Approach to Sleep Disorders in the Traditional School of Indian Medicine: Alternative Medicine II


Sedative herbs

Stimulant herbs

Acorus calamus Linn

Erythrina indica Lam

Aconitum ferox Wallb

Actaea racemosa (Linn) Nutt

Euphorbia hirta Linn

Alstonia venenata

Alangium begoniaefolium (Roxb)

Ferula sumbul

Anamirta cocculus (Linn)

Alstonia scholaris (Linn)

Fumaria officinalis Linn

Bassia longifolia Koen

Anacardium occidentale Linn

Garcinia mangostana Linn

Camellia sinensis (Linn)

Anemone obtusiloba

Humulus lupulus Linn

Cinnamomum zeylanicum c

Anthemis nobilis Linn

Hyoscyamus niger Linn

Coffea arabica Linn

Apium graveolens

Jasminum officinale Linn

Cyperus scariosus

Areca catechu Linn

Lactuca virosa Linn

Eryngium caeruleum Bieb

Artemisia capillaris

Lavandula angustifolia Mill

Heracleum candicans Wall

Avena sativa Linn

Leonurus cardiaca Linn

Ilex paraguariensis

Atropa acuminata Royle ex Lindl

Leucas lavandulaefolia Rees

Panax pseudoginseng WalIa

Azadirachta indica

Marsilea minuta Linn

Piper longum Linnd

Bacopa monnieri (Linn) Wettst

Melia azedarach Linn

Rivea corymbosa

Berberis vulgaris Linn

Melilotus officinalis Linn

Rosmarinus officinalis Linn

Blumea balsamifera DC

Melissa officinalis Linn

Selenicereus grandiflorus

Boswellia serrata Roxb

Myristica fragrans Houtt

Strychnos ignatii Bergius

Butea superba Roxb

Nardostachys jatamansi DC

Strychnos nuxvomica Linn

Calendula officinalis Linn

Nelumbo nucifera Gaertn

Taraxacum officinale

Calophyllum inophyllum Linn

Nepeta hindostana (Roth)

Theobroma cacao Linn

Cannabis sativa Linn

Nyctanthes arbortristis Linn
 
Canscora decussata Schult

Origanum majorana Linn
 
Capparis zeylanica Linn

Panax pseudoginseng WalIa
 
Cardiospermum halicacabum Linn

Papaver somniferum Linn
 
Carthamus tinctorius Linn

Passiflora incarnata Linn
 
Cassia fistula Linn

Perilla frutescens (Linn)
 
Catharanthus roseus (Linn)

Phaseolus trilobus
 
Cedrus deodara (Roxb)

Piper longum Linn
 
Celastrus paniculatus Willd

Piper nigrum Linn
 
Centella asiatica (Linn)

Pongamia pinnata (Linn)
 
Cichorium intybus Linn

Prunus amygdalus
 
Cinnamomum camphora (Linn)

Rauvolfia serpentine
 
Cissus quadrangula Linn

Scutellaria galericulata Linn
 
Citrus maxima (Burm)

Selinum vaginatum
 
Clerodendrum phlomidis Linn

Sida rhombifolia Linn
 
Clitoria ternatea Linn

Sonchus arvensis Linn
 
Cochlospermum gossypium

Stephania glabra Miers
 
Convolvulus pluricaulis Choisy

Strobilanthes callosus Nees
 
Cymbopogon citratus (DC) Stapf

Valeriana officinalis Linn
 
Cyperus rotundus Linn

Waltheria indica Linn
 
Datura stramonium Linn

Withania somnifera (Linn)
 
Delphinium denudatum Wall

Xylosma longifolium Clos
 
Eclipta alba (Linn) Hassk

Ziziphus jujuba Mill
 
Elaeocarpus ganitrus Roxb
  

Latin names of the herbs are given in the alphabetical order in the table

aGinsenosides Rb and Rc are “diols,” while Rg is a “triol” (“triol” group is arousing; “diol” is sedative)

bRoots possess depressant activity, but after mitigation in cow’s milk for 2–3 days, they exhibit stimulant activity

cAt high doses

dPiperine is a CNS stimulant




Though Box 57.5 gives a long list, some of the herbs that are commonly suggested for treatment of insomnia by Ayurvedic physicians in India are Bijapoora (Citrus medica Linn), Kakajangha (Peristrophe Paniculata), Apamarga (Achyranthes aspera), Kokilaksha (Asteracantha Longifolia), Kantakaridwaya (Solanum xanthocarpum), Vasa (Adhatoda vasica), Kakamachi (Solanum nigrum linn), Punarnava (Boerhavia diffusa), and Vrntaka (Solanum melongeva).

