A REVIEW ON NIDRA: UNDERSTANDING IT THROUGH THE LENS OF VEGA

Introduction

          Considering that a person sleeps 7-8 hours a day, in full lifespan he would be spending about 26 years for sleeping and 7 years trying to sleep. This takes up almost one—third of our lives. Sleep is defined as unconsciousness from which the person can be aroused by sensory or other stimuli. [1] It is well known that sleep is much required to sustain physical, mental and emotional well-being. Afterall, it is during the period of sleep that our body replenishes itself. Even culturally and historically, sleep has been acknowledged as an important part of life. The current generation neglecting sleep for education, career, entertainment and other reasons are putting their health at great risk.

       In Āyurveda, sleep has been discussed at great lengths with different terms including, but not limited to, nidrā, śayana or svapna. Nidrā is considered among non-suppressible urges or the adhāraṇīya vega. [2] It is also a part of the trayopastambha, along with āhāra and brahmacarya. [3] The discussion of nidrā vegadhāraṇa is seen briefly in the dedicated chapter; but it is not limited to the said chapters. The mentions of the same can be seen repeatedly throughout the texts in various diseases, some of the procedures and even as a treatment. It becomes necessary to review all these references together, and related it with nidrāvega, so that it can be clinically applied with ease. Hence, a review of nidrā is done, from the text Aṣṭāṇgaḥṛdaya, taking into account its role as a hetu, a lakṣaṇa and even as cikitsā.

 Review of Nidrāvega

            The concept of vegadhāraṇa is explored in Rogānutpādanīya adhyāya, the fourth chapter of Sūtrasthāna in Aṣṭāṅgahṛdaya. The features of suppression of sleep are described as follows: moha (confusion), mūrdhākṣigaurava (heaviness of head and eyes), ālasya (sluggishness), jṛmbhikā (excessive yawning) and aṅgamarda (bodyache). The only treatments mentioned are Svapna (inducing sleep) and saṃvāhana (gentle massage).

 Nidrā as a Hetu

      Other than the diseases mentioned above, there are few more diseases that may occur due to suppression of the urge to sleep. The following are the instances from Aṣṭāṅgahṛdaya where either suppression of nidrā or its induction/ excess sleep are mentioned as nidāna of a disease.

Table 1.1- References of nidrā as nidāna in various diseases.

Contraindications for divāsvapna and jāgaraṇa

      As sleeping during the day is considered as the cause for many diseases, which has been depicted in the above table, it is also prohibited multiple times, along with waking during night hours. Such references are collected below.

Table 1.2- Contraindications related to sleep

Disrupted sleep in Lakṣaṇa

            The pattern of sleep may vary because of underlying health conditions. Nonetheless, effects of sleep deprivation or excessive sleep will be reflected in the individual, on top of symptoms of the disease he is suffering from. Managing the issue of sleep disturbance is also important for social well-being of patients.

Table 1.3- Nidrā appearing as lakṣaṇa

Jāgaraṇa as a treatment

            Although suppression of sleep is prohibited, it is not an absolute contraindication. There are specific conditions, where suppressing the urge of sleep and avoiding sleep altogether will prove beneficial to an individual. Such conditions are:

Table 1.4- Nidrā vegdhāraṇa as cikitsā

Nidrā in other procedures

            In some of the processes, the due completion of sleep is given importance. Incomplete sleep, on the contrary, is considered as a contraindication in some procedures. All such points which relate nidrā to some procedures are enlisted below.

Table 1.5- Nidrā as a part of other procedure

 Discussion

The diseases and the treatment mentioned under vegadhāraṇa of nidrā is very minimal. The same, when explored in the entire saṃhitā appears quite elaborate. Especially, since udīraṇa of any vega is not explained, we have to creatively imagine various scenarios and then establish it with evidence. Divāsvapna which is discussed in many places, has been considered as a form of udīraṇa of nidrā. This adds a lot of information aboout nidrā dhāraṇa and udīraṇa as hetu. After analysing the results of the review, it may be postulated that it is not only the suppression of urge that causes disease, but also the doṣa being manifested due to abnormal sleep. Vegadhāraṇa is a common hetu for vāta vṛddhi, [4] whereas divāsvapna leads to kapha-pitta vṛddhi. [5]

The same rationale is behind the consideration of nidrā as lakṣaṇa. Even when the disruption is caused due to some morbidity in the body, divāsvapna and jāgaraṇa, being snigdha and rūkṣa repectively, [6] add to this morbidity. Hence, they have to be resolved accordingly.

The qualities attributed to sleep and wakefulness has also been utilized in planning the treatment. Most of the observations in table 1.4 include diseases caused due to morbid kapha. Rūkṣa jāgaraṇa, being the antagonist of snigdha kapha, helps to mitigate these diseases. Divāsvapna is also utilised as treatment, in conditions such as ajīrṇa, where the resulting śleṣmā nourishes the body, rather than harming it. [7] 

Nidrā having an importance as part of some procedures is an interesting finding. In procedures such as nasya and dhūmapāna, time period after waking up from sleep is considered appropriate. Jāgaraṇa and divāsvapna both are contraindications for añjana.

            A simple review of nidrā from one classical text of Āyurveda, proves its importance in maintaining a healthy state. The overall benefits of sleep have been summarized in one verse, saying the health and illness, nourishment and malnourishment, strength and weakness, virility and impotency, clear and improper perception are all dependent upon the quality of sleep. [8] While some of them can be experienced immediately after a couple of nights of bad sleep, few effects are born out of chronic sleep impairments. This statement, made thousands of years ago is being proven in the current scientific world with experiments. It was found in rats that sleep deprivation resulted in loss of weight, in spite of increased calory intake, and eventual death. [9] 

            Insomnia and excessive sleep are among the most common complaints physicians have to deal with, in their practice. Such reviews of the concept result in a better understanding of the concept and lead to a better practice.

References

1. Guyton AC, Hall JE. Textbook of Medical Physiology. 11th ed. Philadelphia: Elsevier; 2006: 739.
2. Aṣṭāṅgahṛdaya, Sūtrasthāna, 4/1, available from https://vedotpatti.in/samhita/Vag/ehrudayam/?mod=read, accessed on 14 Aug 2024
3. Carakasaṃhitā, Sūtrasthāna, 11/35 available from https://niimh.nic.in/ebooks/ecaraka/?mod=read, accessed on 14 Aug 2024
4. Aṣṭāṅgahṛdaya, Nidānasthāna, 1/14, available from https://vedotpatti.in/samhita/Vag/ehrudayam/?mod=read, accessed on 14 Aug 2024
5. Aṣṭāṅgahṛdaya, Sūtrasthāna, 7/56, available from https://vedotpatti.in/samhitaVag/ehrudayam/?mod=read, accessed on 14 Aug 2024
6. Aṣṭāṅgahṛdaya, Sūtrasthāna, 7/55, available from https://vedotpatti.in/samhita/Vag/ehrudayam/?mod=read, accessed on 14 Aug 2024
7. Aṣṭāṅgahṛdaya, Sūtrasthāna, 7/57-59, available from https://vedotpatti.in/samhita/Vag/ehrudayam/?mod=read, accessed on 14 Aug 2024
8. Aṣṭāṅgahṛdaya, Sūtrasthāna, 7/53-54, available from https://vedotpatti.in/samhita/Vag/ehrudayam/?mod=read, accessed on 14 Aug 2024
9. Barrett KE, Barman SM, Brooks HL, Boitano S. Ganong’s Review of Medical Physiology. 23rd ed. New York: McGraw-Hill Education; 2016: 236.