ANIDRA (INSOMNIA): CLASSICAL MANAGEMENT AND MODERN EVIDENCE FOR AYURVEDIC SLEEP INTERVENTIONS
Background: Insomnia is one of the most common sleep complaints and a recognised risk factor for depression and other mental disorders. Charaka counts sleep (Nidra) among the three supports of life (Trayopastambha) and describes the causes, consequences and management of sleeplessness (Anidra) in detail. Objective: To review the classical Ayurvedic understanding and management of Anidra and to evaluate modern evidence for Ayurvedic and related sleep interventions. Methods: Narrative review of classical texts, clinical guidelines on insomnia and published trials and meta-analyses of Ashwagandha, Shirodhara, yoga and other interventions. Results: Ayurveda attributes Anidra mainly to aggravated Vata and Pitta, mental factors such as worry, fear and anger, and irregular routine, and treats it with oleation and massage, Shirodhara and other head therapies, nourishing diet, milk and ghee preparations, Medhya and sleep-promoting herbs, and lifestyle regulation. Among these, Ashwagandha has the strongest evidence: a meta-analysis of randomised trials found a small but significant improvement in overall sleep, larger in people with insomnia and at doses of at least 600 mg per day for eight weeks or more. A randomised crossover pilot study suggested sleep benefits of Shirodhara with sesame oil compared with warm water. Yoga improves self-reported sleep quality in meta-analyses. Conclusion: Ayurveda provides a coherent, largely non-pharmacological framework for insomnia that aligns with modern sleep hygiene and behavioural principles. Ashwagandha and yoga have supportive evidence; Shirodhara and classical formulations need larger controlled trials.Keywords: Anidra; Nidranasha; insomnia; Ashwagandha; Shirodhara; Trayopastambha; sleep hygiene