Siddha Varmathadaval therapy in the management of stress-related insomnia: A case report

Insomnia affects 10-30% of adults globally, with limited non-pharmacological options. This single-case report documents Siddha Varmathadaval therapy for stress-related insomnia. A 55-year-old woman presented with four-month history of insomnia (difficulty initiating/maintaining sleep) and daytime fatigue. Thookaminmai (insomnia) of Vatha-Pitham origin per Siddha principles was diagnosed. Baseline assessments showed severe insomnia (Insomnia Severity Index [ISI] = 21/28, Pittsburgh Sleep Quality Index [PSQI] = 15/21, Athens Insomnia Scale [AIS] = 13/24, Perceived Stress Scale-10 [PSS-10] = 31/40). The patient underwent twenty-one consecutive daily Varmathadaval therapy sessions using Sukku Thailam (90-120 minutes each), administered by a trained Siddha physician. Post-therapy improvements included ISI = 8/28 (62% reduction), PSQI = 6/21 (60% reduction), AIS = 4/24 (69% reduction), and PSS-10 = 12/40 (61% reduction). Traditional Siddha parameters (Manikadai Nool, Neikuri) demonstrated progressive improvement correlating with clinical outcome. Sleep latency decreased (45 → 15 minutes) and total sleep time increased (4-5→6-7 hours). Benefits were sustained at 4-week (ISI = 9) and 12-week (ISI = 11) post-treatment follow-up, with mild stress-related variation. Varmathadaval therapy produced clinically significant, sustained improvements in stress-related insomnia. The therapy was safe and well-tolerated. Controlled trials with prospective stress assessment are warranted.