Therapeutic evaluation of Pāshoya (herbal footbath) in the management of chronic insomnia: A case report.

BACKGROUND

Chronic insomnia is a prevalent sleep disorder associated with impaired daytime functioning and reduced quality of life. Although conventional hypnotic medications may provide symptomatic relief, their long-term use is often limited by adverse effects, tolerance, dependence, and recurrence of symptoms after discontinuation. Pāshoya (herbal footbath), a traditional Unāni regimenal therapy, has historically been used for insomnia; however, published clinical evidence remains limited.

CASE PRESENTATION: A 36-year-old male presented with a one-year history of chronic insomnia characterized by difficulty initiating and maintaining sleep despite previous treatment with multiple hypnotic medications that provided only temporary benefit. Following a one-week washout period, the patient underwent a standardized Pāshoya consisting of Withania somnifera, Valeriana wallichii, Melissa officinalis, Matricaria chamomilla, and Lavandula stoechas. Both feet were immersed in a lukewarm herbal decoction for 20 minutes at bedtime once daily for 45 consecutive days.

INTERVENTION AND OUTCOMES: Clinical improvement was assessed using the Insomnia Severity Index (ISI). The ISI score decreased from 18 (moderate clinical insomnia) at baseline to 12 on Day 15, 8 on Day 30, and 6 on Day 45, indicating resolution of clinically significant insomnia. The patient also reported improved sleep onset, fewer nocturnal awakenings, better daytime functioning, and enhanced sleep quality. No treatment-related adverse events were observed, and the clinical improvement was sustained during a three-month follow-up without additional pharmacological therapy.

CONCLUSION

This case suggests that standardized Pāshoya may represent a safe and potentially beneficial complementary intervention for selected patients with chronic insomnia. Further well-designed controlled studies are required to establish its efficacy, safety, and underlying mechanisms.