PCOS, PHHA Series

Polycystic Ovarian Syndrome & Role of Homeopathy in PCOS

By

Dr Saurav AroraDr. Saurav Arora, BHMS (Gold Medalist), Founder: Vivid Homeopathy 

Dr Bharti Arora

Dr. Bharti Arora, MD (Hom.), BHMS (Silver Medalist), Co-Founder: Vivid Homeopathy 

Issued in Public Interest by

Vivid Homeopathy

www.vividhomeopathy.com | vividhomeopathy@gmail.com | +91 9811425214

Read Online Below or Download PDF here

In This Issue

  • Polycystic Ovarian Syndrome (=PCOS or PCOD)
  • Common Age of Onset
  • What is PCOS
  • Important terms
  • How it happens
  • Clinical Presentation
  • Types of PCOS
  • Prevalence
  • Diagnosis
  • Differential Diagnosis
  • Complications
  • Some Important facts
  • Management
  • Role of Homeopathy in PCOS
  • Recommended Scientific Reading

Polycystic Ovarian Syndrome (=PCOS or PCOD)

Polycystic Ovarian Syndrome or commonly called PCOS or PCOD (disease) is one of the rising endocrine disorders affecting millions of reproductive age group females. It is not only a disease which affects ovaries but may result in reproductive, metabolic, and psychological consequences.

Common Age of Onset

  • Common age of onset is adolescence.
  • Common time of diagnosis: 2nd to 4th decade of life.
  • Some symptoms may appear starting at menarche or post menopause.

What is PCOS

The first consensus definition of PCOS arose from the proceedings of an expert meeting in April 1990 in USA (1990 NIH criteria). It defines PCOS as the combined presence of:

  1. Hyperandrogenism,
  2. Oligoovulation and
  3. Exclusion of related disorders such as Cushing’s syndrome, hyperprolactinemia, and congenital adrenal hyperplasia.

However, in today’s scenario, an increasing awareness about PCOS suggests that the clinical expression of PCOS are broader than that specified by the 1990 NIH criteria.

Important terms

  • Hyperandrogenism = Androgen excess = excessive levels of androgens (male sex hormones such as testosterone).
  • Oligoovulation: Infrequent or irregular ovulation (usually defined as cycles of ≥36 days or <8 cycles a year).
  • Anovulation: is absence of ovulation when it would be normally expected (in a post-menarchal, premenopausal woman).

How it happens

The exact cause of PCOS is still unknown. It is believed that the hormonal imbalances and genetics play important role in its pathogenesis.

  • Females with PCOS often struggle with higher-than-normal production of androgens.
  • This affect the development and release of eggs during ovulation.
  • In many cases excess serum insulin may cause high androgen levels.

Clinical Presentation

The type and severity of symptoms varies from individual. Hyperandrogenism is a primary hallmark of PCOS. PCOS may cause women to develop certain characteristics, such as:

  • Abnormal growth of hair on the face, chest, stomach, thumbs, or toes (hirsutism),
  • Acne
  • Weight gain

Other symptoms/signs include:

  • Deeper voice
  • Decrease in breast size
  • Thin hair
  • Pelvic pain
  • Anxiety or
  • Infertility

Along with PCOS a female may have other concurrent health problems, such as diabetes, hypertension, and high cholesterol. These are linked to the weight gain typical in PCOS patients.

Types of PCOS

PCOS may express in following subtypes:

  1. HYPERANDROGENISM, normal cycle, PCO IN ULTRASOUND.
  2. Normal androgens, OLIGO-ANOVULATION, normal
  3. HYPERANDROGENISM, OLIGO-ANOVULATION, normal
  4. HYPERANDROGENISM, OLIGO-ANOVULATION, PCO IN ULTRASOUND

Prevalence

  • It affects approximately 5-10% of the female population in developed countries
  • In India it is approximately reported in 9% of the adolescent females.
  • Between 15-35 years of age it is commonly prevalent in around 6 – 13% of females

Diagnosis

PCOS is diagnosed clinically, but certain investigations are advised to diagnose it completely, such as:

  • Androgen level: free testosterone, DHEAS and androstenedione.
  • Sex hormone binding globulin (SHBG): usually low in PCOS.
  • Fasting insulin: elevated in PCOS.
  • Fasting glucose or 2-hour post-prandial glucose: elevated in PCOS.
  • LH/FSH Ratio: PCOS is associated with high LH with normal FSH. Normally, the ratio of LH: FSH is 1:1, but in PCOS, this ratio can get altered to 2:1 or even more.
  • Cholesterol levels: Impaired lipid metabolism may occur together with impaired blood sugar metabolism leading to an increase in both HDL and LDL.
  • Ultrasound to check for the presence of ovarian cysts in a typical pattern.

