Insomnia
1. PRELIMINARY DATA
- No.: 234/2026
- Patient's Name: ABC
- Address: Flat 2001, Ruby Heights, Pune.
- Occupation: Software Engineer (night shifts, screen time, project deadlines)
- Religion: Hindu
- Date: 15/08/2026
- Age: 36 Years
- Sex: Male
- Education: B.Tech
- Status: Married
2. CHIEF COMPLAINTS AND ASSOCIATED TROUBLES
| LOCATION | SENSATION & PATHOLOGY | A/F & MODALITIES | CONCOMITANTS |
|---|
| Mind & Sleep | Difficulty falling asleep, restless sleep, frequent waking, early morning awakening, unrefreshing sleep | < Mental exertion, < Thoughts racing, < Evening/night, < Coffee/tea late, > Warm milk, > Dark quiet room, since 7 years (worse last 3 years, poor concentration from sleep debt) | Daytime fatigue, irritability, headache, anxiety |
| General | Restlessness at night | < Stress | Low mood, worry about sleep |
3. PERSONAL PAST & FAMILY HISTORY
- Past History: Occasional sleeplessness from exams; suppressed anxiety with medication; frequent late-night work; caffeine overuse; mild depression episode 4 years ago.
- Family History: Mother has insomnia. Father has hypertension. Brother has anxiety disorder.
- Developmental Landmarks: All milestones were reached at the appropriate age.
4. PATIENT AS A PERSON (PHYSICAL CHARACTERISTICS)
A. Physical Characteristics
- Appetite: Variable, late-night snacking
- Desires: Warm drinks (+++), Sweets (+)
- Aversions: Cold food
- Thirst: Moderate
- Elimination:
- Urine: Frequent at night
- Stool: Regular
- Perspiration: Scanty
- Sleep: Takes 1-2 hours to fall asleep, wakes multiple times, early 4-5 AM
- Thermal State: Chilly patient (prefers warm bed)
B. Reactions - Physical Factors
- Weather: Aggravation in cold weather
- Position: Better lying in dark quiet room
5. MENTAL STATE (Psychodynamic & Life-Space)
- Nature: Anxious, restless, overthinking
- Anxiety: About work performance, sleep itself
- Fear: Fear of never sleeping well, fear health decline
- Dreams: Racing thoughts, work deadlines, being late
- Other: Broods over day events, feels exhausted |
6. PHYSICAL GENERAL EXAMINATION
- Wt: 74 kg | Ht: 172 cm | Temp: 98.6°F
- RR: 18/min | Pulse: 82 bpm | B.P.: 132/84 mmHg
- Face: Tired, dark circles
- Tongue: Clean
- Nails: Normal
- Skin: Dry
7. SYSTEMIC EXAMINATION
- Nervous: No focal deficits, hyperalert
- CVS: S1, S2 Normal
- Respiratory: Clear
- GIT: Normal
8. ANALYSIS AND EVALUATION OF SYMPTOMS
- Mental General: Anxiety about sleep/work, overthinking, irritability (Grade 3)
- Physical General: Chilly, desire warm drinks, early waking, unrefreshing sleep (Grade 3)
- Particular: Chronic insomnia with racing thoughts, difficulty falling asleep, < night, > warm/dark (Grade 2)
9. SELECTION OF REPERTORY WITH REASON
- Repertory: Kent’s Repertory of Homoeopathic Materia Medica
- Reason: Chronic sleep disorder with strong Mental Generals (anxiety, overthinking) and Physical Generals (chilliness, sleep pattern) dominating; Kent suits sleep rubrics for insomnia.
10. TOTALITY OF SYMPTOMS FOR REPERTORISATION
- Anxiety about sleep
- Overthinking at night
- Desire warm drinks
- Chilly patient
- Sleep difficulty falling
- Early waking 4-5 AM
- Unrefreshing sleep
- Restlessness
- < Mental exertion, night
-
Warm drinks, dark room
- Daytime fatigue/irritability
11. CONVERSION INTO REPERTORIAL RUBRICS
| SR. NO. | SYMPTOMS | RUBRICS WITH SUB-RUBRICS | PAGE NO. (Kent) |
|---|
| 1 | Anxiety sleep | Mind; ANXIETY; sleep, about | 7 |
| 2 | Mind thoughts racing | Mind; THOUGHTS; rushing | 88 |
| 3 | Desire warm drinks | Stomach; DESIRES; warm drinks | 486 |
| 4 | Sleep sleeplessness | Sleep; SLEEP; sleeplessness | 1250 |
| 5 | Sleep waking early | Sleep; SLEEP; waking; early | 1252 |
| 6 | Chilliness | Generalities; COLD; agg. | 1348 |
| 7 | Restlessness | Mind; RESTLESSNESS | 72 |
12. SELECTION OF REPERTORIZATION (NUMERICAL ORDER)
| SR. NO. | REMEDIES | RUBRICS COVERED | TOTAL MARKS |
|---|
| 1 | Coffea Cruda | 7/7 | 21 |
| 2 | Nux Vomica | 6/7 | 18 |
| 3 | Argentum Nitricum | 5/7 | 15 |
13. MIASMATIC INTERPRETATION
| PSORA | SYCOSIS | TUBERCULAR | SYPHILIS |
|---|
| Racing thoughts, irritability, chilly | Chronic overthinking, insomnia | Family anxiety issues | Destructive fear decline |
Dominant Miasm: Psora
14. FINAL STEPS
- Provisional Diagnosis: Insomnia (chronic)
- Differentiation of Remedies: Compared Coffea with Nux Vomica. Nux Vomica has more irritability from overwork, chilly; Coffea matches insomnia from racing thoughts/excitement, hot/chilly mix, desire warm drinks, early waking, < mental activity. Argentum Nitricum more anticipatory.
- Selection of Remedy (Materia Medica): Coffea Cruda matches chronic insomnia with racing thoughts, difficulty falling asleep, early waking, irritability/anxiety, < mental excitement (Ref: Allen’s Keynotes, Boericke).
- Selection of Potency: 200C (Chronic sleep disorder miasmatic case, sensitive constitution)
- Actual Prescription:
- Coffea Cruda 200 — single dose (one dose only, wait & watch)
- Placebo — 4 pills twice a day for 8 weeks
15. FOLLOW-UP'S TABLE
| DATE | COMPLAINTS | REMEDY | ADVICE |
|---|
| 20/09/2026 | Falling asleep faster, less waking, sleep more refreshing | Placebo | No screens before bed, regular sleep schedule, relaxation |
| 20/01/2027 | Sleep mostly normal, rare bad nights, energy & mood better | Placebo | Maintain routine, report stress triggers |