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Pérez-Piñero S, Muñoz-Carrillo JC, Echepare-Taberna J, Muñoz-Cámara M, Herrera-Fernández C, Ávila-Gandía V, Heres Fernández Ladreda M, Menéndez Martínez J, López-Román FJ. Effectiveness of Enriched Milk with Ashwagandha Extract and Tryptophan for Improving Subjective Sleep Quality in Adults with Sleep Problems: A Randomized Double-Blind Controlled Trial. Clocks Sleep 2024; 6:417-432. [PMID: 39189195 PMCID: PMC11348217 DOI: 10.3390/clockssleep6030028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 07/31/2024] [Accepted: 08/02/2024] [Indexed: 08/28/2024] Open
Abstract
A randomized, double-blind and controlled study was conducted to assess the effectiveness of the intake of 250 mL of lactose-free skimmed milk enriched with ashwagandha (Withania somnifera) alone or combined with tryptophan vs. non-enriched milk (control) on the subjective quality of sleep in healthy adults with sleep problems. The duration of supplementation was 90 days. Fifty-two eligible subjects were assigned to the study arms of ashwagandha 250 mg, ashwagandha 250 mg plus tryptophan 175 mg, ashwagandha 600 mg, and control with 13 subjects in each group. It was hypothesized that ashwagandha plus tryptophan could be superior to ashwagandha alone for improving sleep-related variables. Changes in the visual analogue scale (VAS) for sleep quality were significantly higher in the three experimental groups as compared with controls (p = 0.014). Improvements in the subscales of the Pittsburg Sleep Quality Index (PSQI) were found in all groups, but between-group differences were not significant. In the index of insomnia severity, decreases were higher in the three experimental groups as compared with controls especially in the group of ashwagandha 600 mg. Daytime somnolence was also reduced in the three experimental groups. Changes in anxiety levels and Morningness-Eveningness Questionnaire were not observed. The study products did not elicit changes in body composition and were well tolerated and safe. The data did not support the hypothesis, as the combination of ashwagandha and tryptophan did not show greater benefits in improving sleep quality than ashwagandha alone. However, the results from the three experimental groups containing ashwagandha were more favorable compared to the placebo group.
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Affiliation(s)
- Silvia Pérez-Piñero
- Faculty of Medicine, UCAM Universidad Católica San Antonio de Murcia, Carretera de Guadalupe s/n, E-9, 30107 Murcia, Spain; (S.P.-P.); (J.C.M.-C.); (J.E.-T.); (M.M.-C.); (C.H.-F.); (V.Á.-G.)
| | - Juan Carlos Muñoz-Carrillo
- Faculty of Medicine, UCAM Universidad Católica San Antonio de Murcia, Carretera de Guadalupe s/n, E-9, 30107 Murcia, Spain; (S.P.-P.); (J.C.M.-C.); (J.E.-T.); (M.M.-C.); (C.H.-F.); (V.Á.-G.)
| | - Jon Echepare-Taberna
- Faculty of Medicine, UCAM Universidad Católica San Antonio de Murcia, Carretera de Guadalupe s/n, E-9, 30107 Murcia, Spain; (S.P.-P.); (J.C.M.-C.); (J.E.-T.); (M.M.-C.); (C.H.-F.); (V.Á.-G.)
| | - Macarena Muñoz-Cámara
- Faculty of Medicine, UCAM Universidad Católica San Antonio de Murcia, Carretera de Guadalupe s/n, E-9, 30107 Murcia, Spain; (S.P.-P.); (J.C.M.-C.); (J.E.-T.); (M.M.-C.); (C.H.-F.); (V.Á.-G.)
| | - Cristina Herrera-Fernández
- Faculty of Medicine, UCAM Universidad Católica San Antonio de Murcia, Carretera de Guadalupe s/n, E-9, 30107 Murcia, Spain; (S.P.-P.); (J.C.M.-C.); (J.E.-T.); (M.M.-C.); (C.H.-F.); (V.Á.-G.)
| | - Vicente Ávila-Gandía
- Faculty of Medicine, UCAM Universidad Católica San Antonio de Murcia, Carretera de Guadalupe s/n, E-9, 30107 Murcia, Spain; (S.P.-P.); (J.C.M.-C.); (J.E.-T.); (M.M.-C.); (C.H.-F.); (V.Á.-G.)
| | | | | | - Francisco Javier López-Román
- Faculty of Medicine, UCAM Universidad Católica San Antonio de Murcia, Carretera de Guadalupe s/n, E-9, 30107 Murcia, Spain; (S.P.-P.); (J.C.M.-C.); (J.E.-T.); (M.M.-C.); (C.H.-F.); (V.Á.-G.)
- Primary Care Research Group, Biomedical Research Institute of Murcia (IMIB-Arrixaca), 30120 Murcia, Spain
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Sahin K, Gencoglu H, Korkusuz AK, Orhan C, Aldatmaz İE, Erten F, Er B, Morde A, Padigaru M, Kilic E. Impact of a Novel Valerian Extract on Sleep Quality, Relaxation, and GABA/Serotonin Receptor Activity in a Murine Model. Antioxidants (Basel) 2024; 13:657. [PMID: 38929096 PMCID: PMC11200646 DOI: 10.3390/antiox13060657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 04/19/2024] [Accepted: 04/26/2024] [Indexed: 06/28/2024] Open
Abstract
Insomnia is a major global health issue, highlighting the need for treatments that are both effective and safe. Valerian extract, a traditional remedy for sleep problems, offers potential therapeutic options. This research examined the potential sleep-enhancing effects of VA (Valerian Pdr%2) in mice. The study evaluated sleep quality by comparing the impact of the VA extract against melatonin on brain activity, using electrocorticography (ECoG) to assess changes in brain waves. For this purpose, the study utilized two experimental models on BALB/c mice to explore the effects of caffeine-induced insomnia and pentobarbital-induced sleep. In the first model, 25 mice were assigned to five groups to test the effects of caffeine (caffeine, 7.5 mg/kg i.p) alone, caffeine with melatonin (2 mg/kg), or caffeine with different doses of valerian extract (100 or 300 mg/kg) given orally on brain activity, assessed via electrocorticography (ECoG) and further analyses on the receptor proteins and neurotransmitters. In the second model, a different set of 25 mice were divided into five groups to examine the impact of pentobarbital (42 mg/kg) alone, with melatonin, or with the valerian extract on sleep induction, observing the effects 45 min after administration. The study found that ECoG frequencies were lower in groups treated with melatonin and two doses of valerian extract (100 and 300 mg/kg), with 300 mg/kg showing the most significant effect in reducing frequencies compared to the caffeine control group, indicating enhanced sleep quality (p < 0.05). This was supported by increased levels of serotonin, melatonin, and dopamine and higher levels of certain brain receptors in the melatonin and valerian extract groups (p < 0.05). Modulatory efficacy for the apoptotic markers in the brain was also noted (p < 0.05). Additionally, melatonin and both doses of VA increased sleep duration and reduced sleep onset time compared to the pentobarbital control, which was particularly notable with high doses. In conclusion, the findings suggest that high doses (300 mg/kg) of valerian extract enhance both the quantity and quality of sleep through the GABAergic pathway and effectively increase sleep duration while reducing the time to fall asleep in a pentobarbital-induced sleep model in mice.
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Affiliation(s)
- Kazim Sahin
- Department of Animal Nutrition, Faculty of Veterinary Medicine, Firat University, 23119 Elazig, Türkiye;
| | - Hasan Gencoglu
- Department of Biology, Faculty of Science, Firat University, 23119 Elazig, Türkiye; (H.G.); (B.E.)
| | - Ahmet Kayhan Korkusuz
- Department of Physiology, School of Medicine, Istanbul Medipol University, 34810 Istanbul, Türkiye; (A.K.K.); (İ.E.A.)
| | - Cemal Orhan
- Department of Animal Nutrition, Faculty of Veterinary Medicine, Firat University, 23119 Elazig, Türkiye;
| | - İsmail Ertuğ Aldatmaz
- Department of Physiology, School of Medicine, Istanbul Medipol University, 34810 Istanbul, Türkiye; (A.K.K.); (İ.E.A.)
| | - Fusun Erten
- Department of Veterinary Science, Pertek Sakine Genc Vocational School, Munzur University, 62500 Tunceli, Türkiye;
| | - Besir Er
- Department of Biology, Faculty of Science, Firat University, 23119 Elazig, Türkiye; (H.G.); (B.E.)
| | - Abhijeet Morde
- Research and Development, OmniActive Health Technologies, Mumbai 400013, India; (A.M.); (M.P.)
| | - Muralidhara Padigaru
- Research and Development, OmniActive Health Technologies, Mumbai 400013, India; (A.M.); (M.P.)
| | - Ertugrul Kilic
- Department of Physiology, Faculty of Medicine, Istanbul Medeniyet University, 34700 Istanbul, Türkiye;
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Valente V, Machado D, Jorge S, Drake CL, Marques DR. Does valerian work for insomnia? An umbrella review of the evidence. Eur Neuropsychopharmacol 2024; 82:6-28. [PMID: 38359657 DOI: 10.1016/j.euroneuro.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 01/22/2024] [Accepted: 01/25/2024] [Indexed: 02/17/2024]
Abstract
Valerian is one of the most used herbal agents (phytotherapeutics) to manage sleep disturbances, in particular, sleep-onset difficulties in young adults. However, the evidence based on primary studies and systematic reviews that supports its use in this domain is weak or inconclusive. In the current study, an umbrella review was performed on the efficacy of valerian for sleep disturbances with a focus on insomnia. As such, only systematic reviews (with or without meta-analysis) were considered for this study. Systematic searches in PubMed, Web of Science, Scopus, Cochrane Database of Systematic Reviews, PROSPERO and CNKI databases retrieved 70 records. Only 8 articles were considered eligible for qualitative analysis. Overall, data suggested that valerian has a good safety profile, however, the results showed no evidence of efficacy for the treatment of insomnia. Moreover, valerian appears to be effective concerning subjective improvement of sleep quality, although its effectiveness has not been demonstrated with quantitative or objective measurements. Despite its widespread use and prescription by general practitioners, psychiatrists and other professionals, valerian does not have empirical support for insomnia. Further studies, in particular high quality randomized controlled trials, are highly recommended since there are scarce studies and the existing ones are quite heterogeneous and with low methodological quality. The implications of our findings for clinical practice are critically discussed.
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Affiliation(s)
- Valéria Valente
- University of Aveiro, Department of Education and Psychology, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
| | - Daniela Machado
- University of Aveiro, Department of Education and Psychology, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
| | - Susana Jorge
- University of Aveiro, Department of Education and Psychology, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal
| | - Christopher L Drake
- Sleep Disorders and Research Center, Henry Ford Hospital, Detroit, MI 48202, USA
| | - Daniel Ruivo Marques
- University of Aveiro, Department of Education and Psychology, Campus Universitário de Santiago, 3810-193 Aveiro, Portugal; CINEICC - Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal.
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Mobasheri A, Spring-Charles A, Gamaleri FC, McSwan J, Garg M, Sethi VS. Evidence-Based Opinions from Multidisciplinary Experts on Use of Naturopathic Herbal Remedies in Pain Management. J Pain Res 2024; 17:599-608. [PMID: 38347854 PMCID: PMC10860847 DOI: 10.2147/jpr.s432090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/03/2024] [Indexed: 02/15/2024] Open
Abstract
Background Pharmacological approaches to acute and chronic pain management, including non-steroidal anti-inflammatory drugs (NSAIDs) and opioids, are respectively associated with adverse reactions (such as gastrointestinal, cardiovascular, and renal effects) that might limit their use in patients with comorbidities and controversy related to inappropriate use. Naturopathic remedies might offer patients alternative and integrative treatments with minimal side effects. Objective To explore the regional variation in the acceptance and use of naturopathic remedies in pain management. Methods Two expert panel discussions were held by GlaxoSmithKline Consumer Healthcare (now Haleon Pte. Ltd.) over 9 and 12 hours in 2020 and 2021, respectively, and attended by multidisciplinary experts in naturopathy, Ayurvedic medicine, community pharmacy, physiotherapy, clinical pharmacy, Western medicine, academics, and naturopathic pain relief. Experts shared and discussed their experiences of naturopathic treatments and relevant clinical evidence related to different types of pain (including joint and muscle pain, migraine, sleeplessness due to pain, and general pain) and examined barriers to providing support to patients. Results Experts agreed on the potential for curcumin (2020, 71.4% [5/7]; 2021, 91.7% [11/12]) and fish oil (2020, 100% [7/7]) for management of osteoarthritic joint pain although these are not uniformly recommended in osteoarthritis treatment guidelines. In treatment of migraines, coenzyme Q10 and magnesium were favored by experts (2021, 90.9% [10/11] and 63.6% [7/11], respectively). Conclusion The need was emphasized for more and higher quality clinical studies to support naturopathic remedies, which might not be reflected in the latest treatment guidelines. The expert panel also highlighted missed opportunities for physicians and pharmacists to recommend effective naturopathic treatments.