Differential Diagnosis

  • Pregnancy
  • Premature ovarian failure
  • Hyperthyroidism
  • Hypothyroidism
  • Pituitary adenoma
  • Late-onset congenital adrenal hyperplasia
  • Congenital adrenal hyperplasia
  • Androgen-producing tumor of the ovary or adrenal gland
  • Discontinuation of oral contraceptives
  • Rapid weight loss

Complications

Untreated PCOS may be associated with

  • Increased risk for cardiovascular disease
  • Dyslipidaemia
  • Infertility
  • Menstrual irregularities like amenorrhea, dysfunctional uterine bleeding
  • Permanent hirsutism
  • Persistent acne and
  • In some cases increased risk for endometrial cancer, endometrial hyperplasia and, breast cancer.

Some Important facts

  • This disorder was first identified in 1935 by Stein and Leventhal who noticed a condition in women characterized by irregular menstruation, obesity, and hirsutism, in addition to cysts on the women’s ovaries.
  • Genetic and environmental factors when combined with ovarian dysfunction, hypothalamic pituitary abnormalities, and obesity can accentuate PCOS.
  • Hormones imbalance involves estrogen, progesterone and androgens, such as testosterone.
  • The syndrome has major metabolic as well as reproductive morbidities. Reproductive problems may include infertility and various pregnancy complications and clinical signs of androgen excess.
  • Since it is reflected as hormone imbalance, there are instances where metabolic problems are also seen such as insulin resistance, metabolic syndrome, impaired glucose tolerance etc.
  • It is a psychological stress to a female and may result in lack of confidence, poor quality of life, poor self-esteem, depression, anxiety, and possibly eating disorders.

Management

The management of PCOS has four thumb rules:

  • Education: The PCOS and its causes must be taught to the patient. Many times it may be due to an underlying risk factor such obesity or stress.
  • Understanding: PCOS and its pathophysiological understanding is a must. Its present form, how much it is going to trouble a patient, what would be the probable outcome in future etc. must be understood.
  • Treat the Cause: As a thumb rule we need to identify the underlying cause of the PCOS, thus the treatment must aim at considering the root cause and not superficial symptoms only.
  • Eat Healthy Live Healthy: It is now an established fact that PCOS is related to poor life-style, stress and genetics. We can’t modify genetics but we can modify body’s expression and health status. Involment in health activities and treatment is the key rule. The patient is advised to take active interest and participation in timely medication, exercise, and dietary restrictions. Activities may include controlling cholesterol levels, reducing obesity, maintaining blood pressure etc.

Role of Homeopathy in PCOS

Homeopathy heals holistically!

  • Treat the Cause: Homeopathic system of medicine is a therapeutic system of symptoms similarity which is safe, effective, affordable and within reach. It takes into account the holistic approach i.e. person as a whole. This means that we treat every patient on the basis of individualization. During this process prescription is based upon the many factors such as symptoms, sign, causation, history, family history, mental status and inherent nature of the person, likings, disliking etc. This is synonymous with term Constitutional Medicine.
  • The PCOS has been termed as a syndrome as it affects many systems of the body. Therefore, it may be considered as a constitutional problem rather than a local disease.
  • Homoeopathic intervention aims at halting the progress, providing symptomatic relief and curing the patient.
  • Homeopathic medicines stimulate the hypothalamic-pituitary-ovarian axis thereby strengthens the immune system and trigger the natural release of hormones.

The homeopathic treatment of PCOS is divided into three major parts:

  • Initial stages (detected early): Constitutional treatment and/or specifics to control the symptoms.
  • Developed stages: Specific medicines to control symptoms and to regularise the body’s hormonal imbalance.
  • PCOS with other morbidities: Specific medicines are repeated too often and given for longer duration. The aim is to control the situation and improve quality of life of patients.

