Ayurvedic Alternatives to Zolpidem, Benzodiazepines & Suvorexant for Insomnia

Abstract

It is one of the most common problems arising these days affecting about 30 – 40% of the population. It may be related to increasing stress, digital exposure, overthinking, irregular routines, emotional disturbances, improper diet and lifestyle changes, etc. which is characterized by the complaint of difficulty in falling or maintaining sleep or nonrestorative sleep. Nowadays different tranquilisers are prescribed for the treatment of insomnia. These medications provide significant relief during the initial phase of treatment however, prolonged and continuous use often leads to various adverse effects which arise the need to look for a natural way for its management. So, let’s discuss it in detail.

Introduction

Benzodiazepines, Zolpidem, Zaleplon, Suvorexant are sedatives and hypnotics that are used in the treatment of insomnia. Sedatives and hypnotics are a broad group of central nervous system (CNS) depressant medications used to reduce anxiety, induce calmness and promote sleep. Benzodiazepines are a class of medications which enhance the GABA-A receptor function. It includes diazepam, lorazepam, temazepam, etc. It is available in the market under brand names Xanax, Valium, Restoril, etc. It can cause significant muscle relaxation, anti convulsant effects. When taken for a long period of time it causes dependency and rebound insomnia. Zolpidem, Zaleplon are drugs of class Non Benzodiazepine Hypnotics which Selectively target the alpha 1 subunit of the GABA-A receptor. It is available in the market under brand names Ambien, Sonata , etc. These are chemically different to diazepines but the effects are the same. Suvorexant is an orexin receptor antagonist used in the management of insomnia, particularly in patients experiencing difficulty in falling asleep or maintaining sleep. It is available in the market under the brand name Belsomra.

Mode Of Action Of Sedatives-Hypnotics

• These drugs primarily act on the central nervous system (CNS) by enhancing inhibitory neurotransmission.

• The benzodiazepines bind to specific BZ sites on GABA-A receptors and increases the frequency of Cl⁻ channel opening. It does Non-selective enhancement of GABA.
• Non Benzodiazepine Hypnotics bind selectively to the BZ₁ (α1) subunit of the GABA-A receptor. They increase the frequency of chloride channel opening. It does highly selective enhancement of GABA at α1 sites.
• Suvorexant works by blocking the orexin receptors (which are responsible for wakefulness), thereby suppressing the wake drive and helping to induce and maintain sleep.

• This results in hyperpolarization of neurons that reduces the neuronal excitability which leads to sedation and hypnosis.

Indication

• Insomnia
• Anxiety disorders
• Seizure and convulsive disorder
• Alcohol withdrawal syndrome

Contraindication

• Hypersensitivity
• Acute narrow angle glaucoma
• Severe respiratory or hepatic insufficiency
• Pregnancy and lactation
• Severe depression or suicidal tendencies

Adverse Effects

• Drowsiness and sleepiness
• Dependency and withdrawal symptoms
• Dizziness and blurred vision
• Slowed reflexes and reaction time
• Impaired motor skills
• Slurred speech
• Cognitive impairment
• Poor sleep quality

Ayurvedic Perspective Of Nidra (Sleep)

In Ayurveda, Nidra (Sleep) is one the three upstambha (Pillars) and is very needed for mental as well as physical health and nidranasha or anidra (Insomnia) is mainly due to the aggravation of the Vata Dosha along with the involvement of Pitta and Kapha Dosha. Disturbed Doshas affect the Manovaha Srotas (Nervous system) leading to hyperactivity of the nervous system, poor sleep initiation, irritability, restlessness, nighttime awakenings, etc. Some of the Ayurvedic herbs useful in this are:

Ayurvedic Herbs Useful In Insomnia

1. Tagar (Valeriana wallichii)

Its roots are mainly known for its calming effects and are used to promote relaxation and support sound sleep due to its active phytoconstituents like valerenic acid, valepotriates, valeranal, bornyl acetate. It improves circadian rhythm and sleep onset. It pacifies Vata and Pitta Dosha and helps in balancing the emotional disturbances which are a common cause in insomnia.