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Affiliation(s)
- Ali Mobasheri
- Research Unit of Health Sciences and Technology, Physics and Technology, University of Oulu, Oulu, Finland
- Department of Regenerative Medicine, State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania
- Department of Joint Surgery, Sun Yat-sen University, Guangzhou, People’s Republic of China
- World Health Organization Collaborating Center for Public Health Aspects of Musculoskeletal Health and Aging, Université de Liège, Liège, Belgium
| | | | | | - Joyce McSwan
- PainWISE Pty Ltd, Gold Coast, Queensland, Australia
| | - Manohar Garg
- Nutraceuticals Research Program, University of Newcastle, Callaghan, Newcastle, NSW, Australia
| | - Vidhu Sood Sethi
- Medical Affairs, Haleon (Formerly GlaxoSmithKline Consumer Healthcare) Pte. Ltd., Singapore
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Pinder NE, Ligocki IY, Horton BM, Hoover JE. Valerenic acid reduces anxiety-like behavior in young adult, female (C57BL/6J) mice. Behav Brain Res 2024; 457:114717. [PMID: 37852540 DOI: 10.1016/j.bbr.2023.114717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/05/2023] [Accepted: 10/14/2023] [Indexed: 10/20/2023]
Abstract
Extracts from the plant Valeriana officinalis are marketed as an herbal remedy to treat anxiety and insomnia. Valerenic acid (VA) is a major chemical component of Valeriana extracts. To date, there is relatively little information about how VA affects behavior. The purpose of these experiments was to (1) test whether administration of VA induces measurable changes in anxiety-like, depression-like, or locomotor behaviors; (2) determine whether the effects of VA on behavior are dose-dependent; and (3) compare the effects of VA on behavior to those of diazepam, a commonly prescribed treatment for anxiety. Young adult, female mice (C57BL/6J; 3-4 months old; 12 mice/group) were given one of three dosages of VA (3 mg/kg, 6 mg/kg, or 12 mg/kg), diazepam (1 mg/kg), or a vehicle control solution (20% ethanol v/v) by intraperitoneal injection. Thirty minutes after injection, each mouse was tested in the elevated plus maze (EPM), open field test (OFT), and tail suspension test (TST), in that order. All tests were video recorded and analyzed for relevant behavioral parameters. The results demonstrated that VA treatment effectively reduced multiple anxiety-related behaviors measured in the EPM. In fact, at a dose of 12 mg/kg, the anxiolytic effect of VA was just as robust as that of diazepam. Furthermore, the effects of VA on behavior were specifically anxiolytic, as VA did not induce changes in locomotor activity in the OFT, or depression-related behavior as measured in the TST. Our results provide strong support for VA as a putative anxiolytic drug.
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Affiliation(s)
- Natalie E Pinder
- Department of Biology, Millersville University, P.O. Box 1002, Millersville, PA 17551, USA
| | - Isaac Y Ligocki
- Department of Biology, Millersville University, P.O. Box 1002, Millersville, PA 17551, USA
| | - Brent M Horton
- Department of Biology, Millersville University, P.O. Box 1002, Millersville, PA 17551, USA
| | - John E Hoover
- Department of Biology, Millersville University, P.O. Box 1002, Millersville, PA 17551, USA.
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Chandra Shekhar H, Joshua L, Thomas JV. Standardized Extract of Valeriana officinalis Improves Overall Sleep Quality in Human Subjects with Sleep Complaints: A Randomized, Double-Blind, Placebo-Controlled, Clinical Study. Adv Ther 2024; 41:246-261. [PMID: 37899385 PMCID: PMC10796483 DOI: 10.1007/s12325-023-02708-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 10/03/2023] [Indexed: 10/31/2023]
Abstract
INTRODUCTION Sleep deficit or poor sleep leads to ill-health, whereas sleep deprivation for longer periods of time increases the risk of developing adverse conditions associated with poor quality of life, and high socioeconomic impact. The treatments for sleep disturbances include melatonin and over-the-counter medicines like diphenhydramine and doxylamine, all of which have negative side effects. Valerian (Valeriana officinalis L.) is a traditional herb and the most preferred alternate sleep solution to manage sleep complaints. METHODS Eighty adult subjects with sleep complaints were randomized in 1:1 ratio to receive either V. officinalis extract (VE) or placebo for 8 weeks in a double-blind, placebo-controlled, parallel, clinical study. Primary efficacy endpoints included the Pittsburgh Sleep Quality Index (PSQI) and sleep latency using wrist actigraphy (WA), as well as a number of secondary endpoints, including sleep parameters such as actual sleep time and sleep efficiency using WA, the Epworth Sleepiness Scale (ESS), the Beck Anxiety Inventory (BAI), the Visual Analogue Scale (VAS) for the feeling of waking up refreshed, and a tertiary endpoint of sleep parameters using polysomnography (PSG) in a subset of 20 subjects per group. Safety parameters included physical examination, vital sign measurements, hematology, and clinical chemistry tests. Adverse events and serious adverse events were monitored throughout the study period. RESULTS Seventy-two subjects (35 and 37 subjects in the placebo and VE groups, respectively) completed the study and were included in the efficacy assessments. On Days 14, 28, and 56, the PSQI Total Score in the VE group decreased significantly (p < 0.05) compared to the placebo group. Further, the VE group showed significant improvements (p < 0.05) in sleep latency and actual sleep time on Days 3, 14, 28, and 56, and sleep efficiency on Days 14, 28, and 56, as evaluated by WA. There was a decrease (p < 0.05) in anxiety (BAI) on Days 14, 28, and 56, daytime drowsiness (ESS) on Days 28 and 56, and an increased feeling of waking up refreshed (VAS) on Days 28 and 56 compared to placebo. PSG results carried out in subset of subjects revealed significant improvements (p < 0.05) in total sleep time, sleep latency, and sleep efficiency on Day 56 in the VE group compared to the placebo group. No safety concerns were observed throughout the study. CONCLUSION VE supplementation significantly improved various subjective and objective parameters of sleep in young subjects with mild insomnia symptoms, such as overall sleep quality, sleep latency, sleep efficiency, and total sleep time. We also observed decreased anxiety and daytime sleepiness, and improved feeling of being refreshed after waking up with VE supplementation. VE was found to be safe and well tolerated throughout the study. TRIAL REGISTRATION Clinical Trials Registry of India: CTRI/2022/05/042818.
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Affiliation(s)
- Harshith Chandra Shekhar
- BGS Global Institute of Medical Sciences, No. 67, BGS Health and Education City, Uttarahalli Road, Kengeri, Bengaluru, 560060, Karnataka, India
| | - Lincy Joshua
- Leads Clinical Research and Bio Services Pvt. Ltd., No. 9, 1st Floor Mythri Legacy, Kalyan Nagar, Chelekere Main Road, Bengaluru, 560043, Karnataka, India
| | - Jestin V Thomas
- Leads Clinical Research and Bio Services Pvt. Ltd., No. 9, 1st Floor Mythri Legacy, Kalyan Nagar, Chelekere Main Road, Bengaluru, 560043, Karnataka, India.
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Bae GY, Ko K, Yang E, Park SS, Suh HJ, Hong KB. Combined Effects of Ziziphus jujuba, Dimocarpus longan, and Lactuca sativa on Sleep-Related Behaviors through GABAergic Signaling. Foods 2023; 13:1. [PMID: 38201029 PMCID: PMC10778002 DOI: 10.3390/foods13010001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/11/2023] [Accepted: 12/15/2023] [Indexed: 01/12/2024] Open
Abstract
We aimed to analyze the increase in the sleep-promoting effects based on the mixed ratio of botanical extracts, Ziziphus jujuba seeds, Dimocarpus longan fruits, and Lactuca sativa leaves, using animal models. Behavioral analyses, including an analysis of the total sleep time of Drosophila melanogaster, were conducted to select the optimal mixed ratio of the three botanical extracts. The effects were verified in a caffeine-induced sleepless model, specific neurotransmitter receptor antagonists, and ICR mice. In D. melanogaster exposed to 2.0% of each extract, group behavior was significantly reduced, and the mixed extracts of Z. jujuba, D. longan, and L. sativa (4:1:1 and 1:4:1) significantly increased the total sleep time with individual fruit flies. In the caffeine-induced insomnia model, mixed extracts (4:1:1 and 1:4:1) led to the highest increase in total sleep time. An analysis of locomotor ability revealed a significant reduction in the mobility percentage in the mixed extract groups (0:0:1, 1:0:1, 1:1:1, 4:1:1, and 1:4:1). The administration of Z. jujuba extract and mixed extracts (4:1:1) significantly increased the expression of GABAA-R, whereas the administration of the mixed extracts (4:1:1) and (1:4:1) significantly increased the expression of GABAB-R1 and GABAB-R2, respectively. D. longan extract and the mixed ratio (1:4:1) reduced the subjective nighttime movement and increased the total sleep time in the presence of flumazenil. An analysis of ICR mice indicated that the administration of mixed extracts (4:1:1) significantly increased sleep duration in a dose-dependent manner. These results indicated that the mixed ratio of Z. jujuba, D. longan, and L. sativa extracts, particularly the mixed ratio of 4:1:1, may have sleep-enhancing effects in fruit flies and mice. The study also identified changes in gene expression related to GABA receptors, indicating the potential mechanism for the observed sleep-promoting effects.
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Affiliation(s)
- Gi Yeon Bae
- Department of Integrated Biomedical and Life Science, Graduate School, Korea University, Seoul 02841, Republic of Korea; (G.Y.B.); (H.J.S.)
| | - Kayoung Ko
- Department of Food Science and Nutrition, Jeju National University, Jeju 63243, Republic of Korea; (K.K.); (E.Y.); (S.-S.P.)
| | - Eunseon Yang
- Department of Food Science and Nutrition, Jeju National University, Jeju 63243, Republic of Korea; (K.K.); (E.Y.); (S.-S.P.)
| | - Sung-Soo Park
- Department of Food Science and Nutrition, Jeju National University, Jeju 63243, Republic of Korea; (K.K.); (E.Y.); (S.-S.P.)
| | - Hyung Joo Suh
- Department of Integrated Biomedical and Life Science, Graduate School, Korea University, Seoul 02841, Republic of Korea; (G.Y.B.); (H.J.S.)
- BK21FOUR R&E Center for Learning Health Systems, Korea University, Seoul 02841, Republic of Korea
| | - Ki-Bae Hong
- Department of Food Science and Nutrition, Jeju National University, Jeju 63243, Republic of Korea; (K.K.); (E.Y.); (S.-S.P.)
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Riemann D, Espie CA, Altena E, Arnardottir ES, Baglioni C, Bassetti CLA, Bastien C, Berzina N, Bjorvatn B, Dikeos D, Dolenc Groselj L, Ellis JG, Garcia-Borreguero D, Geoffroy PA, Gjerstad M, Gonçalves M, Hertenstein E, Hoedlmoser K, Hion T, Holzinger B, Janku K, Jansson-Fröjmark M, Järnefelt H, Jernelöv S, Jennum PJ, Khachatryan S, Krone L, Kyle SD, Lancee J, Leger D, Lupusor A, Marques DR, Nissen C, Palagini L, Paunio T, Perogamvros L, Pevernagie D, Schabus M, Shochat T, Szentkiralyi A, Van Someren E, van Straten A, Wichniak A, Verbraecken J, Spiegelhalder K. The European Insomnia Guideline: An update on the diagnosis and treatment of insomnia 2023. J Sleep Res 2023; 32:e14035. [PMID: 38016484 DOI: 10.1111/jsr.14035] [Citation(s) in RCA: 52] [Impact Index Per Article: 52.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 08/21/2023] [Indexed: 11/30/2023]
Abstract
Progress in the field of insomnia since 2017 necessitated this update of the European Insomnia Guideline. Recommendations for the diagnostic procedure for insomnia and its comorbidities are: clinical interview (encompassing sleep and medical history); the use of sleep questionnaires and diaries (and physical examination and additional measures where indicated) (A). Actigraphy is not recommended for the routine evaluation of insomnia (C), but may be useful for differential-diagnostic purposes (A). Polysomnography should be used to evaluate other sleep disorders if suspected (i.e. periodic limb movement disorder, sleep-related breathing disorders, etc.), treatment-resistant insomnia (A) and for other indications (B). Cognitive-behavioural therapy for insomnia is recommended as the first-line treatment for chronic insomnia in adults of any age (including patients with comorbidities), either applied in-person or digitally (A). When cognitive-behavioural therapy for insomnia is not sufficiently effective, a pharmacological intervention can be offered (A). Benzodiazepines (A), benzodiazepine receptor agonists (A), daridorexant (A) and low-dose sedating antidepressants (B) can be used for the short-term treatment of insomnia (≤ 4 weeks). Longer-term treatment with these substances may be initiated in some cases, considering advantages and disadvantages (B). Orexin receptor antagonists can be used for periods of up to 3 months or longer in some cases (A). Prolonged-release melatonin can be used for up to 3 months in patients ≥ 55 years (B). Antihistaminergic drugs, antipsychotics, fast-release melatonin, ramelteon and phytotherapeutics are not recommended for insomnia treatment (A). Light therapy and exercise interventions may be useful as adjunct therapies to cognitive-behavioural therapy for insomnia (B).