Homeopathic medicines can be taken safely along with other/conventional medications (ADD-ON Therapy).

  • The patient is asked to maintain a gap of approx. 30 mins between different medications.
  • The key point of treating PCOS is holistic healing and not hormonal or ultrasonography normalcy only.

Following medicines are commonly used frequently in homeopathy as constitutional or specific or both:

  • Apis mellifica
  • Natrum muriaticum
  • Platina
  • Phosphorus
  • Sepia
  • Pulsatilla (both in potency and mother tincture)
  • Thuja occidentalis
  • Senecio aureus
  • Oophorinum
  • Jonesia Asoca
  • Etc.

As a common myth, mother tinctures are not always superior to potencies. The right potency may be mother tincture, trituration or a dilution depending on severity and presentation of the case.

Recommended Scientific Reading

  1. Azziz R, Carmina E, Dewailly D, Diamanti – Kandarakis E, Escobar-Morreale HF, Futterweit W, et al. The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report. Fertil Steril. Feb 2009;91(2):456-88. [Medline].
  2. Stein IF, Leventhal ML. Amenorrhea associated with bilateral polycystic ovaries. AJOG 1935; 29(2):181-191.
  3. Garad, R., Teede, H. J., & Moran, L. (2011). An evidence-based guideline for Polycystic Ovary Syndrome. Australian Nursing Journal, 19(4): 30.
  4. Heidi A. Polycystic ovary syndrome (PCOS) in urban India. Manlove University of Nevada, Las Vegas. Available from: http://bit.ly/1Dq1fbP [Last accessed on 26 April 2015].
  5. Nidhi R, Padmalatha V, Nagarathna R, Amritanshu R. Prevalence of polycystic ovarian syndrome in Indian adolescents. J Pediatr Adolesc Gynecol 2011;24:223‑7.
  6. Nidhi R, Padmalatha V, Nagarathna R, Amritanshu R. Prevalence of Polycystic Ovarian Syndrome in Indian Adolescents. Journal of Pediatric and Adolescent Gynecology 2011; 4: 223–27.
  7. Polycystic Ovary Syndrome: Current and Emerging Concepts. Springer. Lubna Pal 2014. London
  8. Burghen G.A., Givens J.R., Kitabchi A.E. (1980) Correlation of hyperandrogenism with hyperinsulinism in polycystic ovarian disease. J Clin Endocrinol Metab 50: 113–116
  9. Jeffcoate, William et al. Diabète des femmes à barbe: a classic paper reread. The Lancet , Volume 356 , Issue 9236 , 1183 – 1185
  10. Kierland RR, Lakatos I, Szijarto L. Acanthosis nigricans: An analysis of data in twenty-two cases and a study of its frequency in necropsy material. J Invest Dermatol 1947:9:299-305
  11. Brown J, Winkelmann RK. Acanthosis nigricans: a study of 90 cases. Medicine 1968 47:33-51
  12. Kahn CR, Flier JS, Bar RS, Archer JA, Gorden P, Martin MM, Roth J 1976 The syndromes of insulin resistance and acanthosis nigricans. N Engl J Med 294:739–745
  13. Hughesdon PE 1982 Morphology and morphogenesis of the stein-leventhal ovary and of so-called “hyperthecosis.” Obstet Gynecol Surv 37:59–77
  14. Roe AH, Dokras A. The Diagnosis of Polycystic Ovary Syndrome in Adolescents. Reviews in Obstetrics and Gynecology. 2011;4(2):45-51.
  15. Legro RS. Polycystic ovary syndrome: current and future treatment paradigms. Am J Obstet Gynecol. 1998;179:S101–8.

 

Disclaimer

This article does not intend to replace the in-person consultation. The facts are for general purpose and public awareness only, and must not be taken as Medical Consultation in any form. For consultation, treatment and specific queries you need to contact your healthcare professional.

Not for Medico-legal purposes.

© Vivid Homeopathy & Arora’s Homeopathic Clinic 2017.

