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Case Report

AAM. 2021; 10(2): 177-185

Shiromardana - A novel Ayurveda add on therapy in the management of Opioid withdrawal insomnia- A case report.

Subhash P M, Suhas Kumar Shetty.


Sleep is very important in sustaining life. Insomnia or sleeplessness, is a disorder characterized by an inability to fall asleep or to stay asleep for a desired duration. Insomnia is generally seen as a symptom that can accompany alcohol or psychoactive substance withdrawal syndrome. Insomnia is a common symptom in opioid withdrawal syndrome. Nidranasha is the Ayurvedic term used for disturbed or reduced sleep. A male patient aged 26 years suffering from opioid withdrawal syndrome presenting with difficulty in initiation of sleep, disturbed sleep, generalized weakness, watering from eyes, anger outbursts and body pain who has abstained from opioid use since10 days was admitted in the hospital for whom internal medications and external therapies along with Shiro abhyanga (oil massage on head) and shaashtika shaali pinda shiromardana (procedure in which a continuous pressure on head is given using a poultice made of cooked rice) were administered. Shiromardana is a unique therapeutic procedure which is based on the principles of murdhni taila (oil application on head) and shaashtika shaali pinda sweda (SSPS-fomentation using cooked rice poultice). This case study aims to observe the added effect of Shiro abhyanga followed by shaashtika shaali pinda shiromardana in insomnia caused due to opioid withdrawal syndrome. So, both are used in combination here to treat insomnia caused due to opioid withdrawals which in turn is a vataja type of disorder. The pre and post, therapeutic assessment of severity of insomnia of the patient was conducted using the Insomnia severity index scale on day 1 and day 13 respectively and the results showed that the severity of insomnia reduced from moderately severe form to subthreshold form. So shaashtika shaali pinda shiromardana may be applied as an add on therapy to cases of Opioid withdrawal insomnia, in which routine line of management does not bring out considerable results.

Key words: Ayurveda, Shiroabhyanga , Shashtika Shaali Pinda Shiromardana, Opioid withdrawal insomnia, Case report

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