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Affiliation(s)
- Dieter Riemann
- Department of Clinical Psychology and Psychophysiology, Centre for Mental Health (Department), Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Center for Basics in NeuroModulation (NeuroModulBasics), Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Colin A Espie
- Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neuroscience at the University of Oxford, Oxford, UK
| | | | - Erna Sif Arnardottir
- Reykjavik University Sleep Institute, School of Technology, Reykjavik University, Reykjavik, Iceland
- Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
| | - Chiara Baglioni
- Human Sciences Department, University of Rome Guglielmo Marconi Rome, Rome, Italy
| | | | - Celyne Bastien
- École de Psychologie, Université Laval, Québec, Québec, Canada
| | | | - Bjørn Bjorvatn
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Dimitris Dikeos
- First Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Leja Dolenc Groselj
- Institute of Clinical Neurophysiology, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Jason G Ellis
- Northumbria Sleep Research Laboratory, Northumbria University, Newcastle, UK
| | | | | | | | | | - Elisabeth Hertenstein
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Kerstin Hoedlmoser
- Centre for Cognitive Neurosciences, University of Salzburg, Salzburg, Austria
| | - Tuuliki Hion
- East-Viru Central Hospital, Kohtla-Järve, Estonia
| | | | - Karolina Janku
- Center for Sleep and Chronobiology Research, National Institute of Mental Health, Klecany, Czech Republic
| | - Markus Jansson-Fröjmark
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden and Stockholm Health Care Services, Stockholm, Sweden
| | - Heli Järnefelt
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Susanna Jernelöv
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden and Stockholm Health Care Services, Stockholm, Sweden
| | - Poul Jørgen Jennum
- Department of Clinical Medicine, University of Copenhagen, Kobenhavn, Denmark
| | - Samson Khachatryan
- Department of Neurology and Neurosurgery, Armenian National Institute of Health, Yerevan, Armenia
| | - Lukas Krone
- Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neuroscience at the University of Oxford, Oxford, UK
- Department of Neurology, Inselspital, University of Bern, Berne, Switzerland
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Simon D Kyle
- Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neuroscience at the University of Oxford, Oxford, UK
| | - Jaap Lancee
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Damien Leger
- Université Paris Cité, APHP, Hôtel Dieu de Paris, Centre du Sommeil et de la Vigilance, Paris, France
| | - Adrian Lupusor
- Functional Neurology, Institute of Neurology and Neurosurgery, Chisinau, Moldova
| | - Daniel Ruivo Marques
- Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
- CINEICC - Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Christoph Nissen
- Department of Psychiatry, University Hospital Geneve, Geneve, Switzerland
| | - Laura Palagini
- Psychiatry Unit, Department of Clinical and Experimental Medicine, School of Medicine, University of Pisa, Pisa, Italy
| | - Tiina Paunio
- Department of Psychiatry and SleepWell Research Program, Faculty of Medicine, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland; Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | - Dirk Pevernagie
- Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
| | - Manuel Schabus
- Centre for Cognitive Neurosciences, University of Salzburg, Salzburg, Austria
| | - Tamar Shochat
- The Cheryl Spencer Institute of Nursing Research, University of Haifa, Haifa, Israel
| | - Andras Szentkiralyi
- Institute of Epidemiology and Social Medicine, University of Münster, Münster, Germany
| | - Eus Van Someren
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
- Departments of Integrative Neurophysiology and Psychiatry, Center for Neurogenomics and Cognitive Research, Amsterdam UMC, Amsterdam Neuroscience, VU University, Amsterdam, The Netherlands
| | - Annemieke van Straten
- Department of Clinical, Neuro- and Developmental Psychology & Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Adam Wichniak
- Sleep Medicine Center and Third Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - Johan Verbraecken
- Multidisciplinary Sleep Disorders Centre, Antwerp University Hospital and University of Antwerp, Antwerp, Belgium
| | - Kai Spiegelhalder
- Department of Clinical Psychology and Psychophysiology, Centre for Mental Health (Department), Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Larit F, León F. Therapeutics to Treat Psychiatric and Neurological Disorders: A Promising Perspective from Algerian Traditional Medicine. PLANTS (BASEL, SWITZERLAND) 2023; 12:3860. [PMID: 38005756 PMCID: PMC10674704 DOI: 10.3390/plants12223860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 11/05/2023] [Accepted: 11/10/2023] [Indexed: 11/26/2023]
Abstract
Ancient people sought out drugs in nature to prevent, cure, and treat their diseases, including mental illnesses. Plants were their primary source for meeting their healthcare needs. In Algeria, folk medicine remains a fundamental part of the local intangible knowledge. This study aims to conduct a comprehensive ethnomedicinal investigation and documentation of medicinal plants and the different plant formulations traditionally used in Algeria for the treatment of pain, psychiatric, and neurological disorders. It also intends to improve the current knowledge of Algerian folk medicine. Several scientific databases were used to accomplish this work. Based on this investigation, we identified 82 plant species belonging to 69 genera and spanning 38 distinct botanical families used as remedies to treat various psychological and neurological conditions. Their traditional uses and methods of preparation, along with their phytochemical composition, main bioactive constituents, and toxicity were noted. Therefore, this review provides a new resource of information on Algerian medicinal plants used in the treatment and management of neurological and psychological diseases, which can be useful not only for the documentation and conservation of traditional knowledge, but also for conducting future phytochemical and pharmacological studies.
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Affiliation(s)
- Farida Larit
- Laboratoire d’Obtention de Substances Thérapeutiques (LOST), Université Frères Mentouri-Constantine 1, Route de Ain El Bey, Constantine 25017, Algeria
| | - Francisco León
- Department of Drug Discovery and Biomedical Sciences, College of Pharmacy, University of South Carolina, Columbia, SC 29208, USA;
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Lad A, R Tubaki B, S KS. Effects of Mamsyadi Kwatha in primary insomnia - A randomized controlled trial. J Ayurveda Integr Med 2023; 14:100830. [PMID: 38035532 PMCID: PMC10698534 DOI: 10.1016/j.jaim.2023.100830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 10/28/2023] [Accepted: 10/28/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Insomnia is the second most commonly presenting symptom, after pain, in clinics. Insomnia prevalence in India is 28.1 %. OBJECTIVE This study explores the effect of Mamsyadi Kwatha in the management of primary insomnia. MATERIALS AND METHODS Fifty patients attending KLE Ayurveda hospital meeting the diagnostic criteria of primary insomnia (DSM IV TR) were enrolled. Patients were randomly divided into two groups: group MK and TK. Intervention in group MK was 24 ml of Mamsyadi Kwatha twice a day and in group TK was 24 ml of Tagaradi Kwatha twice a day for 30 days. Assessment was done through primary outcome measures like Pittsburgh sleep quality index (PSQI), Epworth sleepiness scale (ESS), insomnia severity index (ISI). Secondary outcome measures were sleep diary recordings of past 15 days and depression anxiety and stress scale (DASS). Follow ups were at base line, 15th and 30th day of interventions. Laboratory assessments of liver function test, haemoglobin, and serum creatinine levels were carried at base line and 30th day of intervention. RESULTS Effect on primary and secondary outcomes showed that both the drugs were comparable. = Within group comparison of both the drugs showed that they produced significant improvement in PSQI, ESS, ISI, sleep diary variables, and DASS. However, Mamsyadi kwath has additional benefit of early recovery in total sleep. Both the drugs showed good safety profile evaluated through serum creatinine and liver function tests. CONCLUSION The effects of Mamsyadi Kwatha is comparable to Tagaradi Kwatha. Both drugs produced significant improvement in clinical assessments of insomnia, anxiety, depression, and stress.
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Affiliation(s)
- Amruta Lad
- Department of Kayachikitsa, DBAET's SBG Ayurvedic Medical College and Hospital, Belagavi, Karnataka, 591108, India
| | - Basavaraj R Tubaki
- Department of Kayachikitsa, Shri BMK Ayurveda Mahavidyalaya, A Constituent Unit of KLE Academy of Higher Education & Research, Belagavi, Karnataka, India.
| | - Kavya Shree S
- Department of Kayachikitsa, Shri BMK Ayurveda Mahavidyalaya, A Constituent Unit of KLE Academy of Higher Education & Research, Belagavi, Karnataka, 590003, India
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11
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Ko K, Ahn Y, Cheon GY, Suh HJ, Cho YJ, Park SS, Hong KB. Effects of Dendropanax morbiferus Leaf Extract on Sleep Parameters in Invertebrate and Vertebrate Models. Antioxidants (Basel) 2023; 12:1890. [PMID: 37891970 PMCID: PMC10604594 DOI: 10.3390/antiox12101890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 10/19/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023] Open
Abstract
Dendropanax morbiferus is highly valued in traditional medicine and has been used to alleviate the symptoms of numerous diseases owing to its excellent antioxidant activity. This study aimed to evaluate the sleep promotion and related signaling pathways of D. morbiferus extract (DE) via behavioral analysis, molecular biological techniques, and electrophysiological measurements in invertebrate and vertebrate models. In Drosophila, the group treated with 4% DE experienced decreased subjective nighttime movement and sleep bout and increased total sleeping time. Moreover, substantial changes in locomotor activity, including distance moved, velocity, and movement, were confirmed in the 4% DE-treated group. Compared to Drosophila in which insomnia and oxidative stress were induced by exposure to 0.1% caffeine, the DE-treated group improved sleep-related parameters to the level of the normal group. In the Drosophila model, exposure to 4% DE upregulated the expression of gamma-aminobutyric acid (GABA)-related receptors and serotonin receptor (5-HT1A), along with the expression of antioxidant-related factors, glutathione, and catalase. In the pentobarbital-induced sleep test using ICR mice, the duration of sleep was markedly increased by high concentration of DE. In addition, through the electroencephalography analysis of SD-rats, a significant increase in non-rapid-eye-movement sleep and delta waves was confirmed with high concentrations of DE administration. The increase in sleep time and improvement in sleep quality were confirmed to be related to the expression of altered GABA receptors and the enhancement of the contents of the neurotransmitters GABA and serotonin (5-HT) because of high DE administration. High-dose administration of DE also increased the expression of antioxidant-related factors in the brain and significantly decreased malondialdehyde content. Taken together, DE induced improvements in sleep quantity and quality by regulating neurotransmitter content and related receptor expression, along with high antioxidant activity, and may have a therapeutic effect on sleep disorders.
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Affiliation(s)
- Kayoung Ko
- Department of Food Science and Nutrition, Jeju National University, Jeju 63243, Republic of Korea
| | - Yejin Ahn
- Research Group of Functional Food Materials, Korea Food Research Institute, Wanju-gun 55365, Republic of Korea
| | - Ga Yeong Cheon
- Department of Food Science and Nutrition, Jeju National University, Jeju 63243, Republic of Korea
| | - Hyung Joo Suh
- Department of Integrated Biomedical and Life Science, Graduate School, Korea University, Seoul 02841, Republic of Korea
| | - Yun Jae Cho
- R&D Center, JEJUPANATEK Inc., Jeju 63243, Republic of Korea
| | - Sung-Soo Park
- Department of Food Science and Nutrition, Jeju National University, Jeju 63243, Republic of Korea
| | - Ki-Bae Hong
- Department of Food Science and Nutrition, Jeju National University, Jeju 63243, Republic of Korea
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12
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Seidel J, Du Y, Devanathan R, Law R, Hu Z, Zill NA, Iavarone AT, Zhang W. Tag and Snag: A New Platform for Bioactive Natural Product Screening from Mixtures. Molecules 2023; 28:5726. [PMID: 37570695 PMCID: PMC10421080 DOI: 10.3390/molecules28155726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/20/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
Natural products provide an unparalleled diversity of small molecules to fuel drug screening efforts, but deconvoluting the pharmacological activity of natural product mixtures to identify key bioactive compounds remains a vexing and labor-intensive process. Therefore, we have developed a new platform to probe the non-specific pharmacological potential of compounds present in common dietary supplements via shotgun derivatization with isotopically labeled propanoic acid, a live cell affinity assay, which was used to selectively recognize the population of compounds which bind tightly to HeLa cells in culture, and a computational LC-MS data analysis of isotopically labeled compounds from cell lysate. The data analysis showed that hundreds of compounds were successfully derivatized in each extract, and dozens of those compounds showed high affinity for HeLa cells. In total, over a thousand isotopically labeled compounds were screened for cell affinity across three separate experiments, resulting in the identification of several known bioactive compounds with specific protein targets and six previously unreported structures. The new natural products include three tulsinol compounds which were isolated from Ocimum tenuiflorum and three valeraninium alkaloids from Valeriana officinalis. The valeraninium alkaloids constitute a distinct new family of alkaloids from valerian, which may have previously undescribed bioactivity. These results collectively demonstrate the tag and snag workflow's viability as a drug discovery method.
