. Letter it is also published in Ayurveda formulary of India in Second volume [9].

Physical Properties

Chemical Analysis

Discussion

Nidra is among the three important tripods of life (Ahara, Nidra, Brahmacharya) as per Ayurvedic Acharyas. Complete loss of Nidra is known as Nidranaash or Anidra. It is caused by Vata Vaigunya. Nidra is the Upastambha (sub- supporting pillar of life) that is essential in maintaining good health of a person. Happiness and sorrow, growth and wasting, strength and weakness, virility and impotence and the knowledge and ignorance as well as the existence of life and its cessation depend on the sleep [12]. Allopathic hypnotic drugs are useful for short term treatment in insomnia which is due to acute stage. Long term uses of certain classes of sedatives cause physical dependence, withdrawal symptoms and also have a number of side effects. Complaints of insomnia tend to be persistent or recurrent over time. Thus, it seems that patients with chronic insomnia need some form of treatment. Excessive consumption of food with dry property, barley, excessive exercise, fasting and intercourse, hunger, uncomfortable bed, improper induction of Vamana (emesis), Virechana (purgation), Nasya (nasal medications), Raktamokshana (bloodletting), Dhooma (medicated smoke) [13] are the main aetiological factors in producing Nidranasha. Psychological causes fear, anxiety, anger excessive sorrow, greed, agitation are also responsible for stress induced insomnia. Tamo Guna of mind along with Kapha Dosha helps in generating sleep. When our mind gets disturbed due to psychological factors like fear, anxiety, anger, excessive sorrow, greed agitation, there is increase in Rajo Guna which closely resembles with the Vata Dosha. Hence increase in Rajo Guna ultimately increases Vata Dosha & diminishes the effect of Tamo Guna ultimately leading to insomnia.

In Ayurveda, many therapies are used for the maintenance of health and eradication of diseases. Basti therapy is the best treatment of Vitiated Vata Dosha. Thus it normalizes the functions of different Srotasa as it clears the obstruction and allows free movement of bioenergetics through the channels. Thus it acts as Curative, Rejuvenative and Preventive measure. It cures all kinds of diseases due to its varied pharmacodynamics and various kinds of drugs used in its preparation.

Mahanarayana Taila has been selected as the trial drug in the present study. The drugs of Mahanarayana Taila have Prajasthapana, Rasayana, Balya, Brimhaniya properties which will corrects the all Dhatu and its Updhatu subsequently results in inducing good sleep. The drugs of Mahanarayana Taila possess anti-oxidant, adaptogenic, immune-modulatory etc… Properties which may help in relieving the stress and gives soothing effect to mind. According to Ayurvedic physiology Pitta and Kapha both are dependent on Vata as it governs their functions. Basti eradicates morbid Vata from the root along with other Dosha and in addition it gives nutrition to the body tissue [14]. Therefore, Basti therapy covers more than half of the treatment of all the disease [2], while some authors consider it as the complete remedy for all the ailments.

Matra Basti through rectum reaches instantly into systemic circulation thus has faster absorption and quick results. According to the modern science, there is no digestive action of fat or oil in stomach. The fat digestion and absorption takes place in large intestine and no food substances other than water and salt are absorbed from the large intestine not because it is not possible but the Chyme contains no absorbable substances by the time it reaches the large intestine. Basti drugs contain Sneha Dravya in sufficient quantity. Hence Basti drugs mixed with Sneha Dravya when introduced through the rectum get easily absorbed in large intestine. So Basti produces effective result in Insomnia.

Conclusion

According to modern science, sleep is said to nourish and repair the damages to the tissues caused by various catabolic activities of the body. Proper sleep provides balance of the body constituents, alertness, good vision, good complexion, fired digestive power as well as happiness, vigor, virility, nutrition and long life. Every upcoming challenge should be taken as an opportunity to grow and should be dealt peacefully. So Matra Basti with Mahanarayana Taila is cost effective, rapid absorped and no adverse effect processor i.e. superior to all other treatment.