Clinical Efficacy of a Unani Polyherbal Formulation in Chronic Insomnia: A Case Study

Abstract Insomnia, defined as difficulty in initiating or maintaining sleep or experiencing nonrestorative sleep, is a common condition with significant health implications. It affects nearly 10% of adults, with a higher prevalence among women, the elderly, and individuals facing socioeconomic hardships. In classical Unani medicine, insomnia is termed “ Sahar ” and is attributed to an imbalance in the brain’s temperament, particularly due to excess ḥarārat (heat) and yubūsat (dryness). Although Unani physicians have historically managed insomnia effectively using various polyherbal formulations, scientific validation of these treatments remains limited. This article evaluates the safety and efficacy of a Unani polyherbal formulation (AFA), comprising Asrūl ( Rauvolfia serpentina Benth ex. Kurz), Filfil siyāh ( Piper nigrum L.), and Asgandh ( Withania somnifera (L.) Dunal), in the management of chronic insomnia. A 35-year-old male patient with a one-year history of insomnia was treated with a 50% hydroalcoholic extract of AFA at a dose of 500 mg daily for six weeks. The Insomnia Severity Index (ISI) was used to assess therapeutic outcomes, and the score improved from 26 (severe) to 2 (no clinically significant insomnia), with no reported adverse effects and normal laboratory findings throughout the study. These findings suggest that the AFA formulation may serve as a safe and effective alternative for the management of insomnia, warranting further investigation.