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Affiliation(s)
- Jeremy Seidel
- Department of Chemical and Biomolecular Engineering, University of California Berkeley, Berkeley, CA 94720-3220, USA; (J.S.)
| | - Yongle Du
- Department of Chemical and Biomolecular Engineering, University of California Berkeley, Berkeley, CA 94720-3220, USA; (J.S.)
- California Institute for Quantitative Biosciences (QB3), University of California Berkeley, Berkeley, CA 94720-3220, USA
| | - Rohin Devanathan
- Department of Chemical and Biomolecular Engineering, University of California Berkeley, Berkeley, CA 94720-3220, USA; (J.S.)
| | - Richard Law
- Department of Chemical and Biomolecular Engineering, University of California Berkeley, Berkeley, CA 94720-3220, USA; (J.S.)
| | - Zhijuan Hu
- Department of Chemical and Biomolecular Engineering, University of California Berkeley, Berkeley, CA 94720-3220, USA; (J.S.)
- California Institute for Quantitative Biosciences (QB3), University of California Berkeley, Berkeley, CA 94720-3220, USA
| | - Nicholas A. Zill
- Department of Chemical and Biomolecular Engineering, University of California Berkeley, Berkeley, CA 94720-3220, USA; (J.S.)
| | - Anthony T. Iavarone
- California Institute for Quantitative Biosciences (QB3), University of California Berkeley, Berkeley, CA 94720-3220, USA
- QB3—Chemistry Mass Spectrometry Facility, University of California Berkeley, Berkeley, CA 94720-3220, USA
| | - Wenjun Zhang
- Department of Chemical and Biomolecular Engineering, University of California Berkeley, Berkeley, CA 94720-3220, USA; (J.S.)
- California Institute for Quantitative Biosciences (QB3), University of California Berkeley, Berkeley, CA 94720-3220, USA
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Wang H, Gu Y, Khalid R, Chen X, Han T. Herbal medicines for insomnia through regulating 5-hydroxytryptamine receptors: a systematic review. Chin J Nat Med 2023; 21:483-498. [PMID: 37517817 DOI: 10.1016/s1875-5364(23)60405-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Indexed: 08/01/2023]
Abstract
Insomnia is a common sleep disorder without effective therapy and can affect a person's life. The mechanism of the disease is not completely understood. Hence, there is a need to understand the targets related to insomnia, in order to develop innovative therapies and new compounds. Recently, increasing interest has been focused on complementary and alternative medicines for treating or preventing insomnia. Research into their molecular components has revealed that their sedative and sleep-promoting properties rely on the interactions with various neurotransmitter systems in the brain. In this review, the role of 5-hydroxytryptamine (5-HT) in insomnia development is summarized, while a systematic analysis of studies is conducted to assess the mechanisms of herbal medicines on different 5-HT receptors subtypes, in order to provide reference for subsequent research.
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Affiliation(s)
- Haoran Wang
- School of Pharmacy, Naval Medical University (Second Military Medical University), Shanghai 200433, China; School of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan 250355, China
| | - Yanqiu Gu
- Department of Pharmacy, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai 201999, China
| | - Rahman Khalid
- Faculty of Science, School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, England
| | - Xiaofei Chen
- School of Pharmacy, Naval Medical University (Second Military Medical University), Shanghai 200433, China.
| | - Ting Han
- School of Pharmacy, Naval Medical University (Second Military Medical University), Shanghai 200433, China.
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Zhao FY, Xu P, Kennedy GA, Conduit R, Zhang WJ, Wang YM, Fu QQ, Zheng Z. Identifying complementary and alternative medicine recommendations for insomnia treatment and care: a systematic review and critical assessment of comprehensive clinical practice guidelines. Front Public Health 2023; 11:1157419. [PMID: 37397764 PMCID: PMC10308125 DOI: 10.3389/fpubh.2023.1157419] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/17/2023] [Indexed: 07/04/2023] Open
Abstract
Background There is a need for evidence-informed guidance on the use of complementary and alternative medicine (CAM) for insomnia because of its widespread utilization and a lack of guidance on the balance of benefits and harms. This systematic review aimed to identify and summarize the CAM recommendations associated with insomnia treatment and care from existing comprehensive clinical practice guidelines (CPGs). The quality of the eligible guidelines was appraised to assess the credibility of these recommendations. Methods Formally published CPGs incorporating CAM recommendations for insomnia management were searched for in seven databases from their inception to January 2023. The NCCIH website and six websites of international guideline developing institutions were also retrieved. The methodological and reporting quality of each included guideline was appraised using the AGREE II instrument and RIGHT statement, respectively. Results Seventeen eligible GCPs were included, and 14 were judged to be of moderate to high methodological and reporting quality. The reporting rate of eligible CPGs ranged from 42.9 to 97.1%. Twenty-two CAM modalities were implicated, involving nutritional or natural products, physical CAM, psychological CAM, homeopathy, aromatherapy, and mindful movements. Recommendations for these modalities were mostly unclear, unambiguous, uncertain, or conflicting. Logically explained graded recommendations supporting the CAM use in the treatment and/or care of insomnia were scarce, with bibliotherapy, Tai Chi, Yoga, and auriculotherapy positively recommended based on little and weak evidence. The only consensus was that four phytotherapeutics including valerian, chamomile, kava, and aromatherapy were not recommended for insomnia management because of risk profile and/or limited benefits. Conclusions Existing guidelines are generally limited in providing clear, evidence-informed recommendations for the use of CAM therapies for insomnia management due to a lack of high-quality evidence and multidisciplinary consultation in CPG development. More well-designed studies to provide reliable clinical evidence are therefore urgently needed. Allowing the engagement of a range of interdisciplinary stakeholders in future updates of CPGs is also warranted. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=369155, identifier: CRD42022369155.
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Affiliation(s)
- Fei-Yi Zhao
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia
- Department of Nursing, School of International Medical Technology, Shanghai Sanda University, Shanghai, China
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Peijie Xu
- School of Computing Technologies, RMIT University, Melbourne, VIC, Australia
| | - Gerard A. Kennedy
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia
- Institute of Health and Wellbeing, Federation University, Mount Helen, VIC, Australia
- Institute for Breathing and Sleep, Austin Health, Heidelberg, VIC, Australia
| | - Russell Conduit
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia
| | - Wen-Jing Zhang
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yan-Mei Wang
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Qiang-Qiang Fu
- Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Zhen Zheng
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, Australia
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15
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Jenabi E, Khazaei S, Aghababaei S, Moradkhani S. Effect of Fennel-Valerian Extract on Hot Flashes and Sleep Disorders in Postmenopausal Women: A Randomized Trial. J Menopausal Med 2023; 29:21-28. [PMID: 37160299 PMCID: PMC10183764 DOI: 10.6118/jmm.22026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 01/01/2023] [Accepted: 04/16/2023] [Indexed: 05/11/2023] Open
Abstract
OBJECTIVES This study aims to evaluate the effect of a mixture of fennel and valerian extracts on hot flashes and sleep disorders of postmenopausal women in Iran. A randomized trial was conducted. METHODS A total of 76 postmenopausal women were randomly assigned to either of the two groups: fennel-valerian extract or control. One 500 mg fennel-valerian extract capsule was given twice, daily for 8 weeks. The 500 mg oral placebo capsule (starch) was given the same way. RESULTS The mean duration of hot flashes increased in both the groups over time (P < 0.001). The mean frequency and severity of hot flashes in the intervention group were significantly lower than in the control group, in the first and second months after intervention (P < 0.050). Women in the fennel-valerian extract group had a significantly lower Pittsburgh Sleep Quality Index score than the control group 2 months after intervention (P = 0.030). CONCLUSIONS This study found that fennel-valerian extract was effective for relieving sleep disorders as well as the severity and frequency of hot flashes compared with a placebo.
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Affiliation(s)
- Ensiyeh Jenabi
- Autism Spectrum Disorders Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Salman Khazaei
- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Soodabeh Aghababaei
- Mother and Child Care Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Shirin Moradkhani
- Department of Pharmacognosy, School of Pharmacy, Medicinal Plants and Natural Products Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
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Choi Y, Park YH, Yang C, Kim DH, Lee KW, Lee MY. Protocol for a randomized controlled trial evaluating the effect of Hibiscus syriacus L. flower extract on sleep quality. Front Nutr 2023; 10:1169193. [PMID: 37153917 PMCID: PMC10157466 DOI: 10.3389/fnut.2023.1169193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 03/27/2023] [Indexed: 05/10/2023] Open
Abstract
Introduction Hibiscus syriacus L. flower (HSF) is a food ingredient commonly used for tea, and previous animal studies have reported its sleep-promoting effect. This study aims to test the potential of HSF extract as functional food that improves sleep in humans. Methods and analysis Eighty participants with sleep disturbances who meet the inclusion/exclusion criteria will be enrolled in this study. Since the effect of HSF extract on sleep is considered to be that of a functional food rather than a medicine, participants with severe insomnia will be excluded from the study. The enrolled participants will be randomly assigned to the HSF extract or placebo groups in a 1:1 ratio. The HSF extract and placebo capsules will look identical, and participants, investigators, and outcome assessors will be blinded to the allocation. Four capsules of HSF extract or placebo will be orally administered 30-60 min before bedtime for 4 weeks. The primary outcome of this study will be the change in the Pittsburgh Sleep Quality Index (PSQI) global score from the baseline after 4 weeks. The subjective and objective changes in the participants' sleep will be evaluated using the Insomnia Severity Index (ISI), Epworth Sleep Scale (ESS), sleep diary, and polysomnography (PSG). The occurrence of adverse events will be closely monitored. Discussion The results of this trial will provide data on the efficacy and safety of HSF extract in enhancing sleep quality. Based on the results, the potential of HSF extract as a functional food that improves sleep in humans will be evaluated, and the findings of the trial will be submitted to the Korean Ministry of Food and Drug Safety for consideration as a new functional ingredient that may help to improve sleep quality. Clinical trial registration : Clinical Research Information Service: KCT0007314; Registered 19 May 2022, https://cris.nih.go.kr/cris/search/detailSearch.do/21497.
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Affiliation(s)
- Yujin Choi
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Yu Hwa Park
- R&D Center, Dongkook Pharm. Co., Ltd., Suwon, Republic of Korea
| | - Changsop Yang
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Do Hoon Kim
- R&D Center, Dongkook Pharm. Co., Ltd., Suwon, Republic of Korea
| | - Kye Wan Lee
- R&D Center, Dongkook Pharm. Co., Ltd., Suwon, Republic of Korea
| | - Mi Young Lee
- KM Convergence Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
- *Correspondence: Mi Young Lee,
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Prescription of Silexan Is Associated with Less Frequent General Practitioner Repeat Consultations Due to Disturbed Sleep Compared to Benzodiazepine Receptor Agonists: A Retrospective Database Analysis. Healthcare (Basel) 2022; 11:healthcare11010077. [PMID: 36611537 PMCID: PMC9819079 DOI: 10.3390/healthcare11010077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 12/29/2022] Open
Abstract
The aim of the present study was to analyze the association between the prescription of Silexan and the recurrence of general practitioner (GP) repeat consultations because of disturbed sleep versus benzodiazepine receptor agonists including zolpidem, zopiclone, and zaleplon (Z-drugs). This retrospective cohort study was based on data from the IQVIA Disease Analyzer (DA) database. The study included adult patients treated by 1284 GPs in Germany with a documented sleep disorder and their first prescription of Silexan or Z-drug (prescription between January 2010 and October 2020). The recurrence of seeking medical advice because of sleep disorders in the 15-365 days after the first prescription was evaluated. Multivariate regression models were used, adjusted for age, sex, insurance status, and defined co-diagnoses. Data were available for 95,320 (Silexan: 5204; Z-Drug: 90,526) patients. In total, 15.6% of the Silexan patients and 28.6% of the Z-drug patients had a further documented GP consultation because of a sleep disorder. Silexan prescription was associated with significantly lower odds of recurrent sleep disorder diagnosis in the 15-365 days after the index date (Odds Ratio (OR): 0.56; 95% confidence intervals (CI): 0.51-0.60), although mental burden levels appeared higher in this group. Our study shows that the prescription of Silexan to adult patients consulting GPs for disturbed sleep results in less frequent repeat consultations than Z-drugs. This may support Silexan's role as an efficacious, self-enabling, well-tolerated, and sustained treatment option. Because Silexan is a proven anxiolytic, its impact in improving undiagnosed anxiety disorders may have had a lasting effect for certain patients.
