Efficacy of a Combination of Melissa officinalis L. and Nepeta Menthoides Boiss. & Buhse on Insomnia: A Triple-Blind, Randomized Placebo-Controlled Clinical Trial
Maryam Ranjbar, MD, PhD Candidate,1,2 Alireza Salehi, MD, MPH, PhD,2 Hossein Rezaeizadeh, PhD,3 Mohammad M. Zarshenas, Pharm, PhD,4,5 Khosro Sadeghniiat-Haghighi, MD,6 Mehran Mirabzadeh, Pharm, PhD,7 and Ali Firoozabadi, MD2,8
Background: Insomnia is a prevalent sleep disorder that has not been well managed thus far. There are numerous medicaments for treatment of insomnia, but they have undesirable side effects that make herbal medicine a more viable option.
Objectives: The effectiveness of a combination of Melissa officinalis L. (dry powder) and Nepeta menthoides Boiss. & Buhse (freeze-dried aqueous extract) on insomnia was evaluated.
Design and Setting: Insomniacs who met the entry criteria participated in a triple-blind randomized placebocontrolled clinical trial at the Persian Medicine (PM) clinic in Tehran.
Interventions: The subjects received either 1000 mg of M. officinalis plus 400 mg N. menthoides or a placebo nightly for four weeks in accordance with prescriptions from the pharmaceutical manuscripts on PM and the results of previous studies.
Outcome measures: The Pittsburgh Sleep Quality Index (PSQI), sleep diary, and Insomnia Severity Index (ISI) were used for assessment of insomnia.
Results: Comparison of the treatment and placebo groups showed a significant decrease in the mean difference of ISI (4.97 – 4.69 vs. 1.60 – 3.70; p =; 0.002) and total PSQI (4.14 – 3.69 vs. 1.42 – 2.81; p = 0.001) scores in the treatment group. A significant increase was also observed in total sleep time of treatment group (p < 0.001) based on the sleep diary.
Conclusions: A combination of M. officinalis and N. menthoides Boiss. & Buhse could be an alternative sleep improvement therapy
Source : Journal Alternative and Complementary Medicicne
Link to Full Article
Effect of Traditional East Asian Medicinal herbal tea (HT002) on insomnia: a randomized controlled pilot study
Sujeong Muna, Siwoo Leea Kihyun Parka Sang-Jae Leeb Byung-Hee KohcYounghwa Baeka
Complementary and alternative medicine treatment for insomnia has been sought due to the possible adverse effects of conventional pharmacotherapies. We performed a preliminary evaluation of the feasibility of using, and of the effect of a herbal tea (HT002), based on Traditional East Asian Medicine, in mild-to-moderate insomnia.
Patients (n = 40) with mild-to-moderate insomnia were randomized to the HT002 (n = 20) or waitlist (n = 20) groups. The HT002 group consumed HT002 twice daily for 4 weeks. Outcomes were assessed using the Insomnia Severity Scale (ISI), Pittsburgh Sleep Quality Index(PSQI), and 12-item Short Form Health Survey (SF-12) at baseline and after 4 and 8 weeks.
The ISI score differences from baseline at weeks 4 and 8 were significantly greater in the HT002 than that in the waitlist group (week 4: −4.0 ± 0.8 vs. −0.4 ± 0.8, p < 0.05; week 8: −4.8 ± 0.7 vs. −0.9 ± 0.7, p < 0.05). Changes in PSQI and SF-12 physical component scores in the HT002 group were significantly greater at weeks 4 and 8 (p < 0.05), while SF-12 mental component scores were only significantly larger at 4 weeks (p < 0.05). HT002 was well-tolerated, with only one (5.0%) dropout, and no significant mean liver and renal function test changes post-treatment.
Our preliminary results suggest that a 4-week treatment with HT002 may reduce the severity of insomnia symptoms and improve the quality of life. Further studies devoid of the limitations of our protocol may provide stronger conclusions.
