Background: The proliferation of digital media has fundamentally transformed adolescent lifestyle, profoundly affecting sleep-wake regulation and psychological well-being.Within the classical Unani framework, these two domains—Naum wa Yaqza (sleep and wakefulness) and Ahwal-e-Nafsaniyah (psychological states)—are recognised as two of the six indispensable regulators of health, collectively termed Asbab-e-Sittah Zaruriyyah. Emerging evidence indicates that excessive screen exposure, particularly nocturnal blue-light-mediated melatonin suppression and chronic social-media-induced psychoemotional arousal, disturbs both of these fundamental axes, with downstream consequences for hypothalamic-pituitary-ovarian (HPO) axis integrity and menstrual regularity in adolescent girls. Objectives: This narrative review integrates contemporary biomedical evidence with classical Unani medical concepts to elucidate the mechanistic pathways by which digital media disrupts sleep-wake homeostasis and psychological equilibrium, and to delineate the consequent impact on menstrual health in adolescents. Methods: A thematic narrative synthesis was conducted using peer-reviewed literature on digital media and sleep, psychological well-being, and menstrual health, supplemented by classical Unani texts addressing Naum wa Yaqza, Ahwal-e-Nafsaniyah, and Asbab-e-Sittah Zaruriyyah. Results: Three converging pathways were identified: (1) nocturnal screen exposure suppresses melatonin via the ipRGC-SCN axis and disrupts HPO pulsatility, (2) social-media-associated psychosocial stress activates the HPA axis and suppresses GnRH pulsatility, and (3) these mutually reinforcing perturbations converge on menstrual irregularity via shared neuroendocrine and molecular mechanisms. Conclusion: Digital media use constitutes a contemporary disturbance to Asbab-e-Sittah Zaruriyyah that classical Unani scholars recognised as indispensable for health maintenance. Integrating the Unani explanatory model with modern neuroscience and reproductive endocrinology offers a holistic framework for adolescent menstrual health research, clinical practice, and public health policy.
Digital media; Screen time; Sleep-wake cycle; Naum wa Yaqza; Ahwal-e-Nafsaniyah; Asbab-e-Sittah Zaruriyyah; Menstrual health; Adolescents; Melatonin; HPO axis; Blue light; Unani medicine; Circadian rhythm.
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