Insomnia Definition Insomnia is the most common sleep disorder affecting millions of people as either a primary or comorbid condition. The word “insomnia’ originates from the Latin “in” (no) and “somnus” (sleep). Insomnia is defined as a complaint of difficulty falling or staying asleep which is associated with significant distress or impairment in daytime function and occurs despite an adequate opportunity for sleep. Insomnia is viewed as a symptom and a disorder. Characteristics Insomnia is thought to result from a state of “hyperarousal.” As a result of this elevated state of alertness, sleep may prove difficult. Insomnia is characterized by chronic dissatisfaction with sleep quantity or quality that is associated with difficulty falling asleep, frequent night time awakenings with difficulty returning to sleep, and/or awakening earlier in the morning than desired. At least one in three people will experience insomnia that can cause sleeplessness or waking without feeling refreshed, during their lifetime. Sleep affects all body systems and deleterious effects to the immune, cardiovascular, endocrine and neuronal systems are seen when sleep deprivation occurs (Colrain, 2011). It is important to first understand the process of sleep and the patient’s expectations. Understanding Sleep Sleep is a restorative physiological process characterised by an alteration in brainwave activity, viewed via an electroencephalograph (EEG). This reading shows that brainwave frequency slows as the sleeper drifts from alertness towards deep sleep (N3 phase of sleep) (Dement & Kleitman). In addition, brain, eye, skeletal muscle and heart activity change throughout differing phases of sleep, as shown through polysomnography (PSG). Clocks and rhythms Sleep is governed by two distinctly separate rhythms: the circadian rhythm (i.e. the intrinsic biological clock) and the homeostatic sleep drive (i.e. sleep pressure) (Borbely, 1982). The circadian rhythm is an endogenous cycle of around 24 hours, influenced by melatonin, and matched to environmental cues that synchronise the biological rhythms to the earth’s 24-hour light/dark cycle) such as light, temperature and food. Sleep pressure is governed by adenosine levels in the pre-frontal cortex of the brain: for every hour of waking, there is a steady accumulation of adenosine, increasing the urge to sleep. During sleep, adenosine is anabolised back to adenosine triphosphate (ATP). Together, sleep pressure and the circadian rhythm form the sleep–wake cycle. Optimising factors, such as food, exercise, temperature, light and noise improve the sleep–wake cycle and are generally referred to as ‘sleep hygiene’. The sleep–wake cycle also includes another cycle: the ultradian rhythm, which this can be depicted as a graph that shows the changes in sleep stages as in the figure below. Hypnogram depicting normal adult sleep On a hypnogram, a sleep cycle is usually around 90 minutes and there are four to six cycles of rapid eye movement (REM) sleep/non-REM sleep stages that occur during a major period of sleep. Most slow-wave sleep occurs in the first one or two cycles; this is the deepest period of sleep. The second half of the sleeping period contains most REM sleep and little or no slow-wave sleep, and may contain brief periods of wakefulness which can be recorded but are not usually perceived. The stage that occurs before waking is normally REM sleep. Etiology of Insomnia Diagnosis of Insomnia The International Classification for Sleep Disorders (ICSD-3) outlines three diagnostic criteria for insomnia: A report of sleep initiation or maintenance problems; Despite adequate opportunity and circumstances to sleep; Resulting in daytime consequences. (Sateia, 2014) The evaluation and diagnosis of insomnia is based on a careful clinical history of the sleep problem and relevant comorbidities. The “3-P” model is a useful framework for assessment (Spielman et al, 1987). Predisposing factors increase the risk for developing insomnia, and include a family history and a lifelong propensity for stress-related poor sleep. Precipitating factors are medical, environmental, or psychosocial stressors that initiate a pattern of poor sleep. Perpetuating factors are behaviors and other factors that lead to a vicious cycle of continued sleep disturbance. For instance, many individuals with insomnia spend more time in bed trying to “catch up” on sleep. Increased time in bed and increased attention and effort to sleep fuel hyperarousal and perpetuate insomnia. Management of Insomnia The goals of insomnia treatment are to improve quantitative and qualitative aspects of sleep, to reduce the distress and anxiety associated with poor sleep, and to improve daytime function (Schutte et al, 2008). Insomnia treatment includes two broad categories:Non‐pharmacological treatments and pharmacological therapies. Non pharmacological treatments The use of CBTI aims to reduce maintaining factors that perpetuate insomnia. CBTI is a short-term treatment that includes 4 to 8 sessions on average and adopts a multi-component approach, which typically includes sleep restriction, stimulus control, cognitive therapy, sleep hygiene, and relaxation training (Smith et al, 2003). Sleep restriction involves limiting the amount of time spent in bed to the amount of actual total sleep time, which is typically derived from 1 to 2 weeks of sleep diary data. In stimulus control the objective is to have the patient limit the amount of time spent awake in bed and re-associate the bed and bedroom with sleep to regulate sleep–wake schedules. Cognitive therapy is designed to challenge maladaptive beliefs and attitudes that serve to maintain insomnia. Worrying, faulty attributions, or unrealistic expectations of sleep may lead to increased emotional distress, and thus lead to additional sleep disturbance, causing a vicious cycle. Challenging dysfunctional thoughts associated with sleep is believed to decrease the anxiety and arousal associated with insomnia. CBT helps replace dysfunctional cognitions with more adaptive, realistic, and alternative interpretations based on past evidence. Learning relaxation techniques can be effective in reducing physiological hyperarousal in the patient. Research suggests that relaxation is especially effective in helping with sleep initiation (Morn et al, 1994) Pharmacological treatments Different class of drugs such as Benzodiazepines, Z-drugs, melatonin agonists, tricyclic antidepressants, orexin receptor antagonists are used. Yogic management Yoga Practices: IAYT based therapy module of VHG How yogic management is different from conventional treatment? Yoga addresses all aspects of the human body i.e., physical, mental and emotional levels which. Yogic management considers removing

