Ayurvedic Understanding of Sleep Disturbances in Autism Spectrum Disorders

Sleep is a physiological process that drives synaptic pruning, memory consolidation, glymphatic clearance, and endocrine regulation, all processes essential for homeostatic stability. Sleep disturbances in Autism Spectrum Disorder (ASD) significantly impair daily functioning and the overall quality of life for both the child and the caregiver. It is highly prevalent and often persist throughout life, with standard treatment emphasizing behavioural interventions followed by melatonin supplementation when behavioural strategies prove insufficient. Nidra is the natural physiological state of mental and sensory withdrawal that allows rest and restoration, serving as one of the three pillars of health (Traya Upastambha) along with ahara and brahmacharya. Unmada is a psychiatric disorder characterized by perversion of mind, intellect, memory, and conduct, caused by vitiation of Vāta-Pitta-Kapha and Mānasika Doṣas (Rajas and Tamas). A comprehensive literature review was conducted across classical Ayurveda texts and contemporary scientific databases, including PubMed and Scopus to explore the conceptual and clinical parallels between autism and the balaunmada state. This conceptual review aims to analyze sleep disorders in ASD through the Ayurvedic frameworks of Nidranasha/Alpanidra/ Anidra in Unmada. By consolidating traditional wisdom with contemporary clinical challenges, the paper seeks to elucidate the Samprapthi (pathogenesis) of sleep disturbances in ASD viewed through the lens of sareerika and manasika dosha which will in turn help to deliver Ayurvedic treatments protocols. By identifying sleep disturbances as a subset of Unmada (behavioral/developmental disorders) a more holistic, etiology-based management strategy can be developed. This theoretical foundation will provide the necessary framework for designing safe and effective Ayurvedic protocols for managing sleep disturbances in ASD.