For reprint and collaborations please contact Dr. Saurav Arora at vividhomeopathy@gmail.com

Air Pollution, PHHA Series

Effects of Air Pollution on Health and Role of Homeopathy

Choose Your Language [gtranslate]

Public Health and Homeopathy Awareness Initiative Series

Air Pollution: Its Effects on Health & Role of Homeopathy in Air Pollution Related Diseases

By

Dr Saurav AroraDr. Saurav Arora, BHMS (Gold Medalist), Founder: Vivid Homeopathy 

Dr Bharti Arora

Dr. Bharti Arora, MD (Hom.), BHMS (Silver Medalist), Co-Founder: Vivid Homeopathy 

Issued in Public Interest by

Arora’s Homeopathic Clinic

An Establishment under

Vivid Homeopathy

www.arorasclinic.com | vividhomeopathy@gmail.com | +91 9811425214

Read Online Below or Download PDF here

Air is the Most Essential Thing

Air is a mechanical mixture of gases, and the most essential thing for an organism to survive. It normally contains Nitrogen (78%), Oxygen (21%), Carbon dioxide and other gases in proportion. In addition to these gases, air also contains water vapour, traces of ammonia and suspended matter such as dust, bacteria, spores, and vegetable debris, etc.

Apart from supplying the life-giving oxygen, air and atmospheric conditions serve several functions.  The human body is cooled by the air contact; special senses of hearing and smell function through air-transmitted stimuli; disease agents are conveyed by air.

The term “air pollution” denotes the presence of substances (e.g. gases, mixtures of gases and particulate matter) in the ambient surroundings, generated by the activities that interfere with the human health, safety or comfort, and is injurious to organisms, and other environmental media. It also results in chemicals entering the food chain, drinking water and thereby, adding substantial disease burden and affecting the quality of life.  The problem of air pollution was first recognized about 500 years ago when the burning of coal in cities was increasing, and since then it is increasing at an alarming rate all over the globe.

During foggy weather, when little wind is present the smoke generated from pollution is mixed with fog and form “SMOG”

The smog is making it difficult for people to see and breathe. 

Types

  1. Personal air exposure: refers to exposure to dust, fumes and gases to which an individual is exposed directly or indirectly, eg. Smoking.
  2. Occupational air exposure: exposure to harmful concentration of aerosols, vapors, and gases in working environment.
  3. Community air exposure:  This is most serious, complex, consists of varieties of assortment of pollution sources, meteorological factors, and wide variety of adverse social, economic, and health effects.

Air Pollutants

Till date more than 100 substances have been identified which pollute the air. These vary from place to place depending upon the specific complex of contaminant source. Following are few examples of primary and secondary air pollutants:

  • Carbon monoxide
  • Sulphur dioxide
  • Nitrogen oxides
  • Hydrocarbons
  • Particulate matter
  • Lead
  • Benzen
  • Ozone
  • PAN (peroxy acetyl nitrate)
  • Photochemical smog
  • Aerosols and mists: Sulphuric acid  (H2SO4), Nitric acid (HNO3)

Indoor Air Pollution

  • Indoor air pollution is one of the four most critical global environmental problems.
  • It exposes more people worldwide to important air pollutants than pollution in outdoor air.
  • Rural people in developing countries may receive as much as two-thirds of the global exposure to particulates.
  • Women and children suffer the greatest exposure.

Sources of Indoor Pollution

  • Indoor air pollution contributes to acute respiratory infections in young children, chronic lung disease, and cancer in adults, and may induce adverse pregnancy outcomes.
  • Non-smoking women exposed to indoor coal smoke have a risk of lung cancer similar to that of men who smoke lightly.

Effects on Health

Air pollution has short term and long term effects. The direct effects are reflected in airway system and then spread to multi-systems. It ranges from:

  • Upper and lower respiratory tract infections (acute and chronic)
  • Acute and recurrent bronchitis
  • Acute respiratory distress
  • Asthmatic attacks
  • Aggravation of pre-existing respiratory and heart disease.
  • Lung cancer

The short term and long term exposure is also linked with short life expectancy and reduced quality of life.