Source : Integrative Medicine Research
Link to Full Article
Sleep modulates haematopoiesis and protects against atherosclerosis
Cameron S. McAlpine, Máté G. Kiss, Sara Rattik, Shun He, Anne Vassalli, Colin Valet, Atsushi Anzai, Christopher T. Chan, ohn E. Mindur, Florian Kahles, Wolfram C. Poller, Vanessa Frodermann, Ashley M. Fenn, Annemijn F. Gregory, Lennard Halle, Yoshiko Iwamoto, Friedrich F. Hoyer, Christoph J. Binder, Peter Libby, Mehdi Tafti, Thomas E. Scammell, Matthias Nahrendorf & Filip K. Swirski
Sleep is integral to life1. Although insufficient or disrupted sleep increases the risk of multiple pathological conditions, including cardiovascular disease2, we know little about the cellular and molecular mechanisms by which sleep maintains cardiovascular health. Here we report that sleep regulates haematopoiesis and protects against atherosclerosis in mice. We show that mice subjected to sleep fragmentation produce more Ly-6Chigh monocytes, develop larger atherosclerotic lesions and produce less hypocretin—a stimulatory and wake-promoting neuropeptide—in the lateral hypothalamus. Hypocretin controls myelopoiesis by restricting the production of CSF1 by hypocretin-receptor-expressing pre-neutrophils in the bone marrow. Whereas hypocretin-null and haematopoietic hypocretin-receptor-null mice develop monocytosis and accelerated atherosclerosis, sleep-fragmented mice with either haematopoietic CSF1 deficiency or hypocretin supplementation have reduced numbers of circulating monocytes and smaller atherosclerotic lesions. Together, these results identify a neuro-immune axis that links sleep to haematopoiesis and atherosclerosis.
Source : Journal Nature
Link to Abstract
The Effect of Mind-Body Therapies on Insomnia: A Systematic Review and Meta-Analysis
Xiang Wang,1 Peihuan Li,1 Chen Pan,1 Lisha Dai,1 Yan Wu,1 and Yunlong Deng
Background/Purpose. Sleep plays an important role in individuals’ health. The functions of the brain, the cardiovascular system, the immune system, and the metabolic system are closely associated with sleep. As a prevalent sleep disorder, insomnia has been closely concerned, and it is necessary to find effective therapies. In recent years, a growing body of studies has shown that mind-body therapies (MBTs) can improve sleep quality and ameliorate insomnia severity. However, a comprehensive and overall systematic review has not been conducted. In order to examine the effect of MBTs on insomnia, we conducted a systematic review and meta-analysis evaluating the effects of MBTs on sleep quality in healthy adults and clinical populations.
Methods. PubMed, EMBASE, the Cochrane Library, and review of references were searched up to July 2018. English language studies of all designs evaluating the effect of MBTs on sleep outcomes in adults with or without diseases were examined. To calculate the SMDs and 95% CIs, we used a fixed effect model when heterogeneity was negligible and a random effect model when heterogeneity was significant.
Results. 49 studies covering 4506 participants published between 2004 and 2018 were identified. Interventions included meditation, tai chi, qigong, and yoga which lasted 4 to 24 weeks. The MBTs resulted in statistically significant improvement in sleep quality and reduction on insomnia severity but no significant effects on sleep quantity indices, which were measured by sleep diary or objective measures. We analyzed the effects of tai chi and qigong separately as two different MBTs for the first time and found that qigong had a slight advantage over tai chi in the improvement of sleep quality. Subgroup analyses revealed that the effect of MBTs on sleep quality in healthy individuals was larger than clinical populations. The effect of MBTs might be influenced by the intervention duration but not the frequency.
Conclusions. MBTs can be effective in treating insomnia and improving sleep quality for healthy individuals and clinical patients. More high-quality and well-controlled RCTs are needed to make a better conclusion in further study.
Source : Evidence Based Complementary and Alternative Medicine Journal
Link to Full Article
Effects of Aromatherapy on the Anxiety, Vital Signs, and Sleep Quality of Percutaneous Coronary Intervention Patients in Intensive Care Units
Mi-Yeon Cho,1 Eun Sil Min,2 Myung-Haeng Hur,2 and Myeong Soo Lee
The purpose of this study was to investigate the effects of aromatherapy on the anxiety, sleep, and blood pressure (BP) of percutaneous coronary intervention (PCI) patients in an intensive care unit (ICU). Fifty-six patients with PCI in ICU were evenly allocated to either the aromatherapy or conventional nursing care. Aromatherapy essential oils were blended with lavender, roman chamomile, and neroli with a 6 : 2 : 0.5 ratio. Participants received 10 times treatment before PCI, and the same essential oils were inhaled another 10 times after PCI. Outcome measures patients' state anxiety, sleeping quality, and BP. An aromatherapy group showed significantly low anxiety (t=5.99, P < .001) and improving sleep quality (t=-3.65, P=.001) compared with conventional nursing intervention. The systolic BP of both groups did not show a significant difference by time or in a group-by-time interaction; however, a significant difference was observed between groups (F=4.63, P=0.36). The diastolic BP did not show any significant difference by time or by a group-by-time interaction; however, a significant difference was observed between groups (F=6.39, P=.011 ). In conclusion, the aromatherapy effectively reduced the anxiety levels and increased the sleep quality of PCI patients admitted to the ICU. Aromatherapy may be used as an independent nursing intervention for reducing the anxiety levels and improving the sleep quality of PCI patients.