Common Myths about food 1. Ghee is Fattening: Ghee has many uses beyond the kitchen. According to Ayurveda ghee has healing properties when used appropriately. A good desi ghee, home prepared or organic taken in moderation helps in assimilation and maintains a good gut health and does not cause increase in weight. It also contributes to bone health and immune system. 2. Fats are Bad for Health: Fats are of 2 types – Good fat and bad fat. Good fat (Monounsaturated and polyunsaturated fat) which is present in Nuts and seeds, avocado etc in moderation help in heart health, absorb vitamins from food and many more. Saturated and trans fat present in cookies cakes junk food leads to health issues. 3. Healthy food habits is only for people who are sick or overweight: People often tend to think that a person who is lean can indulge in any food and in any quantity and people who are obese have to cut off lot of things. Taking care of your diet, life style and stress as it’s every individual’s responsibility to take care of the body. Health is not measured in terms of weight. Its lot more than that. 4. Healthy food habits needs Expensive items: There is common misconception about food that fancy is being healthy. A peanut or ground nut is equally nutritious and dense compared to almonds. The choice of food depends on the season, your body, nature of your physical activity and many more factors.

Food Combination for Better Health Ayurveda, the ancient holistic science mentions logical approach for correct diet based on the body constitution. Your digestive fire (agni) helps to understand how well food is digested. When 2 or more food having different taste, energy and post digestive effect are combined it can obstruct the enzyme system which is mostly result of overloaded agni and may result in indigestion. The same prolonged for long may lead to toxin accumulation in the body. But same food taken separately or with right combination helps to stimulate agni and benefit our health. The commonest known wrong food combination is Milk and fruits. The post digestive effect of two food is different which disturbs the digestion (leading to mandagni) and lead to different digestive disorders. Milk is avoided combining with salt as well. Now, lot of people are thinking how to figure out the right food combination? Well answer is stick to your traditional meal preparation which has right food combination. Be it Dosa sambar or dal khichadi with ghee or a dry fruit laddoo. Let us take the example of dry fruit laddoo. Ghee in the laddoo will help to reduce the heat potency nature of few dry fruit and coconut on the other hand provide’s healthy fat to absorbe all the vitamins from dry fruits. Next time when you want to enjoy a cup of traditionally prepared Kheer, go ahead and enjoy without guilt and counting calories, but of course in moderation!