Effects of specific pollutants

General Management

The keywords of general management with respect to Air Pollution are:

Prevention

  • More you prevent yourself from harmful allergens, dust, smoke, pollution and smog, more it would be beneficial for your health.
  • Try to avoid early morning exposure to smog, cold air when your city is too much polluted.
  • Avoid travelling in crowded areas, malls and street where number of people and vehicles are intense.
  • Avoid taking walks on main roads, rather prefer parks with greenery.

Eat Healthy

  • Eating healthy foods keep your immunity intact and strong.
  • Food items like Jaggery, food rich in vitamin E and C keeps your immunity intact.
  • Avoid taking spicy and sour foods.

Keep your airways clear and clean

  • Use masks where ever necessary.
  • Avoid smoking and Passive-Smoking.
  • Keep your home free of dust, perfumes, strong smells and garbage.

Medication

  • Timely medication helps your immunity to fight disease better.
  • Don’t ignore symptoms even if they are minor and nonspecific.

Education

  • Keep yourself educated regarding hazards of air pollution and how to tackle them.
  • Keep an eye on neighbourhood for any polluting activities such as open fires, release of chemicals from factories, old polluting vehicles etc.
  • Try not to use own vehicles when you are travelling alone.
  • Opt for Car-Pool in where ever possible.

Ask for your rights

  • At working environments ask for masks, air purifiers, and less exposure to air/chemical pollution
  • Take opinion of medical specialists if you feel unwell while working.
  • Support govt. initiatives to keep your city clean and green

Role of Homeopathy in Diseases arising from Air Pollution

Homeopathy heals holistically!

  • Homeopathic medicines stimulates the body’s inner strength and boost the immune system to work well i.e. to reduce the disease load and to improve the overall health.
  • The constitutional or individualized homeopathy is known to reduce to tendency to catch respiratory illnesses.
  • The prescription is dependent upon symptoms, signs, tendencies, history and causation.
  • The treatment can be curative, palliative or supportive depending upon state and staging of disease.
  • In every stage homeopathy has a definitive role to play.
  • Homeopathic medicines can be taken safely along with other/conventional medications (ADD-ON Therapy).
  • In addition to constitutional/individualized medicines, the following medicines are frequently used on the basis of causation and symptom similarity:
  • Allium cepa: Rhinitis, coryza copious, fluent, watery, acrid discharge; burning in nose, mouth, throat; violent sneezing; eyes red, burning with profuse, watery, bland lacrimation; headache, cough, hoarseness.
  • Ammonium carb: Complaints from fumes, charcoal fumes; emphysematous changes in lungs; frequent sneezing, profuse discharge from nose, burning like hot water; stoppage of nose at night, wake up from sleep; sensation of dust particles in throat; dry tickling cough; chokes; wheezing.
  • Arsenicum album: An important remedy that is used in majority of complaints incidental to air pollutants, e.g. conjunctivitis, rhinitis, asthmatic bronchitis, emphysema, lung cancer, leukaemia and other malignancies, etc; quick respiration; suffocation inducing cough; scanty, frothy expectoration; sneezing without relief; burning in eyes; burning pains all over.
  • Blatta orientalis: Complaints from fumes, coal dust, smoke; relieves bronchospasm, acts as expectorant; dyspnoea, oppression of breathing; cough, with thick and purulent sputum.
  • Bromium: Complaints from coal dust; allergy to dust; complaints of sailors who suffer from asthma when they go ashore, better on sea. Dry spasmodic cough, airway feels filled with smoke; difficulty in inspiring, as if breathing through sponge.
  • Carbo veg: Complaints from carbon gas, carbon monoxide, dust, smoke, fumes from incomplete combustion of fuels. Collapse from imperfect oxidation. Oppressed, quick respiration; air-hunger, longing for fresh air; wants windows open; long spasms of cough with weakness, wheezing, gagging.
  • Cassia sophera: Complaints from exposure to dust, smoke; asthma, dry cough, with pain in chest, irritation in throat, better warmth; expectoration thick, yellowish; worse during winters, change of weather.
  • Dulcamara: Ailments from changing, damp environment, foggy weather, cold damp conditions, air-conditioned rooms; dry, teasing, spasmodic cough; hoarseness; dyspnoea after physical exertion.
  • Euphrasia: Inflammation of the conjunctiva; profuse acrid lacrimation; profuse, fluent bland coryza, sneezing in morning; violent cough in day time, abundant expectoration; worse indoors, warmth; better in open air.
  • Lobelia inflata: Ailments from smoke, dust; emphysematous changes; extreme dyspnoea; cough with sneezing, gasping; scanty expectoration; extreme nausea and vomiting, cannot bear taste or smell of tobacco.
  • Natrum sulph: Ailments incidental to spring & rainy season; dyspnoea; coughs continuously, towards end hacks up thick, ropy, greenish mucus.
  • Pothos foetidus: Ailments from smoke, dust; great dyspnoea and cough, frequent sneezing, pain in throat and chest, anxiety, abdominal distension and tension, better in open air.
  • Phosphorus: An important remedy that may be used in majority of complaints incidental to air pollutants, e.g. conjunctivitis, rhinitis, asthmatic bronchitis, emphysema, lung cancer, leukaemia, and other malignancies, etc. Breathing anxious, panting, short, hurried, very much oppressed; tightness across chest; violent hard, dry, tight, racking cough in spasmodic paroxysms.
  • Plumbum metallicum: An important remedy for lead toxicity. Interference with homoeostasis, rapid reduction in number of red cells, with pallor, icterus, anaemia. Localized neuralgic pains, neuritis, paralysis, wrist drop; stinging and tearing in limbs, with twitching, numbness.
  • Sulphurous acid: Persistent choking cough with copious expectoration; hoarseness, constriction of chest, difficult breathing.
  • Sabadilla: Rhinitis, pharyngitis; violent spasmodic sneezing, abundant watery nasal discharge, itching and tingling in nose, redness and burning in eyes, lacrimation, frontal headache, dryness and irritation in throat.
  • Sambucus: Nasobronchial hypersensitivity; paroxysmal nightly suffocative attacks; nose stopped up at night, breath through mouth; cough deep, restlessness, profuse perspiration.
  • Sanguinaria can: Nasobronchial hypersensitivity, asthmatic bronchitis. Severe dyspnoea, constriction in chest, severe spasmodic cough. Expectoration of thick yellow mucus, dislodged with difficulty. Sneezing, profuse watery mucus from nose; sensitive to flowers, odours.
  • Spongia: Complaints from sudden change of atmosphere, smoke. Severe form of asthmatic bronchitis, with dryness of respiratory tract. Severe dyspnoea, with wheezing, suddenly wakes up at night with intense suffocation; respiration rapid, short.

