Clinical importance of Nasya with Tila Taila in the management of Nidranasha (Primary Insomnia): A case study

 Corresponding author: D. Amirtha Kadesh Abiram Copyright © 2025 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution Liscense 4.0. Clinical importance of Nasya with Tila Taila in the management of Nidranasha (Primary Insomnia): A case study D. Amirtha Kadesh Abiram 1, *, Chitta Ranjan Das 2 and Jeniffer ponsingh 2 1 PG, Department of Panchakarma, Sri Jayendra Saraswathi Ayurveda college and Hospital, In Affiliation with Sri Chandrasekharendra Saraswathi Viswa Mahavidyalaya, Kanchipuram, India. 2 Department of Panchakarma, Faculty of Ayurveda, Sri Jayendra Saraswathi Ayurveda college and Hospital, In Affiliation with Sri Chandrasekharendra Saraswathi Viswa Mahavidyalaya, Kanchipuram, India. World Journal of Advanced Research and Reviews, 2025, 26(03), 1336-1340 Publication history: Received on 04 April 2025; revised on 11 June 2025; accepted on 13 June 2025 Article DOI: https://doi.org/10.30574/wjarr.2025.26.3.2283 Abstract Introduction: Aging is a natural physiological process which is characterized by gradual weakening of metabolic process. Ayurveda has considered Jara as a natural and inevitable process as well as natural disease. One of the common problems seen in geriatric group is Insomnia which impairs cognitive and physical functioning and is associated with a wide range of impaired daytime functions across a number of emotional, social, and physical domains. Globally, the prevalence of insomnia has been reported in the range of 12%–40% in the older population aged >65 years whereas it has been reported to be 82.17% in India which is a common troubling problem in the elderly individual. Materials and methods: A 64 years old female patient presented with disturbed sleep at night, fatigue, lack of concentration, loss of interest in day today activity for 2 years. The line of treatment focused on this case is Nasya with Tila taila 4ml each nostril for 7 days. RESULTS: There was a visible and significant improvement seen in sleep pattern and were assessed using Athens Sleep Questionnaire (ASQ). The ASQ shown significant improvement from 21 (Before Nasya) and 11 (After Nasya). Discussions and conclusion: In Ayurveda Nidranasha which is included in 80 Nanatmaja Vata Vikaras. As per fundamental principles kapha is predominant dosha during childhood, pitta during the adulthood and Vata Dosha during old age. In aged the prana and Udana Vata gets vitiated which results in derangement of Bhuddhi, Smritihrasa, Varnaviparyaya, Balakshaya. Tila Taila has a property of Madhura Rasa, Madhura Vipaka, Balya and Rasayana Karma which is Vataghnesha Uttam administered as Nasya through Nasal route reaches Sringataka Marma eventually spreads in Murdha through micro intra cranial circulation. The Tryosine amino acids and other essential component present in Tila has been directly connected to the serotonin activity of brain also in the production of Melanin which leads to improvement in Sleep and anti-aging effect on brain. Keywords: Insomnia; Nasya; Nidranasha; Tila Taila 1. Introduction Aging is a natural physiological process which is characterized by gradual weakening of metabolic process. Ayurveda has considered Jara as a natural and inevitable process as well as natural disease. One of the common problems seen in geriatric group is Insomnia which impairs cognitive and physical functioning and is associated with a wide range of impaired daytime functions across a number of emotional, social, and physical domains. Globally, the prevalence of insomnia has been reported in the range of 12%–40% in the older population aged >65 years whereas it has been World Journal of Advanced Research and Reviews, 2025, 26(03), 1336-1340 1337 reported to be 82.17% in India which is a common troubling problem in the elderly individual. In Ayurveda Ahara, Nidra and Brahmacharya are known as Trayopastamba which is important in maintaining the equilibrium of living were the inclusion of Nidra in the three Upastambha proves its importance. Nidra is defined as when the mind and body are tired then Kapha Dosha and Tamasa Guna will be increased in the body, in which sensory organs are unable to function properly. This condition leads to development of Nidra. As per fundamental principles Kapha is predominant Dosha during childhood, Pitta during the adulthood and Vata Dosha during old age. The vitiation of Vata in old age leads to Nidranasha is one of the Vatananatmaja Vyadhi described by Acharya Charaka. In this case study the presentation of Nidranasha (Primary Insomnia) in old age is related to Prakopa of Vata in Shiras Sthana and treated with principle of Nasya Karma for stipulated period and observations are noted. 