Jeevaneeya Mahakashaya is a group of drugs that is given great importance in the original classics of Ayurveda. Jeevaneeya Mahakashaya means a group of substances that are extremely beneficial for life. The ten herbal drugs mentioned in Jeevaneeya Mahakashaya are Jeevaka, Rhshabhaka, Meda Madhura, Mahameda, Kakoli, Ksheerakakoli, Mudgaparni, Mashaparni, Jeevanti, and Madhuka. The drugs of this Mahakashaya have not been evaluated scientifically till date, though they are believed to be beneficial to sleep [59]. Decoction of Jeevaneeya group of drugs is administered with milk and ghee (melted butter), as per tradition. Herbs such as Acorus calamus (Vacha), Papaver somniferum (Ahiphena), and Rauwolfia serpentina (Sarpagandha) are used infrequently as it is believed that they have other effects. Ayurvedic drugs are given either orally or applied onto the skin. External application is given as much importance as oral medication. External application can vary from anointing to using it with body massage and bath. External application can be on the head or throughout the body. Application of herbal drugs on the head is one of the preferred treatments in sleep medicine. Valerian (Tagara), Piper longum (Pippalimoola), Citrus medica linn (Bijapooraka), Withania somnifera (Ashwagandha), Acorus calamus (Vacha), and Acorus gramineus (Bhutanashini) are some of the herbs where some kind of scientific evaluation for their use in sleep medicine is ongoing.


Valerian (Tagara)


The herb Tagara (known as Indian Valerian or Valeriana wallichi) is a perennial herb, found in plenty all over India, Pakistan, and Afghanistan. It is considered an important medicinal herb and is mentioned in all scriptures of Ayurveda. Valerian is one Asian herb which has been studied rather extensively using randomized placebo-controlled trials, mostly outside India [60]. There is a mild subjective improvement in sleep, especially when used for two weeks or more, though objective testing had shown less consistent results. One study has reported an increase in slow-wave sleep after consumption of this herb [61].


Root of Piper longum (Pippalimoola)


Root of Pippalimoola is usually administered with jaggery (Guda Pippalimoola). According to traditional belief, the powder of Pippalimoola boiled with Guda can be used as linctus to cure even chronic sleeplessness. Beneficial effects of this preparation on patients of insomnia are mentioned in a thesis submitted to a health university in Mysore (India) in 2010. The study showed that the administration of Guda Pippalimoola along with practice of yoga and diet regimentation gave the most beneficial effect. Though administration of Guda Pippalimoola with yoga was also beneficial to some extent, diet regimen alone did not show any positive effect. Sleep was not assessed on the basis of polysomnography in this study [62].


Citrus medica Linn (Bijapooraka)


Bijapooraka is an important plant of mentioned in Materia Medica of Ayurveda. Though its various parts are widely used to treat many ailments in traditional system of medicine, the powder of Bijapooraka leaves is used with honey to treat insomnia [63]. The leaf of Bijapooraka contains lysigenous cavities with the presence of oil globules, calcium oxalate crystals, paracytic stomata, and incomplete ring of sclerenchyma [64].


Withania somnifera (Ashwagandha)


Ashwagandha is a shrub cultivated in India and North America whose roots have been used for thousands of years by Ayurvedic practitioners as a folk remedy. Ashwagandha is consumed in various forms. In traditional medicine, its powder is mixed with sugar and ghee for consumption. In experimental animals, systemic application of the defined extract from Ashwagandha led to slightly enhanced acetylcholine esterase activity in the lateral septum and globus pallidus, whereas in the vertical diagonal band acetylcholine esterase activity was reduced [65]. Oral administration of Ashwagandha (100 mg/kg) prevented the rise in lipid peroxidation in stress-induced rabbits and mice [66]. In a clinical study, 18 apparently healthy volunteers received Ashwagandha capsules (aqueous extract, 8:1) daily in two divided doses with increase in daily dosage every 10 days for 30 days (750 mg/day × 10 days, 1000 mg/day × 10 days, 1250 mg/day × 10 days). Six subjects reported improvement in quality of sleep [67]. The most useful action of Ashwagandha is to reduce stress and perhaps indirectly aid in sleep.


Acorus calamus Linn. (Araceae)


Araceae, commonly known as “sweet flag” or “calamus,” is a semiaquatic, perennial, aromatic herb with creeping rhizomes. The plant is found in the northern temperate and subtropical regions of Asia, North America, and Europe [68]. Araceae rhizome and its constituents, particularly alpha- and beta-asarone, possess a wide range of pharmacological activities such as sedative, CNS depressant, behavior-modifying, anticonvulsant, acetylcholinesterase-inhibitory, memory-enhancing, anti-inflammatory, antioxidant, antispasmodic, cardiovascular, hypolipidemic, immunosuppressive, cytoprotective, antidiarrheal, antimicrobial, anthelmintic, insecticidal, adulticidal, diuretic, genotoxic, and mutagenic activities [58, 68]. Roots and rhizomes of Araceae prolong the behaviorally assessed “sleeping time” of mice and rats when used with pentobarbital, hexobarbital, and ethanol [69, 70]. The essential oil and alcoholic and aqueous extracts showed depressant action on normotensive mongrel dogs [71]. The hypnotic potentiating action has been claimed to be mediated through serotonin and catecholamines [72]. Alpha-asarone, one of the active principles of Araceae, potentiated the pentobarbital-induced-sleeping time periods by two- to threefold [73]. Assessment of sleep using electrophysiological signal has shown that alpha-asarone could induce sleep and decrease in body temperature in rats [74].

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Oct 7, 2017 | Posted by in NEUROLOGY | Comments Off on Approach to Sleep Disorders in the Traditional School of Indian Medicine: Alternative Medicine II

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