Disclaimer

This article does not intend to replace the in-person consultation. The facts are for general purpose and public awareness only, and must not be taken as Medical Consultation in any form. For consultation, treatment and specific queries you need to contact your healthcare professional.

Not for Medico-legal purposes.

© Vivid Homeopathy & Arora’s Homeopathic Clinic 2017.

For reprint and collaborations please contact vividhomeopathy@gmail.com

Sleep

Difficult, Disturbed or No Sleep: Homeopathy Has A Role To Play

Homeopathic Treatment of Sleep Disorders

Dr. Saurav Arora, Dr. Bharti Arora

Consultants, Arora’s Homeopathic Clinic

+919811425214 | vividhomeopathy@gmail.com | www.arorasclinic.com

Introduction

The value of sleep can’t be surpassed. Sleep is essential, sleep is vital. It is said that one’s success lies in the quality of sleep. The stress, lifestyle, and co-morbidities are making our life miserable, which is directly reflected in the quality of sleep we have. Either we sleep late or we sleep less, the outcome is reflected directly or indirectly in the work output. It is commonly urged by patients that if they have a quality sleep, everything would be fine perfectly in their life. In this situation, what should be the approach to deal sleep disorders? This article delineates the homeopathic perspective of sleep disorders and the probable/actual solution in homeopathy. And yes, if you are a patient and reading this, you must seek a homeopath to get rid of your sleep problems. Homeopathy Heals Holistically!

Commonest Sleep Problems

No sleep problem is common but every sleep problem is commonest. Lack of sleep, disturbed sleep, sleep apnea, sleep deprivation, and restless legs syndrome are some of the common presentations.