Neck pain and Yoga therapy Neck pain is a common complaint in this modern era due to bad posture by using mobile phones, computers, work stress, less physical activity, and poor lifestyle. Neck pain may start gradually and get worsened by poor neck movements and wrong posture for a prolonged duration. The muscular strain may aggravate work stress and improper neck posture while sleeping. Sometimes the neck pain may radiate to the shoulder and arms. The best way is to reduce and prevent this neck pain is through Yoga therapy. There are many yoga practices that will help in reducing neck pain and prevent the worst muscular strain. Regular yoga practices will strengthen the muscles and joints, improve blood circulation and lifestyle. A female patient aged 33years came with the complaint of sharp and severe pain in the neck for the past 2 years and no history of any cervical spondylitis with no abnormalities in the x-ray of the cervical spine. She had a score of 8 on the visual analog scale for her pain and underwent 10 days of yoga therapy. At the end of the 10th day, her score was 2 on the visual analog scale. She had better improvement in her neck movement, reduced frequency of getting pain, and was satisfied with the yoga therapy teaching. She was asked to continue the same practices every day at home. Yoga Therapy Practices Neck Exercises : Neck up-down, sideward looking and bending movements with proper breathing, shoulder rotation and arms stretching. Breathing Exercises : Breathing exercises include hand in and out, hand stretching breathing, tiger breathing. Pranayama : Practice of Breath Regulation. It includes Nadishuddi, Bhramari. Article By :Dr. Anitha

Shoulder pain and Acupuncture Shoulder pain is a common condition seen in homemakers, painters and one who works in the teaching field. Excess usage of a single hand for a prolonged duration causes pain and worsens the condition. The type of pain may vary from person to person. The severity of pain may increase if we do not treat it in early-stage and may lead to reduced or restrict movement to the shoulder. There are many types of shoulder pain caused by injuries to tendons, muscles, bursa, or ligaments of the shoulder joints. There are many ways to get rid of the pain. Using integrative medicine helps for a long-term remedy. Acupuncture is one of the traditional methods of Chinese treatment including the fine needle insertion to various points to reduce the pain. It helps in releasing the endorphins which are responsible for overall well-being and pleasure. It also helps in reducing pain and muscular strain by increasing blood circulation. Experience at VHG clinic : A male patient aged 42 years came with the complaint of pain in the left shoulder and was taken through 7 sessions of acupuncture regularly. He had good changes in pain rating where the score reduced from 5 to 1 on the visual analog scale. He had improvement in the movement of his shoulders. Article By : Dr. Anitha

Greeva basti for neck pain Neck pain is a common complaint of most of people. Common Causes are, Bad posture by using mobile phones and computer Work stress Lack of physical activity Poor lifestyle Neck pain may start gradually and get worsened by poor neck movements and wrong posture for prolonged duration. The muscular strain may aggravate work stress and improper neck posture while sleeping. Sometimes the neck pain may radiate to shoulder and arms also. Untreated neck pain may lead to cervical spondylosis, cervical spondylitis, spinal stenosis, herniated disk, cervical radiculopathy, restricted neck movement, and other neck injuries. Remedial measure : Greeva basti Greeva basti is a Sanskrit word. ‘Greeva’ refers to neck and basti stands for container or retention. It is an ayurvedic care for neck pain. The greeva basti is nothing but hot oil therapy or oil pooling therapy on the neck. Procedure Patients must lie down on their abdomen (prone posture). The ring is prepared using urad dal preferably dried in the sun. Place the ring on the neck region and stick it with dough. Medicated oil prescribed by a doctor is to be used for the treatment. The indirectly heated oil will be poured into the ring and maintaining the temperature of oil is essential Patients should be asked to avoid vigorous exercise during the course of this treatment. Benefits Relieves pain Reduces stiffness and inflammation Strengthens the muscles of neck Gives nourishment to the joints and improves the circulation Our observation A female patient had complaints of severe pain with the score of 29 on the PDR Oswestry neck pain questionnaire. She was advised greeva basti for 7 days. After completing her 7 days of treatment, the score of PDR Oswestry reduced to 12. This shows a significant result that role of greeva basti helps in reducing neck pain to the great extent. For further management of pain she was taken throough seroes of yoga practices as Yoga therapy Article By :Dr. Anitha Recommended Readings Do It Yourself Kit for Neck Pain Relief – https://s10550624.saturnwp.link/neck-pain-kit Do It Yourself Kit for Back Pain Relief – https://s10550624.saturnwp.link/back-pain-kit