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Cheng C, Wan H, Cong P, Huang X, Wu T, He M, Zhang Q, Xiong L, Tian L. Targeting neuroinflammation as a preventive and therapeutic approach for perioperative neurocognitive disorders. J Neuroinflammation 2022; 19:297. [PMID: 36503642 PMCID: PMC9743533 DOI: 10.1186/s12974-022-02656-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 11/23/2022] [Indexed: 12/14/2022] Open
Abstract
Perioperative neurocognitive disorders (PND) is a common postoperative complication associated with regional or general anesthesia and surgery. Growing evidence in both patient and animal models of PND suggested that neuroinflammation plays a critical role in the development and progression of this problem, therefore, mounting efforts have been made to develop novel therapeutic approaches for PND by targeting specific factors or steps alongside the neuroinflammation. Multiple studies have shown that perioperative anti-neuroinflammatory strategies via administering pharmacologic agents or performing nonpharmacologic approaches exert benefits in the prevention and management of PND, although more clinical evidence is urgently needed to testify or confirm these results. Furthermore, long-term effects and outcomes with respect to cognitive functions and side effects are needed to be observed. In this review, we discuss recent preclinical and clinical studies published within a decade as potential preventive and therapeutic approaches targeting neuroinflammation for PND.
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Affiliation(s)
- Chun Cheng
- Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Shanghai, 200434 China ,grid.24516.340000000123704535Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai, 200434 China ,grid.24516.340000000123704535Clinical Research Center for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, 200434 China
| | - Hanxi Wan
- Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Shanghai, 200434 China ,grid.24516.340000000123704535Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai, 200434 China ,grid.24516.340000000123704535Clinical Research Center for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, 200434 China
| | - Peilin Cong
- Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Shanghai, 200434 China ,grid.24516.340000000123704535Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai, 200434 China ,grid.24516.340000000123704535Clinical Research Center for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, 200434 China
| | - Xinwei Huang
- Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Shanghai, 200434 China ,grid.24516.340000000123704535Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai, 200434 China ,grid.24516.340000000123704535Clinical Research Center for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, 200434 China
| | - Tingmei Wu
- Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Shanghai, 200434 China ,grid.24516.340000000123704535Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai, 200434 China ,grid.24516.340000000123704535Clinical Research Center for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, 200434 China
| | - Mengfan He
- Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Shanghai, 200434 China ,grid.24516.340000000123704535Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai, 200434 China ,grid.24516.340000000123704535Clinical Research Center for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, 200434 China
| | - Qian Zhang
- Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Shanghai, 200434 China ,grid.24516.340000000123704535Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai, 200434 China ,grid.24516.340000000123704535Clinical Research Center for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, 200434 China
| | - Lize Xiong
- Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Shanghai, 200434 China ,grid.24516.340000000123704535Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai, 200434 China ,grid.24516.340000000123704535Clinical Research Center for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, 200434 China
| | - Li Tian
- Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Shanghai, 200434 China ,grid.24516.340000000123704535Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai, 200434 China ,grid.24516.340000000123704535Clinical Research Center for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, 200434 China
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19
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Cheon J, Kim M. Comprehensive effects of various nutrients on sleep. Sleep Biol Rhythms 2022; 20:449-458. [PMID: 38468613 PMCID: PMC10899959 DOI: 10.1007/s41105-022-00408-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 07/16/2022] [Indexed: 10/16/2022]
Abstract
Sleep problems have become common among people today. Sleep disorders are closely associated with physiological and psychological diseases. Among the ways of improving objective or subjective sleep quality, controlling elements associated with food intake can be more efficient than other methods in terms of time and cost. Therefore, the purpose of this study was to understand the effects of nutrients and natural products on sleep. An extensive literature search was conducted, and related articles were identified through online databases, such as Elsevier, Google Scholar, PubMed, Springer, and Web of Science. Expert opinion, conference abstracts, unpublished studies, and studies published in languages other than English were excluded from this review. The effects of macronutrients and diet adjustment on sleep differed. Although not all nutrients independently affect sleep, they comprehensively affect it through tryptophan metabolism. Furthermore, natural foods related to GABA have an effect on sleep similar to that of sleeping pills. Taken together, our results suggest that humans can control both their objective and subjective sleep quality based on their lifestyle and food consumption. However, until now, direct studies on the relationship between human sleep and nutrition, such as clinical trials, have been insufficient. As both objective and subjective sleep quality are the factors determining the quality of life of individuals, further studies on those are needed to improve it.
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Affiliation(s)
- Jaehwan Cheon
- Department of Chemistry & Life Science, BioScience Research Institute, Sahmyook University, Hwarangro 815, Nowongu, 01795 Seoul, Republic of Korea
| | - Mikyung Kim
- Department of Chemistry & Life Science, BioScience Research Institute, Sahmyook University, Hwarangro 815, Nowongu, 01795 Seoul, Republic of Korea
- Department of Pharmacy, Uimyung Research Institute for Neuroscience, Sahmyook University, Hwarangro 815, Nowongu, Seoul, 01795 Republic of Korea
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20
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Verma K, Singh D, Srivastava A. The Impact of Complementary and Alternative Medicine on Insomnia: A Systematic Review. Cureus 2022; 14:e28425. [PMID: 36176875 PMCID: PMC9509538 DOI: 10.7759/cureus.28425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2022] [Indexed: 11/14/2022] Open
Abstract
Insomnia is characterized by difficulty in maintaining sleep and early morning awakenings. Although pharmacotherapies and psychological interventions remain essential for conventional treatment, motivational factors and interest in using complementary and alternative therapies for insomnia have developed over the last two decades. This review aims to comprehensively explore the effects of complementary and alternative medicine (CAM) on improving sleep quality to guide evidence-based clinical decision-making and inform future research. Several electronic databases such as MEDLINE, PubMed, Scopus, EMBASE, Clinical key, Cochrane, and Research gate were explored to search the relevant articles. For the systematic review, CAM studies were classified under "manual practices," "natural practices," and "mind-body practices." A total of 35 clinical trials were selected for inclusion in the systematic review, comprising adult samples. The systematic review revealed 11 RCTs with manual practice, 12 with mind-body practice, and 12 with natural medicine practice. The methodological quality of the RCTs was measured using the modified Jadad scale, a scientific quality index of ≥ 5/10 (on the augmented Jadad scale). Effect sizes (Cohen’s d) were calculated and reported in all placebo-controlled studies with the available data. Regardless of systematic reviews, and randomized controlled trials on CAM, acupuncture, acupressure, herbal medicine, yoga, and tai chi, for insomnia, most of the RCTs did not agree with the findings. Further RCT for insomnia should be developed by considering the current advanced studies in the field of CAM.
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21
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Brown AF, Richardson CME, Newby N, Pulsipher S, Hoene T. Effect of a Multi-Ingredient Supplement Designed to Regulate Mood on Physiological and Psychological Outcomes: A Randomized, Double-Blind, Placebo-Controlled Trial. J Diet Suppl 2022:1-12. [DOI: 10.1080/19390211.2022.2077880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Ann F. Brown
- Department of Movement Sciences, University of Idaho, Moscow, ID, USA
| | | | - Nathan Newby
- Department of Movement Sciences, University of Idaho, Moscow, ID, USA
| | - Sydney Pulsipher
- Department of Movement Sciences, University of Idaho, Moscow, ID, USA
| | - Talje Hoene
- Department of Psychology and Communication Studies, University of Idaho, Moscow, ID, USA
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22
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Winter AS, Haverkamp C, Gratzke C, Huber R, Lederer AK. Valerian and postoperative sleep: a retrospective cohort analysis of gynecological, urologic, and general surgical patients. Sleep 2022; 45:6594703. [DOI: 10.1093/sleep/zsac122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 05/21/2022] [Indexed: 10/18/2022] Open
Abstract
Abstract
Study Objectives
Postoperative sleep disturbances appear to be a common complication after surgery being treated with sleep-promoting medication such as valerian, but robust data and evidence of medicinal approaches are lacking.
Methods
We performed a retrospective cohort analysis of all 21 168 urological, gynecological, and general surgical patients of the University Medical Center Freiburg, Germany, who underwent surgery between 2015 and 2020. Target parameters were the usage of sleep-promoting medication to estimate the occurrence of postoperative sleep disturbances as well as the kind of sleep medication with a special focus on herbal medication such as valerian.
Results
Drug-treated sleep disturbances occurred in 15% (n = 3083) of the patients. Valerian was the second most applied drug (n = 814, 26.4%) after classic benzodiazepines (n = 1 138, 36.9%). The majority of patients got valerian as monotherapy. Age, length of stay, and comorbidities were associated with demand for sleep medication in general (p < .001). Valerian monotherapy was more common in women (OR 1.53, 95% CI: 1.33–1.77, p < .001), elderly patients (OR 1.50, 95% CI: 1.29–1.75, p < .001), and patients with prolonged hospital stay (OR 2.23, 95% CI: 1.91–2.61, p < .001).
Conclusions
Valerian plays an important role in the treatment of postoperative sleep disturbances clinically, and it appears to be a promising therapeutic approach especially in women, older and sicker patients, and those with prolonged hospital stay. Further research has to clarify the efficacy of valerian postoperatively.
Clinical trial registration
DRKS00027903, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00027903
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Affiliation(s)
- Anne-Sophie Winter
- Department of Medicine II, Center for Complementary Medicine, University Medical Center , Freiburg , Germany
| | - Christian Haverkamp
- Institute of Digitalization in Medicine, University Medical Center , Freiburg , Germany
| | - Christian Gratzke
- Department of Urology, University Medical Center , Freiburg , Germany
| | - Roman Huber
- Department of Medicine II, Center for Complementary Medicine, University Medical Center , Freiburg , Germany
| | - Ann-Kathrin Lederer
- Department of Medicine II, Center for Complementary Medicine, University Medical Center , Freiburg , Germany
- Department of General, Visceral and Transplant Surgery, University Medical Center of the Johannes Gutenberg-University , Mainz, Germany
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23
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Hibino S, Hayashida K. Modifiable Host Factors for the Prevention and Treatment of COVID-19: Diet and Lifestyle/Diet and Lifestyle Factors in the Prevention of COVID-19. Nutrients 2022; 14:1876. [PMID: 35565841 PMCID: PMC9102954 DOI: 10.3390/nu14091876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/20/2022] [Accepted: 04/24/2022] [Indexed: 11/17/2022] Open
Abstract
Many studies have shown that the immune system requires adequate nutrition to work at an optimal level. Not only do optimized nutritional strategies support the immune system, but they also reduce chronic inflammation. Nutritional supplements that are recommended for patients with critical illnesses are thought to also be effective for the coronavirus disease 2019 (COVID-19) patients in the intensive care unit. Some studies have recommended fresh fruits and vegetables, soy, nuts, and antioxidants, such as omega-3 fatty acids, to improve immune system activity. Although nutritional status is considered to be an important prognostic factor for patients with COVID-19, there is to date no sufficient evidence that optimal nutritional therapies can be beneficial for these patients. Some have argued that the COVID-19 pandemic is a good opportunity to test the effectiveness of nutritional intervention for infectious diseases. Many researchers have suggested that testing the proposed nutritional approaches for infectious diseases in the context of a pandemic would be highly informative. The authors of other review papers concluded that it is important to have a diet based on fresh foods, such as fruits, vegetables, whole grains, low-fat dairy products, and healthy fats (i.e., olive oil and fish oil), and to limit the intake of sugary drinks as well as high-calorie and high-salt foods. In this review, we discuss the clinical significance of functional food ingredients as complementary therapies potentially beneficial for the prevention or treatment of COVID-19. We believe that our review will be helpful to plan and deploy future studies to conclude these potentials against COVID-19, but also to new infectious diseases that may arise in the future.