2. Ashwagandha (Withania somnifera)

Its root contains withanine which acts as a sedative and hypnotic. It acts as a potent adaptogen and lowers cortisol levels thus decreasing hyperarousal which is the major cause of insomnia. It has ushana virya (warm potency), brimhaniya (nourishing), balya (strengthening), rasayana (rejuvenating) properties which are helpful in nourishing and strengthening the body thus strengthens the mind and body coordination and insomnia due to chronic illness.

3. Jatamansi (Nardostachys jatamansi)

It contains jatamansone, nardostachone, nardin, jatamansic acid, lignans and sesquiterpenes which contribute to its CNS calming activity. The Ayurvedic Pharmacopoeia of India recommends its use in disturbed mental states and insomnia. It modulates the GABAergic neurotransmission, promoting relaxation and extending sleep duration due to its Medhya properties and by reducing anxiety or depression symptoms that disrupt sleep.

4. Brahmi (Bacopa monnieri)

It contains bacosides A & B, alkaloids (brahmine, herpestine), flavonoids, and saponins which reduce stress, enhance serotonin production and promote relaxation. As a nerve tonic, it helps in calming hyperactive nerves and brain activity, which is beneficial for those with racing thoughts at bedtime.

5. Sarpagandha (Rauwolfia serpentine)

Its primary alkaloid Reserpine, depletes monoamines in brain synaptic vesicles, calming neural hyperactivity and inducing sedation without dependency. It pacifies Vata dosha and acts as Nidra Janak (sleep generator) for Nidranasha linked to hypertension, mania or epilepsy. But it also lowers blood pressure so it should be taken only after consulting a doctor to avoid hypotension and shock. It depletes catecholamines (norepinephrine/dopamine) and helps in deep relaxation in cases related to stress and hypertension.

Home Remedies That Help In Insomnia

• Warm milk with nutmeg (jaiphal) or ghee before bed as it calms Vata Dosha.
• Turmeric milk at night as it calms the mind and reduces body tension.
• Warm oil foot massage as it stimulates nerve endings, reduces Vata and promotes relaxation.
• Drinking buffalo milk at night as its properties induce sleep.
• Warm bath before bed as it creates thermal relaxation which helps in easier sleep onset.
• Avoid use of mobile phones or laptops because blue light blocks melatonin which is a major reason for insomnia these days.

Planet Ayurveda’s Alternatives For Insomnia

Planet Ayurveda is a well known Indian company that specializes in herbal and Ayurvedic products and focuses on providing natural remedies based on classical Ayurveda principles for a wide range of health conditions. Planet Ayurveda offers herbal remedies that support sleep by calming the nervous system, reducing stress, and balancing the vitiated Dosha. One of the product that is very helpful is:

Indian Valeriana Capsules

It is a capsule formulation of Planet Ayurveda which contains standardised extract of Tagar (Valeriana wallichii). It contains chemical compounds like valerenic acid, valepotriates, etc. which inhibits the breakdown of GABA, leading to a calming effect on the central nervous system. It acts as a natural tranquilizer which slows down brain activity and helps the person drift off to sleep more peacefully without the particular side effects.

Dosage 1-2 capsules twice a day with plain water after meals.

Conclusion

Benzodiazepines, Zolpidem, Zaleplon, Suvorexant are the drugs which are primarily used to induce and maintain sleep in patients with insomnia and other sleep disorders. While hypnotics provide rapid relief from insomnia, their long term use leads to risks like dependence, cognitive impairment, and rebound insomnia. Ayurvedic alternatives offer a safe, natural and holistic approach to improve sleep quality. Ayurvedic herbs like Brahmi (Bacopa monnieri), Ashwagandha (Withania somnifera), etc. promote relaxation by balancing the vitiated Doshas, enhancing GABAergic activity and addressing root causes like stress without causing sedation. Thus integrating Ayurvedic herbs with lifestyle interventions ensures sustainable and restorative sleep, making them a superior long term strategy over conventional hypnotics.