Scientifically, if we consider the International Classification of Sleep Disorders then we have the following categorizations:

DYSSOMNIA: Dyssomnia is a disturbance of the body’s natural resting and waking patterns. The sufferer is either too awake at night or too sleepy in the day. The dyssomnia may be due to:

  • Internal or Intrinsic factors such as physiological or psychological cause and the presentation may be insomnia, narcolepsy, sleep apnea, Periodic Limb Movement Disorder.
  • Outside or Extrinsic factors such as high altitude, allergies, alcohol abuse, noises, sleep deprivation due to other commitments.
  • Circadian Rhythm Disturbances such as jet travel, work in shifts, delayed sleep phase.

PARASOMNIA:  The “parasomnia” refers to all the abnormal things that may happen during sleep such as:

  • Arousal Disorders: sleepwalking, sleep terrors, confusional arousals.
  • Sleep-Wake Transition Disorders: somniloquy, hypnic jerks, rhythmic movement disorder (pediatrics).
  • REM Parasomnias: Rapid Eye Movement Sleep Behaviour Disorder (RBD), nightmares, sleep paralysis
  • Other: Bruxism, enuresis, etc.

MEDICAL-PSYCHIATRIC disorders in which sleep abnormality is a major symptom of some other medical disorder, but not the primary problem:

  • Depression
  • Schizophrenia
  • Alcoholism
  • Dementias
  • Infection

Sleep is also associated with few factors which are very common such as:

  • Shift work or overwork
  • Noise
  • New baby
  • Hunger
  • Eating late
  • Alcohol, coffee, tea or other stimulants
  • Uncomfortable bed
  • Cold
  • Insufficient exercise
  • Depression
  • Anxiety or fear
  • Excitement
  • Pain – teething, earache, colic
  • Old age

Homeopathic Aspects – Treat the Individual – Treat the Cause – Treat Holistically

In homeopathy, as we believe in treating a case holistically, we must enquire the causation and presentation from various point of views. Referring to basic homeopathic philosophy, we must see the presenting complaints and signs, causations, past history, family history, mental state, any specific illness etc. After we are done with a thorough examination of the individual and case, we draw a totality in which we must give importance to the uncommon and peculiar symptoms.

Practically, in the majority of the cases, we are struck with two major challenges – modifiable and non-modifiable causes. Sometimes it may just be the home environment of the patient which is the cause of sleep disorders. Therefore, it is not just an individual whom we should give priority, but the environment and the other factors associated with the patient as an individual. In situations where we can’t modify the factors, we must counsel patient to deal them confidently and with a positive mind.

A homeopath may play a dual role in such situations. Along with our medication, we are the great counselors. As we know the in-depth analysis of a case we can manage a patient well. In case we need to take help of an allied practitioner we must not hesitate to do so.

Moving further to homeopathic aspects, we have, in repertory the following rubrics which are worth considering in Sleep symptoms:

  • Anger, after: Coloc., Nux-v., Bry., Cham., Coff.
  • Anxiety, from:, Ars., Cocc., Bry., Caust., Cham, Kali-c. Lach
  • Excitement, from:  Hyos., Nux-v., Arg-n., Aur-m.
  • Fear, fright, from: Bry., Cham., Cimic., Cocc., Ign.
  • Grief, from: Nat-m., Ign., Kali-br., Sulph.,
  • Mental exertion, after:  Nux-v., Calc.
  • Old people: Acon, Bar-c., Phos., Ars.
  • Restlessness, from:  Apis, Ars., Merc-c., Alum., Bry.
  • Thoughts, from: Calc., Coff., Hep., Nux-v., Op.
  • Wine, after abuse of: Nux-v., Coff. Coffee; abuse of, after: Coff., Cham., Nux-v.