Source : Evidence Based Complementary and Alternative Medicine
Link to Full Article
The Effects of Music Intervention on Sleep Quality in Community-Dwelling Elderly
Wang Qun, Chair Sek Ying, Wong Eliza Mi Ling, and Li Xiaomei.
Objectives: To examine the effects of music intervention on sleep quality in community-dwelling elderly people.
Design: Two-armed randomized controlled trial.
Settings: Four urban communities in Xi`an, China.
Participants: People aged 60 years or older with poor sleep quality (Pittsburgh Sleep Quality Index [PSQI] score >7).
Interventions: All participants received one sleep hygiene education session and biweekly telephone calls. Each participant in the intervention group received an MP3 player with a music database. The participants selected the preferred music and listened for 30–45 minutes per night for 3 months.
Outcome measures: Sleep quality, the main study outcome, was measured by PSQI at baseline, 1 month, 2 months, and 3 months.
Results: Sixty-four elderly people with a mean age of 69.38 ± 5.46 years were randomly assigned to the control group (n = 32) or the intervention group (n = 32). All participants completed the study, and none reported discomfort related to the music intervention. The intervention group demonstrated continuous improvements in sleep quality, with a global PSQI score of 13.53 at baseline, 9.28 at 1 month, 8.28 at 2 months, and 7.28 at 3 months. Although the global PSQI score in the control group also decreased from 12.26 at baseline to 8.72 at 3 months, the intervention group achieved greater improvements at each measurement (all p < 0.05). Repeated-measures analysis of variance revealed significant group-by-time interaction effects in global PSQI score and three component scores: sleep latency, sleep efficiency, and daytime dysfunction (all p < 0.05).
Conclusion: Music is a safe and effective nonpharmacological intervention for improving the sleep quality of community-dwelling elderly people, especially in improving sleep latency, sleep efficiency, and daytime dysfunction.
Source : Journal Alternative and Complementary Medicine
Link to Full Article
Lavender Aromatherapy Improves Sleep Quality in College Students
Lillehei AS, Halcón LL, Savik K, Reis R. Effect of inhaled lavender and sleep hygiene on self-reported sleep issues: A randomized controlled trial. J Altern Complement Med. 2015;21(7):430-438.
Sleep problems are associated with numerous health concerns such as anxiety, depression, cardiovascular disease, hypertension, inflammation, obesity, impaired glucose tolerance, and diabetes. Essential oils, such as lavender (Lavandula angustifolia, Lamiaceae) flower, which have sedative or hypnotic properties, have been evaluated for sleep therapy. The purpose of this randomized, double-blind, placebo-controlled study was to evaluate the effect of inhaled lavender essential oil on sleep quality and quantity in college students.
Students (n = 79, aged 18-36 years) with self-reported sleep issues (difficulty falling asleep, frequent awakenings during the night, or daytime sleepiness) were recruited from the University of Minnesota, Minneapolis, Minnesota, campus. Students were excluded if they were pregnant, working a night shift, or used prescription sleep medication. All subjects received sleep hygiene information based on the National Institutes of Health (NIH) recommendations—specifically, (1) maintain a regular sleep schedule; (2) avoid fluid intake before bed and food, caffeine, alcohol, and nicotine late in the day; (3) create a good sleeping environment (e.g., wear ear plugs and a sleep mask, and avoid screens and texting); (4) create a relaxing bedtime routine; (5) keep up with school work; and (6) exercise regularly.
Each 3-cm adhesive patch contained a 1-cm disc of absorbent material impregnated with 55 µL lavender oil (supplied by Wyndmere Naturals, Inc.; Minnetonka, Minnesota) or left blank (placebo). Based on the gas chromatography-mass spectrometry (GC-MS) analysis provided to the principal investigator, "the essential oil used was chemically consistent with the International Organization for Standardization (ISO) for L. angustifolia."The patch (supplied by Bioesse Technologies, LLC; Minnetonka, Minnesota) had a skin-barrier backing to prevent skin absorption of the essential oil and a time-release function to last 6-8 hours. For 5 consecutive nights, subjects applied a patch on their mid-upper chest at bedtime and removed it in the morning.