Janu basti for Knee pain Knee Pain is one of the commonest pains seen especially after 40years of age. The pain interferes in daily activity including walking. The knee joint is made of bone cartilage ligaments when there is a problem with any of this structure pain is seen. There is a lot of reason for knee pain. Common Causes Injury to ligament: Usually results due to sudden twisting or so. Rheumatoid Arthritis: RA is an Inflammatory and auto immune disorder. Pain is seen in all joints which include knees as well. Osteoarthritis: Mainly occur in old age, due to wear and tear in the joints especially in the weight-bearing joint. Injury to Tendon and cartilage. Janu Basti Janubasti is oiling pooling therapy on the knee joint. Janu means Knee and basti is a container. Procedure A ring is prepared using urad dal preferably dried in the sun. The ring is attached to the knee or both knee joints of the patient; the junction of the ring and skin is sealed with wet flour the oil does not leak. Medicated oil prescribed by the doctor specifically for the patient’s condition is poured in the ring. Oil is heated passivelyIn order to maintain uniform temperature during the procedure cool oil is replaced with warm oil at regular intervals. Patients should be asked to avoid vigorous exercise during the course of this treatment. Slight massage is done from the Knee joint to feet on the same oil. Benefits Strengthen the knee Joint and muscles around the joint. Reduces inflammation. Relieves stiffness. Article By :Dr. Shraddha SurathkalRecommended Readings Do It Yourself Knee Pain Relief Kit – https://s10550624.saturnwp.link/knee-pain-kit

Knee pain and yoga therapy Knee Pain is one of the commonest pains seen especially after 40years of age. The pain interferes in daily activity including walking. The knee joint is made of bone cartilage ligaments when there is a problem with any of this structure pain is seen. There is a lot of reasons for knee pain. Common Causes Injury to ligament: Usually results due to sudden twisting or so. Rheumatoid Arthritis: RA is an Inflammatory and autoimmune disorder. Pain is seen in all joints which include knees as well. Osteoarthritis: Mainly occur in old age, due to wear and tear in the joints especially in the weight-bearing joint. Injury to Tendon and cartilage. Yoga Therapy Yoga Therapy has shown significant reduction in pain, improved strength, balance and gait. Psychological components such as anxiety are important aspects to be addressed in pain management and yoga does its contribution. Typical yoga practices consist of, Yogic Sukshma Vyayama: These are safe repetitive stretching movements synchronized with breathing that mobilize and strengthens particular muscle and joints. Asana: Asana is featured by effortless maintenance in the final posture. Asana is selected suitable for patients who relax and strengthen the knee joints. Relaxation Techniques: To relax the whole body. Pranayama: The practice of voluntary regulated breathing while the mind is directed to flow of breath to balance the autonomic system. Article By : Dr. Shraddha Surathkal