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Affiliation(s)
- Sawako Hibino
- Y’s Science Clinic Hiroo, Medical Corporation Koshikai, Tokyo 106-0047, Japan
- Department of Clinical Gene Therapy, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Kazutaka Hayashida
- Division of Pulmonary Medicine, Boston Children’s Hospital, Boston, MA 02459, USA;
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24
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Moser D, Hussain S, Rainer M, Jakschitz T, Bonn GK. A validated method for the rapid quantification of melatonin in over-the-counter hypnotics by the atmospheric pressure solid analysis probe (ASAP). ANALYTICAL METHODS : ADVANCING METHODS AND APPLICATIONS 2022; 14:1603-1610. [PMID: 35383798 DOI: 10.1039/d2ay00352j] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Melatonin is a hormone that regulates the biological day and night cycle. It is mainly produced by the pineal gland during the night. People suffering from insomnia use it as a soporific drug. The aim of this study was to develop a method for the rapid quantification of melatonin in hypnotics. For that purpose, atmospheric pressure solid analysis probe-assisted mass spectrometry was applied, where no chromatographic separation is needed. Thereby, one single analysis takes less than 1 min. Reference measurements were performed with ultra-high-performance liquid chromatography coupled with a quadrupole-time-of-flight mass spectrometer. Both methods were validated and real sample extracts were tested. The coefficients of determination were above 0.97 for both methods. The limits of detection and quantification were below 1 mg kg-1. Both methods gave comparable results. Moreover, the content of melatonin differed from the specified value in many samples. The highest and lowest observed deviations were 78% and 1%, respectively.
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Affiliation(s)
- Daniel Moser
- ADSI-Austrian Drug Screening Institute GmbH, Innrain 66a, 6020 Innsbruck, Austria
- Institute of Analytical Chemistry and Radiochemistry, University of Innsbruck, Innrain 80/82, 6020 Innsbruck, Austria.
| | - Shah Hussain
- ADSI-Austrian Drug Screening Institute GmbH, Innrain 66a, 6020 Innsbruck, Austria
| | - Matthias Rainer
- Institute of Analytical Chemistry and Radiochemistry, University of Innsbruck, Innrain 80/82, 6020 Innsbruck, Austria.
| | - Thomas Jakschitz
- ADSI-Austrian Drug Screening Institute GmbH, Innrain 66a, 6020 Innsbruck, Austria
| | - Günther K Bonn
- ADSI-Austrian Drug Screening Institute GmbH, Innrain 66a, 6020 Innsbruck, Austria
- Institute of Analytical Chemistry and Radiochemistry, University of Innsbruck, Innrain 80/82, 6020 Innsbruck, Austria.
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25
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Murlanova K, Cohen N, Pinkus A, Vinnikova L, Pletnikov M, Kirby M, Gorelick J, Drori E, Pinhasov A. Antidepressant-like effects of a chlorogenic acid- and cynarine-enriched fraction from Dittrichia viscosa root extract. Sci Rep 2022; 12:3647. [PMID: 35256610 PMCID: PMC8901669 DOI: 10.1038/s41598-022-04840-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 12/28/2021] [Indexed: 11/30/2022] Open
Abstract
Dittrichia viscosa is a perennial Mediterranean plant used in traditional medicine for “calming purposes”, pointing at a possible antidepressant activity of the plant. We conducted chromatographic and bioassay-guided fractionation of D. viscosa root extract to isolate a specific fraction (fraction “K”) with antidepressant-like characteristics in vivo and strong antioxidant properties in vitro. A single dose of “K” reduced immobility time in the forced swim test with a mouse model possessing a depressive-like phenotype. Neurochemical profiling for 5-hydroxytryptamine (5-HT) and its primary metabolite, 5-hydroxyindoleacetic acid (5-HIAA), in prefrontal cortex and hippocampus of “K”-treated mice showed reduction in 5-HIAA, indicative of either serotonin uptake transporter or monoamine oxidase-A inhibition, as well as slight increases in 5-HT content. These neurochemical alterations, as well as the behavioral changes observed, were comparable to the effects of paroxetine. “K” also protected PC12 cells in a H2O2 cytotoxicity assay, thus demonstrating antioxidant properties, yet paroxetine augmented oxidative damage and cell death. Identification of the main compounds in “K” by high-performance liquid chromatography-tandem mass spectrometry (HPLC–MS/MS) indicated that chlorogenic acid and cynarine comprised 87% of the total components. D. viscosa root extract appears to produce antidepressant and cytoprotective effects and may serve as an attractive alternative to standard therapies for depression.
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Lee E, Bang Y, Yoon IY, Choi HY. Entrapment of Binaural Auditory Beats in Subjects with Symptoms of Insomnia. Brain Sci 2022; 12:brainsci12030339. [PMID: 35326295 PMCID: PMC8945912 DOI: 10.3390/brainsci12030339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/20/2022] [Accepted: 02/28/2022] [Indexed: 11/16/2022] Open
Abstract
Binaural beat (BB) stimulation, which has two different frequencies for each ear, is reportedly effective in reducing anxiety and controlling mood. This study aimed to evaluate the brain wave entrainment effect of binaural beats and to propose an effective and safe supplementary therapy for relieving the symptoms of insomnia. Subjects between 20 and 59 years of age with subclinical symptoms of insomnia were recruited from the community. Quantitative electroencephalography was measured twice, before and two weeks after the BB intervention. Participants used the apparatus with or without 6 Hz BB for 30 min before going to bed for two weeks. When music with BB was played, the relative theta power increased (occipital, p = 0.009). After two weeks of intervention with music, the theta power increased when listening to music with BB (parietal, p = 0.009). After listening to music with BB for two weeks, the decrease in the beta power was more noticeable than after using music-only devices when participants listened to music in the laboratory (occipital, p = 0.035). When BB were played, the entrapment of the theta wave appeared. Therefore, exposure to music with BB is likely to reduce the hyper-arousal state and contribute to sleep induction.
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Affiliation(s)
- Eunyoung Lee
- Department of Psychiatry, Veteran Health Service Medical Center, Seoul 05368, Korea;
| | - Youngrong Bang
- Department of Psychiatry, Ulsan University Hospital, Ulsan 44033, Korea;
| | - In-Young Yoon
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam 13620, Korea;
- Department of Psychiatry, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Ha-Yun Choi
- Department of Psychiatry, Veteran Health Service Medical Center, Seoul 05368, Korea;
- Department of Psychiatry, Seoul National University College of Medicine, Seoul 03080, Korea
- Correspondence: ; Tel.: +82-2-2225-1158
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27
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Traditional Herbal Remedies Used for Managing Anxiety and Insomnia in Italy: An Ethnopharmacological Overview. HORTICULTURAE 2021. [DOI: 10.3390/horticulturae7120523] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Anxiety and insomnia are among the most common mental health disorders and are a major cause of disability around the world. Traditional herbal medicines are receiving significant attention in global health debates. Several Italian regions maintain rural traditions and are among the most extensively studied areas of Europe regarding medicinal plant uses. The present overview aims to highlight the use of wild and cultivated plants, specifically as sedatives and for insomnia treatment in Italy, and to collect, analyze, and summarize the available literature about their pharmacological activity as well as clinical and pre-clinical studies concerning the most cited plants. In total, 106 wild taxa are used in Italy for sedative purposes. The plant species belong to 76 genera and 32 families, of which the most cited are Asteraceae (24.2%) and Lamiaceae (21.1%). Leaves (29%) and flowers (27%) are the plant parts mostly used as infusion (70%) and decoction (25%). Out of 106 taxa documented, only the most cited are analyzed in this overview (A. arvensis L., C. nepeta L., C. monogyna Jacq., H. lupulus L., L. nobilis L., L. angustifolia Mill., M. sylvestris L., M. chamomilla L., M. officinalis L., O. basilicum L., P. rhoeas L., P. somniferum L., R. officinalis L., T. platyphyllus Scop., and V. officinalis L.). Among the fifteen species selected, only seven have been studied for their pharmacological activity as hypnotic-sedatives. Future pre-clinical and clinical studies are needed to better clarify the mechanism of action of bioactive compounds and confirm the potential of these alternative therapies.
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28
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Porwal A, Yadav YC, Pathak K, Yadav R. An Update on Assessment, Therapeutic Management, and Patents on Insomnia. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6068952. [PMID: 34708126 PMCID: PMC8545506 DOI: 10.1155/2021/6068952] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 09/15/2021] [Accepted: 10/04/2021] [Indexed: 11/18/2022]
Abstract
Insomnia is an ordinary situation related to noticeable disability in function and quality of life, mental and actual sickness, and mishappenings. It represents more than 5.5 million appointments to family doctors every year. Nonetheless, the ratio of insomniacs who are treated keeps on being low, demonstrating the requirement for proceeding with advancement and dispersal of effective treatments. Accordingly, it becomes significant to provide a compelling treatment for clinical practice. It indicates a need for the determination of various critical viewpoints for the evaluation of insomnia along with various accessible alternatives for treatment. These alternatives incorporate both nonpharmacological therapy, specifically cognitive behavioural therapy for insomnia, and a number of pharmacological treatments like orexin antagonists, "z-drugs," benzodiazepines, selective histamine H1 antagonists, nonselective antihistamines, melatonin receptor agonists, antipsychotics, antidepressants, and anticonvulsants. Besides in individuals whose insomnia is due to restless leg syndrome, depression/mood disorder, or/and circadian disturbance, there is insignificant proof favouring the effectiveness of different prescriptions for the treatment of insomnia though they are widely used. Other pharmacological agents producing sedation should be prescribed with care for insomnia therapy because of greater risk of next-day sleepiness along with known adverse effects and toxicities. This review is also aimed at providing an update on various patents on dosage forms containing drugs for insomnia therapy.
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Affiliation(s)
- Amit Porwal
- Faculty of Pharmacy, Uttar Pradesh University of Medical Sciences, Saifai, Etawah, 206130 Uttar Pradesh, India
| | - Yogesh Chand Yadav
- Faculty of Pharmacy, Uttar Pradesh University of Medical Sciences, Saifai, Etawah, 206130 Uttar Pradesh, India
| | - Kamla Pathak
- Faculty of Pharmacy, Uttar Pradesh University of Medical Sciences, Saifai, Etawah, 206130 Uttar Pradesh, India
| | - Ramakant Yadav
- Faculty of Medical Sciences, Uttar Pradesh University of Medical Sciences, Saifai, Etawah, 206130 Uttar Pradesh, India
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Shinjyo N, Waddell G, Green J. Valerian Root in Treating Sleep Problems and Associated Disorders-A Systematic Review and Meta-Analysis. J Evid Based Integr Med 2021; 25:2515690X20967323. [PMID: 33086877 PMCID: PMC7585905 DOI: 10.1177/2515690x20967323] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Sleep problems are widely prevalent and associated with various comorbidities including anxiety. Valerian (Valeriana officinalis L.) is a popular herbal medicine used as a sleep aid, however the outcomes of previous clinical studies are inconsistent. This study was conducted to update and re-evaluate the available data in order to understand the reason behind the inconsistent outcomes and to provide a broader view of the use of valerian for associated disorders. PubMed, ScienceDirect, and Cochrane Library were searched to retrieve publications relevant to the effectiveness of valerian as a treatment of sleep problems and associated disorders. A total of 60 studies (n=6,894) were included in this review, and meta-analyses were performed to evaluate the effectiveness to improve subjective sleep quality (10 studies, n=1,065) and to reduce anxiety (8 studies, n=535). Results suggested that inconsistent outcomes were possibly due to the variable quality of herbal extracts and that more reliable effects could be expected from the whole root/rhizome. In addition, therapeutic benefits could be optimized when it was combined with appropriate herbal partners. There were no severe adverse events associated with valerian intake in subjects aged between 7 and 80 years. In conclusion, valerian could be a safe and effective herb to promote sleep and prevent associated disorders. However, due to the presence of multiple active constituents and relatively unstable nature of some of the active constituents, it may be necessary to revise the quality control processes, including standardization methods and shelf life.