Sleep quantity was measured via a Fitbit® tracker (to measure movement during sleep) and sleep diary, and sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI) and the NIH Patient-Reported Outcomes Measurement Information System (PROMIS) sleep disturbance short form. Subjects also completed a sleep hygiene survey (SHS). Assessments were made at baseline, at day 5, and 2 weeks after the completion of treatment.
The majority of the subjects were white (67%) and female (69%); both treatment groups had similar demographics. There were technical issues with the Fitbit, resulting in unacceptable levels of missing data (only 14% of the data were recovered). The patches were reported to have fallen off during sleep in 37% of the person nights (n = 146); however, the data analysis indicated that the patch falling off was not a significant covariate. Based on SHS scores, sleep hygiene was better during the 5-day treatment phase compared to baseline and post-treatment in both groups; there were no significant differences in SHS scores between groups at any time point. Based on the PSQI, both groups had poor sleep before the intervention, and there was no difference between groups at baseline.
Post-treatment, sleep quantity did not significantly differ between groups; both groups had a significant decrease in awakenings (P = 0.02) and increase in being able to fall asleep easily (P = 0.001).
The PSQI and PROMIS assessments indicated that sleep quality was significantly better for the lavender group compared with the sleep hygiene-only group at day 5 (P = 0.01 and P = 0.04, respectively) and at follow-up (P ≤ 0.001 and P = 0.007, respectively). Better sleep hygiene was also associated with better sleep quality but to a much lesser degree at day 5 (P = 0.02 and P = 0.03, respectively) and at follow-up (P = 0.03, PROMIS only). The lavender group had a clinically significant improvement in sleep quality, while there was no clinically significant change in sleep quality in the sleep hygiene-only group. The lavender group had less daytime fatigue at day 5 and follow-up (P = 0.02 and P = 0.009, respectively) and was more likely to wake refreshed at day 5 (P = 0.01). The 4 adverse event reports (minor skin irritation, each lasting 1 night) were attributed to the patch adhesive.
The authors conclude that, in college students with self-reported sleep issues, lavender essential oil inhalation improved sleep quality, and the effect persisted for 2 weeks after lavender aromatherapy was suspended. "The persistent effect of lavender on sleep quality at two-week follow-up suggests a re-balancing or long-acting effect on the sleep cycle, although the exact mechanism of action is unknown." The limitations of the study were the lack of statistical power to evaluate potential differences due to race or ethnicity, the loss of objective Fitbit data regarding sleep quantity, the subjective self-reporting nature of the data, the lack of standardized dosages due to the poor patch adherence, and the potential failure of subject blinding due to the lavender scent. The authors conclude that this trial "supports the use of lavender and sleep hygiene as safe, accessible, and effective interventions for self-reported sleep issues in college students. Further research to study their effect on other populations and additional studies exploring the duration of intervention effects are needed."
—Heather S. Oliff, PhD
Source : American Botanical Council, Herbclip
Link to Source
Alcohol disrupts sleep homeostasis
Alcohol is a potent somnogen and one of the most commonly used “over the counter” sleep aids. In healthy non-alcoholics, acute alcohol decreases sleep latency, consolidates and increases the quality (delta power) and quantity of NREM sleep during the first half of the night. However, sleep is disrupted during the second half. Alcoholics, both during drinking periods and during abstinences, suffer from a multitude of sleep disruptions manifested by profound insomnia, excessive daytime sleepiness, and altered sleep architecture. Furthermore, subjective and objective indicators of sleep disturbances are predictors of relapse. Finally, within the USA, it is estimated that societal costs of alcohol-related sleep disorders exceeds $18 billion. Thus, although alcohol-associated sleep problems have significant economic and clinical consequences, very little is known about how and where alcohol acts to affect sleep. In this review, we have described our attempts to unravel the mechanism of alcohol-induced sleep disruptions. We have conducted a series of experiments using two different species, rats and mice, as animal models. We performed microdialysis, immunohistochemical, pharmacological, sleep deprivation and lesion studies which suggest that the sleep-promoting effects of alcohol may be mediated via alcohol's action on the mediators of sleep homeostasis: adenosine (AD) and the wake-promoting cholinergic neurons of the basal forebrain (BF). Alcohol, via its action on AD uptake, increases extracellular AD resulting in the inhibition of BF wake-promoting neurons. Since binge alcohol consumption is a highly prevalent pattern of alcohol consumption and disrupts sleep, we examined the effects of binge drinking on sleep-wakefulness. Our results suggest that disrupted sleep homeostasis may be the primary cause of sleep disruption observed following binge drinking. Finally, we have also shown that sleep disruptions observed during acute withdrawal, are caused due to impaired sleep homeostasis. In conclusion, we suggest that alcohol may disrupt sleep homeostasis to cause sleep disruptions.