2. Case study • Name – XYZ • Age – 67 • Gender – Female • Occupation – Homemaker • OP number – 4922/24 • IP number – 783/24 2.1. Chief complaint Patient came to Panchakarma OPD with presenting complaints of disturbed sleep at night, fatigue, lack of concentration, loss of interest in day today activities in the past 2 years. 2.2. History of illness Patient was apparently normal before 2 years, gradually she noticed impairment in daily sleep and loss of interest in activities. 2.3. Medical history Previously was Under Physiotherapy treatment for Cervical pain for 1 month and recovered from the complaint. 2.4. Family history No relevant family history noticed Table 1 Personal history Diet Mixed Appetite Regular Sleep Irregular Bowel Irregular (Sometimes constipated) Micturition Normal Habits NIL Addictions NIL Table 2 General examination BP 120/80mmHg NAILS Normal RR 16 LYMPHNODES Normal EDEMA Absent WEIGHT 74 Kg ICHTERUS Absent PALLOR Absent PR 69 CYANOSIS Absent World Journal of Advanced Research and Reviews, 2025, 26(03), 1336-1340 1338 Table 3 Ashta Sthana Pareeksha NADI Vata Pitta SHABDA Madhyama MALA Sushka SPARSHA Anushnasheeta MUTRA Alpa DRIK Madhyama JIHWA Nirlipta AKRUTHI Madhyama Table 4 Dasavidha Pareeksha PRAKRUTI Vata pitta SATMYAM Sarvarasa VIKRUTI Vata SATVAH Madhyama SARA Medas VAYAH Vriddha SAMHANANA Madhyama AHARA SHAKTI Madhyama PRAMANAM Avara VYAYAMA SHAKTI Avara 3. Line of treatment Nidranasha comes under 80 Nanatmaja Vata Vyadhi[1] and Urdhvajatrugata Vikara Where Vata Dosha mainly involved, therefore medications which offer Vata Shamaka effect can be recommended for pacifying Doshas[2]. Nasya Karma in this regard works greatly to facilitate transportation of drug though the nasal route. The treatment principle of Nasya Karma is incorporated in the case study. Tila Taila was selected as Nasya Karma Aushada, as because it possesses Vatahara properties. There are various references in the Ayurvedic classics which show the effect of Tila Taila on Vatadosha[3]. Table 5 External Treatment S.no Procedure Medicine Duration 1. Nasya Tila Taila 4ml/Nostril 7 days 3.1. Assessment criteria 1. Athens Sleep Questionnaire (ASQ)[4] 4. Results After completion of Nasya karma on 7th day, the patient condition was reassessed. The patient’s sleep pattern is improved. ASQ Scale score decreased. The patient was discharged after 7 days and condition was stable in the followup period of 1 month. Table 6 Athens Sleep Questionnaire (ASQ) Before nasya karma After nasya karma 21 11 5. Discussion 5.1. Probable mode of action of Nasya in Nidranasha The procedure involves Sthanika Abhyanga as Purva Karma which helps to alleviate Vata, this also relaxes body and mind to bring state of sleep. In classics it is suggested that oiling the head region for inducing Nidra. Swedana also World Journal of Advanced Research and Reviews, 2025, 26(03), 1336-1340 1339 perform as Purva Karma to increase local circulation and facilitate maximum absorption of drug in subsequent procedure. Pradhana Karma which Nasya karma where Dravya instilled into the nostrils keeping patient's head in tilted position[5,6]. A human nose has two primary functions namely respiration and olfaction, Olfactory mucosa of nasal cavity which makes the rear end of the nasal cavity is unique in the sense that it is connected to the external environment at one end and to the CNS on the other. The Nasya Karma facilitates drug’s transportation into the brain to stimulate olfactory neurons. Avichchhina Dhara means a continuous flow of oil should be maintained during the procedure, Nasya Dravya reaches the Shringataka Marma - A vital point connected to the Siras. The drug stimulates olfactory neurons and removes vitiated Doshas. Stimulation of this can have profound effect on body since it connected greatly with higher centers of the brain. The olfactory nerve related to the sleep-regulating centers and hypothalamus thus induces mental calmness after receiving medication through Nasya[7,8]. The drugs administered as Nasya penetrate and perfuse the brain cells, correct circulation of Prana, affecting cerebral and sensory center to induce sound sleep. Drugs administered through nostril acts on neurotransmitters (serotonin and dopamine) thus reduce stress and tension which are associated with insomnia. Drug when absorbed through the nasal route they reach to the vascular pathways via nasal mucosa, this process stimulates olfactory bulb and brain center to induce sleep[9]. 