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Affiliation(s)
- Noriko Shinjyo
- Department of Infection and Host Defence, Graduate School of Medicine, 12737Chiba University, Chuo-ku, Chiba, Japan.,School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | | | - Julia Green
- Faculty of Science and Technology, Department of Life Sciences, 4921University of Westminster, London, UK
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30
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Liu X, Duan X, Fan H, Wang H, Jiang X, Fang Y, Tang Q, Xiao J, Li Q. 8-hydroxypinoresinol-4-O-β-D-glucoside from Valeriana officinalis L. Is a Novel Kv1.5 Channel Blocker. JOURNAL OF ETHNOPHARMACOLOGY 2021; 276:114168. [PMID: 33932511 DOI: 10.1016/j.jep.2021.114168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 04/23/2021] [Accepted: 04/26/2021] [Indexed: 06/12/2023]
Abstract
ETHNOPHARMACOLOGY RELEVANCE In folkloric medicine of many cultures, one of the medical uses of Valeriana officinalis Linn is to treat heart-related disease. Recently, it was shown that the ethanol extracts from V. officinalis could effectively prevent auricular fibrillation, and 8-hydroxypinoresinol-4-O-β-D-glucoside (HPG) from the extracts is one of the two active compounds showing antiarrhythmia activities. AIM OF THE STUDY The human Kv1.5 channel (hKv1.5) has potential antiarrhythmia activities, and this study arms at investigating the current blocking effects of HPG on hKv1.5 channel. MATERIAL AND METHODS HPG was obtained from V. officinalis extracts, and hKv1.5 channels were expressed in HEK 293 cells. HPG was perfused while recording the current through hKv1.5 channels. Patch-clamp recording techniques were used to study the effects of HPG at various concentrations (10 μM, 30 μM, and 50 μM) on hKv1.5 channels. RESULTS The present study demonstrated that HPG inhibited hKv1.5 channel current in a concentration-dependent manner; the higher the concentration, the greater is the inhibition at each depolarization potential. During washout, the channels did not full recover indicating that the un-coupling between HPG and hKv1.5 channels is a slow process. CONCLUSION HPG may be an effective and safe active ingredient for AF having translational potential.
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Affiliation(s)
- Xingxing Liu
- Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Liberty Rd., Wuhan, Hubei, 430022, China
| | - Xueyun Duan
- Pharmaceutical Department, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, 430061, Hubei Province, China
| | - Heng Fan
- Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Liberty Rd., Wuhan, Hubei, 430022, China
| | - Hongfei Wang
- Department of Cardiac Surgery, Department of Integrated Traditional Chinese Medicine and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Liberty Rd., Wuhan, Hubei, 430022, China
| | - Xionggang Jiang
- Department of Cardiac Surgery, Department of Integrated Traditional Chinese Medicine and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Liberty Rd., Wuhan, Hubei, 430022, China
| | - Ying Fang
- Hubei University of Chinese Medicine, 16 Huangjiahu W Rd, Hongshan, Wuhan, Hubei, 430065, China
| | - Qing Tang
- Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Liberty Rd., Wuhan, Hubei, 430022, China
| | - Jun Xiao
- The Macrohard Institute of Health, 231 North Ave, Battle Creek, MI, 49017, USA.
| | - Qian Li
- The Macrohard Institute of Health, 231 North Ave, Battle Creek, MI, 49017, USA; The American Academy of Tradition Chinese Medicine Inc., 1925 W County Rd B2, Roseville, MN, 55113, USA.
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Plant Species of Sub-Family Valerianaceae-A Review on Its Effect on the Central Nervous System. PLANTS 2021; 10:plants10050846. [PMID: 33922184 PMCID: PMC8144999 DOI: 10.3390/plants10050846] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/16/2021] [Accepted: 04/19/2021] [Indexed: 12/28/2022]
Abstract
Valerianaceae, the sub-family of Caprifoliaceae, contains more than 300 species of annual and perennial herbs, worldwide distributed. Several species are used for their biological properties while some are used as food. Species from the genus Valeriana have been used for their antispasmodic, relaxing, and sedative properties, which have been mainly attributed to the presence of valepotriates, borneol derivatives, and isovalerenic acid. Among this genus, the most common and employed species is Valerianaofficinalis. Although valerian has been traditionally used as a mild sedative, research results are still controversial regarding the role of the different active compounds, the herbal preparations, and the dosage used. The present review is designed to summarize and critically describe the current knowledge on the different plant species belonging to Valerianaceae, their phytochemicals, their uses in the treatment of different diseases with particular emphasis on the effects on the central nervous system. The available information on this sub-family was collected from scientific databases up until year 2020. The following electronic databases were used: PubMed, Scopus, Sci Finder, Web of Science, Science Direct, NCBI, and Google Scholar. The search terms used for this review included Valerianaceae, Valeriana, Centranthus, Fedia, Patrinia, Nardostachys, Plectritis, and Valerianella, phytochemical composition, in vivo studies, Central Nervous System, neuroprotective, antidepressant, antinociceptive, anxiolytic, anxiety, preclinical and clinical studies.
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Soltani A, Bahrami F, Bahari Z, Shankayi Z, Graily-Afra M, Sahraei H. The effects of Valerian on sleep spindles in a model of neuropathic pain. Sleep Sci 2021; 14:133-139. [PMID: 35082982 PMCID: PMC8764951 DOI: 10.5935/1984-0063.20200110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Accepted: 01/11/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction Valeriana officinalis is known to be one of the most famous herbal supplements for the treatment of anxiety and insomnia. Despite its widespread use in most countries all around the world, there is little scientific information and research on how this medication affects sleep patterns, and there are almost no studies on its effects on the characteristics of sleep spindles. Material and Methods The present study was conducted to investigate the effects of Valerian extract (VAL) on sleep spindles and induced anxiety in chronic neuropathic pain model in rats. 24 male rats were divided into three groups: neuropathic group (n=9) in which the rats underwent chronic constriction injury (CCI), sham group (n=7) in which the sciatic nerves of the animals were exposed without any constriction and also fed with the vehicle, and the third group was under CCI condition and treated with Valerian (n=8). All the rats underwent electrode implant surgery so that we could record electroencephalogram and electromyography waves. In all the three groups, EEG and EMG recordings were recorded three times (150min each time). The initial recording was just prior to the CCI surgery and the rest were 3 and 6 days following CCI surgery. Moreover, cold allodynia and elevated plus maze tests were performed 3 and 6 days following the CCI surgery. Results Valerian treatment could repair the allodynia induced by neuropathy. On the other hand, by Valerian treatment (400mg/kg) during neuropathy, the REM sleep, decreased and the non-REM sleep increased. Moreover, there was an increment in sleep spindle density and spindle frequency even in neuropathic condition. Discussion This herbal supplement improves the quality of sleep in neuropathy conditions.
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Affiliation(s)
- Ashkan Soltani
- Baqiyatallah University of Medical Sciences, Neuroscience Research Center - Tehran - Tehran -Iran
| | - Farideh Bahrami
- Baqiyatallah University of Medical Sciences, Neuroscience Research Center - Tehran - Tehran -Iran.,Baqiyatallah University of Medical Sciences, Physiology and Medical Physics, School of Medicine - Tehran - Tehran - Iran
| | - Zahra Bahari
- Baqiyatallah University of Medical Sciences, Neuroscience Research Center - Tehran - Tehran -Iran.,Baqiyatallah University of Medical Sciences, Physiology and Medical Physics, School of Medicine - Tehran - Tehran - Iran
| | - Zeinab Shankayi
- Baqiyatallah University of Medical Sciences, Neuroscience Research Center - Tehran - Tehran -Iran.,Baqiyatallah University of Medical Sciences, Physiology and Medical Physics, School of Medicine - Tehran - Tehran - Iran
| | - Mehdi Graily-Afra
- Baqiyatallah University of Medical Sciences, Neuroscience Research Center - Tehran - Tehran -Iran.,Baqiyatallah University of Medical Sciences, Physiology and Medical Physics, School of Medicine - Tehran - Tehran - Iran
| | - Hedayat Sahraei
- Baqiyatallah University of Medical Sciences, Neuroscience Research Center - Tehran - Tehran -Iran.,Baqiyatallah University of Medical Sciences, Physiology and Medical Physics, School of Medicine - Tehran - Tehran - Iran
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Shi F, Li Y, Han R, Fu A, Wang R, Nusbaum O, Qin Q, Chen X, Hou L, Zhu Y. Valerian and valeric acid inhibit growth of breast cancer cells possibly by mediating epigenetic modifications. Sci Rep 2021; 11:2519. [PMID: 33510252 PMCID: PMC7844014 DOI: 10.1038/s41598-021-81620-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 01/06/2021] [Indexed: 12/27/2022] Open
Abstract
Valerian root (Valeriana officinalis) is a popular and widely available herbal supplement used to treat sleeping disorders and insomnia. The herb's ability to ameliorate sleep dysfunction may signify an unexplored anti-tumorigenic effect due to the connection between circadian factors and tumorigenesis. Of particular interest are the structural similarities shared between valeric acid, valerian's active chemical ingredient, and certain histone deacteylase (HDAC) inhibitors, which imply that valerian may play a role in epigenetic gene regulation. In this study, we tested the hypothesis that the circadian-related herb valerian can inhibit breast cancer cell growth and explored epigenetic changes associated with valeric acid treatment. Our results showed that aqueous valerian extract reduced growth of breast cancer cells. In addition, treatment of valeric acid was associated with decreased breast cancer cell proliferation, migration, colony formation and 3D formation in vitro in a dose- and time-dependent manner, as well as reduced HDAC activity and a global DNA hypomethylation. Overall, these findings demonstrate that valeric acid can decrease the breast cancer cell proliferation possibly by mediating epigenetic modifications such as the inhibition of histone deacetylases and alterations of DNA methylation. This study highlights a potential utility of valeric acid as a novel HDAC inhibitor and a therapeutic agent in the treatment of breast cancer.
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Affiliation(s)
- Fengqin Shi
- Department of Environmental Health Sciences, Yale University School of Public Health, New Haven, CT, 06520, USA
- Department of Oncology and Hematology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Ya Li
- Department of Environmental Health Sciences, Yale University School of Public Health, New Haven, CT, 06520, USA
- Department of Oncology and Hematology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Rui Han
- Department of Environmental Health Sciences, Yale University School of Public Health, New Haven, CT, 06520, USA
- Department of Oncology and Hematology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Alan Fu
- Department of Environmental Health Sciences, Yale University School of Public Health, New Haven, CT, 06520, USA
| | - Ronghua Wang
- Department of Environmental Health Sciences, Yale University School of Public Health, New Haven, CT, 06520, USA
- Department of Oncology and Hematology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Olivia Nusbaum
- Department of Environmental Health Sciences, Yale University School of Public Health, New Haven, CT, 06520, USA
| | - Qin Qin
- Department of Environmental Health Sciences, Yale University School of Public Health, New Haven, CT, 06520, USA
| | - Xinyi Chen
- Department of Oncology and Hematology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Li Hou
- Department of Environmental Health Sciences, Yale University School of Public Health, New Haven, CT, 06520, USA
- Department of Oncology and Hematology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Yong Zhu
- Department of Environmental Health Sciences, Yale University School of Public Health, New Haven, CT, 06520, USA.
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Desmarchelier MR. Clinical Psychopharmacology for the Exotic Animal Practitioner. Vet Clin North Am Exot Anim Pract 2020; 24:17-35. [PMID: 33189249 DOI: 10.1016/j.cvex.2020.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Literature regarding the clinical use of psychotropic drugs in exotic animals remains scarce. Psychotropic drugs acting on serotonin, dopamine, norepinephrine, and gamma-aminobutyric acid pathways work by decreasing fear and anxiety, reactivity, and hypervigilance, and by improving impulse control. They are indicated for some cases of aggression, self-mutilation, and compulsive and anxiety disorders, including feather-damaging behavior. Side effects are rarely seen when dosages are appropriately adjusted to the individual, starting with a low dose and slowly titrating to effect. Several drug interactions exist between psychotropic drugs and other classes. Psychotropic drugs cannot be used to replace appropriate environmental conditions in exotic animals. before "Side effects".
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Affiliation(s)
- Marion R Desmarchelier
- Department of Clinical Sciences, Faculté de médecine vétérinaire, Université de Montréal, 3200 rue Sicotte, Saint-Hyacinthe, Québec J2S 2M2, Canada.
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35
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Ekstrand B, Scheers N, Rasmussen MK, Young JF, Ross AB, Landberg R. Brain foods - the role of diet in brain performance and health. Nutr Rev 2020; 79:693-708. [PMID: 32989449 DOI: 10.1093/nutrit/nuaa091] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The performance of the human brain is based on an interplay between the inherited genotype and external environmental factors, including diet. Food and nutrition, essential in maintenance of brain performance, also aid in prevention and treatment of mental disorders. Both the overall composition of the human diet and specific dietary components have been shown to have an impact on brain function in various experimental models and epidemiological studies. This narrative review provides an overview of the role of diet in 5 key areas of brain function related to mental health and performance, including: (1) brain development, (2) signaling networks and neurotransmitters in the brain, (3) cognition and memory, (4) the balance between protein formation and degradation, and (5) deteriorative effects due to chronic inflammatory processes. Finally, the role of diet in epigenetic regulation of brain physiology is discussed.
