Role of 'Nidra-Vaishamya' (sleep disturbances) on 'Atyartava' (excessive menstrual bleeding) - A literature review

In the present era, lifestyle modifications such as night-shift work, excessive use of digital devices, social media engagement, and irregular sleep patterns have led to a significant rise in sleep disturbances, collectively described as Nidra-Vaishamya. Sleep plays a crucial role in maintaining physical, mental, and reproductive health. Disturbance in sleep rhythm adversely affects the neuro-endocrine system, particularly the hypothalamic–pituitary–ovarian (HPO) axis, resulting in hormonal imbalance. Atyartava (excessive menstrual bleeding), described in Ayurveda as Asrigdara or Raktapradara, is a common yet often neglected gynaecological disorder affecting women of reproductive age. It not only compromises physical health but also impacts psychological well-being and quality of life. Modern research indicates that exposure to artificial blue light during nighttime suppresses melatonin secretion, disrupts circadian rhythm, elevates cortisol levels, and alters reproductive hormone secretion, such as estrogen, progesterone, LH, and FSH, thereby contributing to menstrual irregularities, including excessive bleeding. Ayurvedic classics emphasise Nidra as one of the Trayopastambha essentials for sustaining life. Nidra-Vaishamya predominantly leads to Vata vitiation, particularly affecting Apana Vayu, which governs menstruation. Classical texts describe Atyartava as a condition resulting from the vitiation of Vata and Pitta Dosha, with Rakta Dhatu as the Dushya. This review critically analyses classical Ayurvedic references along with relevant modern scientific literature to establish the role of sleep disturbances in the etiopathogenesis of Atyartava. The study highlights Nidra-Vaishamya as a significant yet overlooked causative factor in menstrual disorders and emphasises the importance of sleep regulation in preventive and therapeutic approaches.