Basti Basti is considered as the prime treatment among all the panchakarma. It has curative, preventive, and promotive aspects. Basti karma is a procedure where medicated preparations are administered through anal canal. It stays there for a period and comes out as mala(faeces). “Bastina diyathe iti basti” (A.Hru.Su. 19/1) Benefits Srotoshudhhi (Purifies all system and clear minute passages) Vayasthapana (Sustains age) Pushtikara (Provides strength to body) Ruchi (Increases taste perception) Shoolahara (Relieves pain) Kukshiayama (Effective in GI tract disorders) Vajikaroti (Aphrodisiac) Medhokrut (Improves intellectual power) Swapnanuvrutti (Induces sound sleep) Classification Based on location – Pakvashayagata basti : Administration of basti into colon through anal canal – Mutrashayagata basti : Administration of basti into urinary bladder through urethra – Garbhashayagata basti : Administration of basti into uterus through vagina – Vrana basti : Administration of basti into vrana for purification and healing purpose. Based on medication used Sneha basti : Snehas (medicated ghee,oil…) are administrated into colon through anal canal. Anuvasana basti : Uses oil or ghee Matra basti : Half dose of anuvasana basti Niruha basti : Kashaya is the chief constituent of basti dravya along with Madhu (honey), Saindhava (salt), Kalka (paste) and Sneha (oil). In place of Kashaya – Ksheera (milk), Mamsa rasa (meat soup), Gomutra (Cow’s urine) etc are used. Based on number of Basti i)Karma basti : 30 basti are to be administered. ii)Kala basti : 16 basti are to be administered iii)Yoga basti : 8 basti are to be administered This procedure includes : Poorva karma, Pradhana karma, paschat karma Poorva Karma – Pre Preparation   Selection of indicated patient Examination of the vitals of patient Prepare basti dravya Patient is asked to pass faeces, urine, and flatus Abhyanga (Massage) and Swedana (Fomentation) is given to patient Patient is asked to come in empty stomach (Niruha basti) Advised to take food (Anuvasana basti) Pradhana Karma – Main Procedure Administered in afternoon after digestion of previous meal and not feeling hungry. Patient is asked to lie down on left side and keep his/head on his/her arms like pillow. Patient is asked to flex his/her right leg, left leg fully extended. Anus and enema nozzle is lubricated. Air bubble is removed, and enema nozzle is introduced slowly. Slowly inject the basti content and gradually withdraw the nozzle. Patient is said to lie on his/her back with his/her body in raised position. On urge for defecation, he should not suppress it. Paschat Karma – Post Preparation Niruha basti : Warm water bath : Diet – Rice with soup of meat or pulses Anuvasana basti : Buttocks of patient is patted : Relax in supine position : Raise foot end of the table to little extent Symptoms of Proper Adminitstration Prasrushta vit (Evacuation of bowel without discomfort) Prasrushta mutra (Evacuation of urine without discomfort) Ruchi in ahara (Taste in food) Agni vruddhi (Good appetite) Ashaya laghava (Lightness of body) Rogopashamana (Recovery of disease) Bala (Increases strength) Clarity of senses, intellect Returning of faeces and oil separately without sticking with each other Indications Kukshi roga(GI disorders) Obstruction to flow of Varcha(Faeces), Mutra(Urine) Adhmana(Distension of abdomen) Shiroshula(Headache), Karna shula(Earache) Shosha(Emaciation) Arthritis Cardiac disorders Tremors Contraindications Ajeerna(Just after meals) Yanaklanta(Excessive traveling) Kshut trushna(Hungry, Thirsty) Ama atisara(Diarrhoea due to indigestion) Visuchika(Gastroenteritis) Intestinal obstruction Kushta(Skin disorders) Its time to detox using Panchakarma Article By :Ms. Arpitha (Final year BAMS student)  

Mud Therapy Pack For Eyes Mud, a fundamental element of nature, exerts a profound influence on our body. Enriched with vital minerals, it bestows positive effects on human health. Through its unique ability to absorb toxins, mud becomes an effective preventive measure against various diseases. Widely recognized for its healing properties, mud therapy cools and relaxes the body, retaining moisture for extended relief. Mud pack for eyes As eyes are sensory organs, we perceive 80% of what comes through our sense of sight. We must maintain the health of our eyes to see this beautiful world. As we have this good opportunity to see the world, we must take care and give rest to our eyes with regular eyewash, good sleep, a Mud pack for our eyes and some yoga practice. As eyes are sensory organs, we perceive 80% of what comes through our sense of sight. We must maintain the health of our eyes to see this beautiful world. As we have this good opportunity to see the world, we must take care and give rest to our eyes with proper sleep. The natural components found in mud make it an effective choice for eye therapy. Mud therapy provides nourishment and it is good for the eyes. Mud Pack for Eyes The mud pack for eyes is applied to cover the eyes entirely and left in place for 20 to 30 minutes. It is particularly helpful for individuals who spend long hours in front of a computer, as it provides relaxation to the eyes. Therapeutically, the pack reduces irritation, itching, and other allergic conditions like conjunctivitis and haemorrhage of the eyeball. The pack can also assist in correcting refractive errors such as nearsightedness or farsightedness. For individuals with glaucoma, the eye mud pack helps to reduce tension in the eyeball, offering relief and support. Mud Therapy It is a system of treatment in which mud is applied either partially or completely over the body to get the desired therapeutic effect. Mud is one of the five elements of nature having an immense impact on the body both in health and sickness. The constitution of mud differs from one place to another, ideally, the mud which is used for therapeutic purposes should be taken from 4-5ft depth and sun-dried and sieved to make it contamination-free before use. Mud procured depending on the place has different properties out of which, • Absorbing• Antimicrobial• Stimulating• Relaxing is a few of them Mud Application depending on the condition applied directly or in the form of packs has the following benefits. • Helps in Reducing inflammation.• Helps in improved blood circulation also relaxes the muscles.• Has a detoxifying property thereby helping in removing toxins.• Used for cosmetic purposes also. Article By :Dr. Anitha     Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *Contact number *Location *Comment or Message Submit