5.2. Probable mode of action of Tila Taila in Nidranasha Tila Taila is an important Vatahara Dravya. The use of Tila in the form of oil can be used as Abhyanga Shirodhara, Nasya, Basti in Panchakarma therapy. The qualities of Tila Taila mentioned in ancient Ayurvedic books include Madhura rasa, Kasaya anurasa, Usna Virya and Madhura Vipaka, as well as Usna, Vyavayi, Visada, Suksma, Tiksna, Guru, Vikasi, Lekhana, and Sara. Action of Tila Taila mentioned in different text of Ayurveda as Brimhana, Vrishya, Prinana, Medhakara, Sthairya, Varnakara, Tvakprasadana, Balya, Krimighna, Chaksusya, Baddhavinmutra, Yoni Shira Karnashul Hara, Chinna-Bhinna Viddha picchita Vrana, Abhyamaga, Garbhashaya shodhan and Loghutakarak[10]. Its consumption is fantastic for raising iron levels, lowering cholesterol, treating heart conditions, and boosting strength. Sesame oil is beneficial for skin. The presence of alkaloids, saponins, flavonoids, tannins, phenols, and minerals are what causes these positive impacts on health. Terpenoid presence gives antibacterial and anti-diabetic properties. Terpenoid also aid in lowering blood pressure and blood sugar levels. Alkaloids are central nervous system stimulants. Flavonoids and phenols give it antioxidant properties also saponins which are antioxidant, anti-cancer and immunity booster[11]. As Prakopa of Vata is seen in Nidranasha condition where the Vata Shamaka Dravya Tila is used in form of Nasya, which is Madhura, Snigdha and guru guna of Tila help in nourishment of the Dosha. Ushna Virya and Snigdha Guna of Tila helps in pacifying vitiated Vata Dosha which is predominant factor in causation of symptoms of ageing. Tila Taila has a property of Madhura Rasa, Madhura Vipaka, Balya and Rasayana Karma which is Vataghnesha Uttam administered as Nasya through Nasal route reaches Sringataka Marma eventually spreads in Murdha through micro intra cranial circulation. The Tyrosine amino acids and other essential component present in Tila has been directly connected to the serotonin activity of brain also in the production of Melanin which leads to improvement in Sleep and anti-aging effect on brain. 6. Conclusion There was a visible and significant improvement seen in sleep pattern and were assessed using Athens Sleep Questionnaire (ASQ). The ASQ shown significant improvement from 21 (Before Nasya) and 11 (After Nasya). Nasya Karma with Tila Taila can be particularly effective in treating Nidranasha as it enhances the bioavailability of the drug through the nasal route, thereby improving its efficacy. This therapy helps alleviate Vata by delivering medication through the nostrils, which stimulate olfactory neurons and improve sleep quality. Compliance with ethical standards Disclosure of conflict of interest No conflict of interest to be disclosed. Statement of informed consent Informed consent was obtained from all individual participants included in the study. References [1] Chakrapani, Charaka Samhita by Agnivesa, edited by Vaidya Jadavaji Trikamji Acharya, Chaukhambha Publications, New Delhi, Reprint 2017, Sutrasthana, 20/11, 113. World Journal of Advanced Research and Reviews, 2025, 26(03), 1336-1340 1340 [2] Pathak kbd. Nidra and nidranasha: a review article. Nidra and nidranasha: a review article. 2019 aug 12;(issn 2455-3301 wjpmr). [3] Jawanjal p. Tila taila a review. World journal of pharmaceutical and medical research. 2018 sep 9;(issn 24553301 wjpmr). [4] Haitham Jahrami, Khaled Trabelsi, Zahra Saif, Md Dilshad Manzar, Ahmed S. BaHammam, Michael V. Vitiello,Reliability generalization meta-analysis of the Athens Insomnia Scale and its translations: Examining internal consistency and test-retest validity,Sleep Medicine,Volume 111,2023, Pages 133-145, ISSN 1389-9457, [5] https://doi.org/10.1016/j.sleep.2023.09.015. [6] Bohra M, Shukla GD. A Comprehensive Review of Nasya Therapy in the Management of Anidra (Insomnia). Himalayan J H Sci [Internet]. 2024 Sep 15 [cited 2024 Sep 15]; 9(3):1-3. Available from: http://www.hjhs.co.in/index.php/hjhs/article/view/211 [7] Maharishi Sushruta, Ayurveda Tattva Sandipika, Kaviraj Ambikadutta Shastri, Part - I, Reprint 2011, Chaukhambha Sanskrit Sansthan, Sushruta Samhita, Sutra Sthana, Chapter-4, Verse No. -32, Page No. -44. [8] Maharishi Sushruta, Ayurveda Tattva Sandipika, Kaviraj Ambikadutta Shastri, Part - I, Reprint 2011, Chaukhambha Sanskrit Sansthan, Sushruta Samhita, Sutra Sthana, Chapter-24, Verse No. -8, Page No. -131. [9] Sharma H. Kashyapa Samhita, Khilla, 5/7. 5th ed. Varanasi: Chaukhambha Sanskrit Sansthan; 1998, pg. 256. [10] Bohra M, Shukla GD. A Comprehensive Review of Nasya Therapy in the Management of Anidra (Insomnia). Himalayan J H Sci [Internet]. 2024 Sep 15 [cited 2024 Sep 15]; 9(3):1-3. Available from: http://www.hjhs.co.in/index.php/hjhs/article/view/211 [11] Jawanjal p. Tila taila a review. World journal of pharmaceutical and medical research. 2018 sep 9;(issn 24553301 wjpmr). [12] The constituents of Medicinal plants, an introduction to the chemistry and therapeutics of herbal medicines, by Andrew Pengelley, first south Asian edition, 2006.