Case Report: A case of post-viral inflammatory insomnia: observed sleep restoration associated with histamine-targeted interventions and implications for mast cell pathways

This case demonstrates a reversible form of inflammatory insomnia and fatigue, likely mediated by mast cell-driven histamine activity. A multi-component intervention targeting histamine pathways, including antihistamine therapy, environmental modification, and dietary adjustment, was associated with rapid and sustained normalization of objective sleep metrics in this patient. These findings highlight the importance of evaluating immune and inflammatory contributors in patients with refractory insomnia and support further investigation of mast cell-related pathways in translational sleep medicine.