Even in homeopathic material medica, sleep has been given prime importance. Some of the excerpts from the homeopathic literature are:

  • Aethusa Cynapium: prostration with sleepiness.
  • Aloe Socotrina: Itching and burning in anus, preventing sleep (Ind.).
  • Ambra Grisea: After business embarrassments, unable to sleep, must get up (Act., Sep.)
  • Ammonium Carbonicum: Loses breath when falling asleep, must awaken to get breath (Grind., Lach.).
  • Anacardium Orientale: Headache: relieved entirely when eating (Psor.); when lying down in bed at night, and when about falling asleep.
  • Antim tart: Great sleepiness or irresistible inclination to sleep,
  • Arsenic Album: Haemorrhoids: with stitching pain when walking or sitting, not at stool; preventing sitting or sleep;
  • Arum Triphyllum: Children refuse food and drink on account of soreness of mouth and throat (Mer.); are sleepless.
  • Caladium: Very sensitive ot noise; slightest noise startles from
  • Cantharis: Sexual desire: increased both sexes; preventing sleep;
  • Cinchona: Unrefreshing sleep or constant sopor;

Clinically, the most commonly used homeopathic remedies are:

Nux vomica 

  • Crowding of thoughts
  • Wakes early but again falls asleep
  • Unrefreshing sleep
  • Side effects of overwork or over-stimulation (Night shifts)

Coffea 

  • Excitement
  • Sleep disturbed by dreams.
  • Hyperactive or hypersensitive children.

Colocynthis 

  • Fit of indigestion or colic.
  • Wakefulness

Chamomilla 

  • Anguish, visions and illusions.
  • Starts with fright, cries, tosses about, is tearful, talks, raves, groans, snores and constantly separates the thighs.
  • Commonly indicated in teething children.

Also, the following serve as homeopathic Anxiolytic agents:

  • Passiflora Incarnata: Restlessness, exhaustion, and sleeplessness.
  • Kali phos: Anxiety, Prostration, Irritability, Brain-fag, Somnabulance
  • Gelsemium: Cannot get fully to sleep; delirious on falling asleep; insomnia from exhaustion; from uncontrollable thinking; tobacco; yawning; sleepless from nervous irritation. Gelsemium has also found to be an anxiolytic agent when used in mice model under experimental conditions (http://ncbi.nlm.nih.gov/pubmed/20401745)
  • Pulsatilla: 3x and 6x were used in a study on mice, and the efficacy of Puls 3x and 6x was comparable to standard drug (http://sciencedirect.com/science/article/pii/S147549161200032X)

There are many patent medicines also, which claim to provide relief in sleep disorders, but there has been a constant demand for the evidence-based studies to establish their roles. In the following studies the role of specific/patents were studied:

2011 IJHDR 10(34):04-14 Anxiolytic and antidepressive effects of the homeopathic complex Homeo-pax® (pre-clinical study) The homeopathic complex Homeo-pax® has anxiolytic and antidepressant properties without affecting motor coordination capacity.
2009 IJHDR 8(28):91-99 Anxiolytic effect of the homeopathic complex Tepeex Results suggest that homeopathic complex Tepeex® has anxiolytic properties without affecting motor coordination.

 

Tapering anti-depressants, insomnia drugs etc.

This is perhaps the most common question asked in clinics. Some basic considerations are:

  • Side effects of “sleeping pills” may include burning or tingling in the hands, arms, feet, or legs; Changes in appetite; Constipation; Diarrhea; Difficulty keeping balance; Dizziness; Drowsiness; Dry mouth or throat; Flatulence; Headache; Heartburn; Stomach pain or tenderness; Uncontrollable shaking of a part of the body; Unusual dreams; Weakness
  • Is it safe to withdraw them??
  • Whenever a drug is tapered, a patient may have “Withdrawal Symptoms
  • Withdrawal symptoms are to be taken as a totality and homeopathic medicines are prescribed to:
    • Reduce their intensity
    • Make a patient at “ease”.
    • Helping him to get rid of “sleeping pills”
  • Withdrawal should be done with caution preferably under supervision of an Expert.

Potency and Repetition

  • Most common and most confusing question
  • Single dose?
  • Multiple doses?
  • Single medicine or combination?
  • At what time during a day/night?
  • Potency & Repetition
    • Low potencies in repeated doses: in cases where causative factor can be easily identified and modified.
    • Moderate potencies in few doses: where causative factor has association but cannot be easily modified
    • High potencies in infrequent doses: where there seems no causative factor(s)
  • Time of Day: Although medicines may be given at any time preferably few doses (may be placebo) should be given before sleep.
  • Single or Combination: This depends on a physician’s outlook towards a case, but clinically a bio-chemic remedy or a tincture may be given for few initial visit, where a patient develops faith and rapport with the doctor.

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