Source : Journal Alcohol
Link to Full Article
Auricular Acupressure Helps Improve Sleep Quality for Severe Insomnia in Maintenance Hemodialysis Patients:A Pilot Study
Yuchi Wu, MS,1,*Chuan Zou, PhD,2,*Xusheng Liu, MS,1Xiuqing Wu, BS,1and Qizhan Lin, MS2
Background:Insomnia is common in patients undergoing maintenance hemodialysis (MHD). Long-term use ofsedative-hypnotic agents is often correlated with increasing adverse effects. Auricular acupressure therapy(AAT) applied to specific auricular acupoints for managing insomnia has achieved favorable outcomes in ahemodialysis unit. This pilot study was performed to demonstrate the potential of AAT for insomnia in MHDpatients and to prepare for a future randomized controlled trial
Methods:Eligible patients were enrolled into this descriptive pilot study and received AAT designed to manage insomnia for 4 weeks. Questionnaires that used the Pittsburgh sleep quality index (PSQI) were completed at baseline, after a 4-week intervention, and 1 month after completion of treatment. Sleep quality and other clinical characteristics, including sleeping pills taken, were statistically compared between different time points.
Results:A total of 22 patients were selected as eligible participants and completed the treatment and questionnaires. The mean global PSQI score was significantly decreased after AAT intervention (p<0.05). Participants reported improved sleep quality (p<0.01), shorter sleep latency (p<0.05), less sleep disturbance(p<0.01), and less daytime dysfunction (p=0.01). They also exhibited less dependency on sleep medications,indicated by the reduction in weekly estazolam consumption from 6.98–4.44 pills to 4.23–2.66 pills(p<0.01). However, these improvements were not preserved 1 month after treatment.
Conclusion:In this single-center pilot study, complementary AAT for MHD patients with severe insomnia wasfeasible and well tolerated and showed encouraging results for sleep quality.
Source : Journal Alternative and Complementary Medicine
Link to Full Article
Sedative Music Facilitates Deep Sleep in Young Adults
Chih-Kuang Chen, MD,1,2 Yu-Cheng Pei, MD, PhD,1,2,3 Ning-Hung Chen, MD,2,4 Li-Ting Huang, MD,1 Shih-Wei Chou, MD, PhD,1,2 Katie P. Wu, MD,1,2 Pei-Chih Ko, MD,1 Alice M.K. Wong, MD,1,3,5 and Chih-Kuan Wu, MD1
1Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital at Taoyuan/Linkou, Taoyuan, Taiwan.2School of Medicine, Chang Gung University, Taoyuan, Taiwan.3Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan.4Division of Pulmonary and Critical Care Medicine, Sleep Center, Chang Gung Memorial Hospital at Taoyuan, Taoyuan, Taiwan.5Graduate Institute of Rehabilitation Science, Chang Gung University, Taoyuan, Taiwan.
Objectives: To investigate the effect of sedative music on the different stages of the sleep cycle in young adults with various sleep latencies by using polysomnography (PSG).
Design: Prospective, randomized, controlled, crossover study.
Setting: Sleep center of a teaching hospital.
Participants: Young adults with different sleep latencies. Poor sleepers (Pittsburgh Sleep Quality Index score ≥5) were excluded.
Interventions: Each participant stayed one night in the sleep center for adaptation and on each of the following two nights was assigned to (1) music and (2) control (without music) conditions in random order. In the music condition, sedative music composed by certified music therapists was played on a compact disc player for the first hour the participant was in bed.
Outcome measures: Sleep measures recorded with PSG, including sleep latency and durations of sleep stages.
Results: Twenty-four young adults (mean±standard deviation, 24.5±2.6 years) participated. They were classified into the short sleep latency (SL) group if the baseline SL of the adaptation night was shorter than 10 minutes or into the long SL group if the baseline SL was 10 minutes or longer. Sedative music did not alter the SL in either group. Sedative music reduced stage II sleep in both SL groups (main effect of music, p=0.03; interaction effect, p=0.87) but increased the duration of deep sleep (stages III and IV) only in the long SL group (main effect of music, p=0.15; interaction effect, p=0.02).
Conclusions: In participants with long SL, sedative music improved the quality of sleep by prolonging the duration of deep sleep. This effect provides an alternative and noninvasive way to improve sleep in selected persons experiencing sleep problems.
Source ; Journal Alternative and Complementary Medicine
Link to Full Article