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Affiliation(s)
- Bo Ekstrand
- Department of Biology and Biological Engineering, Food and Nutrition Science, Chalmers University of Technology, Gothenburg, Sweden
| | - Nathalie Scheers
- Department of Biology and Biological Engineering, Food and Nutrition Science, Chalmers University of Technology, Gothenburg, Sweden
| | | | | | - Alastair B Ross
- Department of Biology and Biological Engineering, Food and Nutrition Science, Chalmers University of Technology, Gothenburg, Sweden.,AgResearch, Lincoln, New Zealand
| | - Rikard Landberg
- Department of Biology and Biological Engineering, Food and Nutrition Science, Chalmers University of Technology, Gothenburg, Sweden
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Philips CA, Ahamed R, Rajesh S, George T, Mohanan M, Augustine P. Comprehensive review of hepatotoxicity associated with traditional Indian Ayurvedic herbs. World J Hepatol 2020; 12:574-595. [PMID: 33033566 PMCID: PMC7522561 DOI: 10.4254/wjh.v12.i9.574] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/16/2020] [Accepted: 08/15/2020] [Indexed: 02/06/2023] Open
Abstract
With growing antipathy toward conventional prescription drugs due to the fear of adverse events, the general and patient populations have been increasingly using complementary and alternative medications (CAMs) for managing acute and chronic diseases. The general misconception is that natural herbal-based preparations are devoid of toxicity, and hence short- and long-term use remain justified among people as well as the CAM practitioners who prescribe these medicines. In this regard, Ayurvedic herbal medications have become one of the most utilized in the East, specifically the Indian sub-continent, with increasing use in the West. Recent well-performed observational studies have confirmed the hepatotoxic potential of Ayurvedic drugs. Toxicity stems from direct effects or from indirect effects through herbal metabolites, unknown herb-herb and herb-drug interactions, adulteration of Ayurvedic drugs with other prescription medicines, and contamination due to poor manufacturing practices. In this exhaustive review, we present details on their hepatotoxic potential, discuss the mechanisms, clinical presentation, liver histology and patient outcomes of certain commonly used Ayurvedic herbs which will serve as a knowledge bank for physicians caring for liver disease patients, to support early identification and treatment of those who present with CAM-induced liver injury.
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Affiliation(s)
- Cyriac Abby Philips
- The Liver Unit and Monarch Liver Lab, Cochin Gastroenterology Group, Ernakulam Medical Center, Kochi 682028, Kerala, India.
| | - Rizwan Ahamed
- Gastroenterology and Advanced GI Endoscopy, Cochin Gastroenterology Group, Ernakulam Medical Center, Kochi 682028, Kerala, India
| | - Sasidharan Rajesh
- Division of Hepatobiliary Interventional Radiology, Cochin Gastroenterology Group, Ernakulam Medical Center, Kochi 682028, Kerala, India
| | - Tom George
- Division of Hepatobiliary Interventional Radiology, Cochin Gastroenterology Group, Ernakulam Medical Center, Kochi 682028, Kerala, India
| | - Meera Mohanan
- Anesthesia and Critical Care, Cochin Gastroenterology Group, Ernakulam Medical Center, Kochi 682028, Kerala, India
| | - Philip Augustine
- Gastroenterology and Advanced GI Endoscopy, Cochin Gastroenterology Group, Ernakulam Medical Center, Kochi 682028, Kerala, India
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Bottoni M, Milani F, Colombo L, Nallio K, Colombo PS, Giuliani C, Bruschi P, Fico G. Using Medicinal Plants in Valmalenco (Italian Alps): From Tradition to Scientific Approaches. Molecules 2020; 25:molecules25184144. [PMID: 32927742 PMCID: PMC7570945 DOI: 10.3390/molecules25184144] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/03/2020] [Accepted: 09/04/2020] [Indexed: 02/07/2023] Open
Abstract
This ethnobotanical survey was carried out in Caspoggio (Valmalenco, SO, Italy) with the purpose of investigating the traditional uses of medicinal plants. Moreover, a bibliographic research meant to validate or refute the uses, focusing on the potentially responsible compounds, was performed. Fifty-nine species, attributable to 30 families (Asteraceae, Pinaceae, Malvaceae, and Lamiaceae the most cited), were mentioned. Arnica montana, anti-inflammatory for traumas and musculoskeletal pains; Pinus mugo, expectorant; Malva sylvestris, anti-inflammatory and soothing; Achillea moschata, digestive. The compounds, responsible for the therapeutic activities, are often polyphenols and terpenoids: helenanin in A. montana, α-pinene, δ-3-carene, and limonene in P. mugo, gossypin and malvin in M. sylvestris, luteolin and apigenin in A. moschata. Scientific evidence for at least one of the traditional activities described was found for 50 species but only in 26 out of 196 works consulted, it is possible to make a comparison between investigated extracts and traditional preparations. This study is thus a stimulus to new phytochemical investigations, mimicking as much as possible the traditional preparations. This work is part of the European Interreg Italy-Switzerland B-ICE project, aimed at creating a management model for the ongoing climate change and searching for new sources of territory valorization as attractions for tourists.
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Affiliation(s)
- Martina Bottoni
- Department of Pharmaceutical Science, University of Milan, 20133 Milan, Italy
- Botanical Garden G.E. Ghirardi, Department of Pharmaceutical Science, University of Milan, Toscolano Maderno, 25088 Brescia, Italy
| | - Fabrizia Milani
- Department of Pharmaceutical Science, University of Milan, 20133 Milan, Italy
- Botanical Garden G.E. Ghirardi, Department of Pharmaceutical Science, University of Milan, Toscolano Maderno, 25088 Brescia, Italy
| | - Lorenzo Colombo
- Department of Pharmaceutical Science, University of Milan, 20133 Milan, Italy
- Botanical Garden G.E. Ghirardi, Department of Pharmaceutical Science, University of Milan, Toscolano Maderno, 25088 Brescia, Italy
| | - Kevin Nallio
- Department of Pharmaceutical Science, University of Milan, 20133 Milan, Italy
- Botanical Garden G.E. Ghirardi, Department of Pharmaceutical Science, University of Milan, Toscolano Maderno, 25088 Brescia, Italy
| | - Paola Sira Colombo
- Department of Pharmaceutical Science, University of Milan, 20133 Milan, Italy
- Botanical Garden G.E. Ghirardi, Department of Pharmaceutical Science, University of Milan, Toscolano Maderno, 25088 Brescia, Italy
| | - Claudia Giuliani
- Department of Pharmaceutical Science, University of Milan, 20133 Milan, Italy
- Botanical Garden G.E. Ghirardi, Department of Pharmaceutical Science, University of Milan, Toscolano Maderno, 25088 Brescia, Italy
| | - Piero Bruschi
- Department of Agricultural, Environmental, Food and Forestry Science and Technology, University of Florence, 50144 Florence, Italy
| | - Gelsomina Fico
- Department of Pharmaceutical Science, University of Milan, 20133 Milan, Italy
- Botanical Garden G.E. Ghirardi, Department of Pharmaceutical Science, University of Milan, Toscolano Maderno, 25088 Brescia, Italy
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Al-Attraqchi OHA, Deb PK, Al-Attraqchi NHA. Review of the Phytochemistry and Pharmacological Properties of Valeriana officinalis. CURRENT TRADITIONAL MEDICINE 2020. [DOI: 10.2174/2215083805666190314112755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The extracts of Valeriana officinalis (V. officinalis) are among the most widely used herbal medications worldwide. The roots of this medicinal plant have been shown to be rich in a diverse set of phytochemicals that are biologically active. Various classes of chemical compounds are present in the roots of V. officinalis including, terpenes valepotriates and lignans. The high amount of bioactive chemical components in the extracts of this plant gives it potential medicinal applications in different pathological conditions such as sleep disorders, cardiovascular diseases, anxiety and depression. The most common medicinal use of V. officinalis extract is for the treatment of insomnia and improving the quality of sleep. Mild sedative effects of the extract, as well as the absence of any significant side effects, make it a popular alternative to the synthetic sedative drugs which are usually associated with undesirable adverse effects. In this review, the bioactive chemical components of V. officinalis and their pharmacological activities are highlighted. Also, the medicinal applications of valerian (V. officinalis) extracts and the possible mechanisms of action for the activities are discussed.
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Hooper S, Lynch T, Coyle K, Hooper D, Hausenblas HA. Effectiveness of NexQuest Natural Frequency Technology ® on sleep and mood of adults with insomnia symptoms: a randomized, double blind and placebo controlled crossover trial. SLEEP SCIENCE (SAO PAULO, BRAZIL) 2020; 13:84-87. [PMID: 32670497 PMCID: PMC7347368 DOI: 10.5935/1984-0063.20190125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Objectives: The study purpose was to conduct a four-week randomized double-blind placebo-controlled crossover trial on adults with insomnia symptoms to examine the effectiveness of Natural Frequency Technology(®) (NFT), found in Philip Stein Sleep Bracelets, on sleep quality, anxiety/stress levels, and mood. Methods: Adults (N = 44, M age = 41.9 years) were randomized to the Placebo Bracelet (PB) or NFT Sleep Bracelet (SB) for two weeks and then the alternative bracelet for two weeks. Self-reported mood, anxiety/stress, and sleep quality were completed at Day 0 (PRE) and following each condition; POST PB and POST SB). Results: When the participants wore the SB, compared to the PB, they had improved sleep quality (i.e., Pittsburgh Sleep Quality Index), anxiety/perceived stress, and mood, p’s < .05. Discussion: The SB may be simple, noninvasive, and non-pharmacological intervention to improve sleep quality and daytime mood.
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Affiliation(s)
- Stephanie Hooper
- Jacksonville University, Applied Health Sciences - Jacksonville - FL - United States
| | - Tarah Lynch
- Jacksonville University, Applied Health Sciences - Jacksonville - FL - United States
| | - Kevin Coyle
- Jacksonville University, Applied Health Sciences - Jacksonville - FL - United States
| | - David Hooper
- Jacksonville University, Applied Health Sciences - Jacksonville - FL - United States
| | - Heather A Hausenblas
- Jacksonville University, Applied Health Sciences - Jacksonville - FL - United States
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40
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El Hajj M, Holst L. Herbal Medicine Use During Pregnancy: A Review of the Literature With a Special Focus on Sub-Saharan Africa. Front Pharmacol 2020; 11:866. [PMID: 32581815 PMCID: PMC7296102 DOI: 10.3389/fphar.2020.00866] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 05/26/2020] [Indexed: 12/15/2022] Open
Abstract
Herbal medicine use has grown considerably worldwide among pregnant women, and is particularly widespread in sub-Saharan Africa. However, herbal medicines used across sub-Saharan Africa are associated with important research gaps and a lack of regulatory framework. This is particularly problematic, as herbal medicine use during pregnancy raises several concerns attributed to the herbal ingredient itself, conventional drug-herbal medicine interactions, and contamination or adulteration of herbal remedies. Moreover, several local herbal remedies used by sub-Saharan African pregnant women have never been botanically identified. In this review, an overview of the practice of herbal medicine, including the regulations, challenges and overall safety, is provided. Then, we discuss the prevalence of herbal medicine use during pregnancy across different sub-Saharan African countries, as well as the indications, adverse outcomes, and effectiveness of the most commonly used herbal medicines during pregnancy in that region.
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Affiliation(s)
- Magalie El Hajj
- Centre for International Health, University of Bergen, Bergen, Norway.,Medical Affairs, Partner 4 Health, Paris, France
| | - Lone Holst
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Centre for Pharmacy, University of Bergen, Bergen, Norway
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41
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Richter K, Kellner S, Miloseva L, Frohnhofen H. [Treatment of insomnia in old age]. Z Gerontol Geriatr 2020; 53:105-111. [PMID: 31965284 DOI: 10.1007/s00391-019-01684-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 12/16/2019] [Indexed: 10/25/2022]
Abstract
Insomnia is one of the most frequent health disorders in old age. It causes suffering and numerous health problems. Therefore, treatment is often indicated. Behavioral therapy is the treatment of choice even in older individuals. In addition, light therapy also has an important role. Pharmacological treatment measures are less well studied, the benefits in long-term use are unclear and should only be applied in the short term to reduce suffering as well as being integrated into a comprehensive treatment concept.
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Affiliation(s)
- Kneginja Richter
- Universitätsklinik für Psychiatrie und Psychotherapie, Paracelsus Medizinische Privatuniversität Nürnberg, Prof.-Ernst-Nathan-Str. 1, 90419, Nürnberg, Deutschland.
| | - Stefanie Kellner
- Institut für E-Beratung, Fakultät für Sozialwissenschaften, Technische Hochschule Nürnberg, Nürnberg, Deutschland
| | - Lence Miloseva
- Fakultät für Medizinwissenschaften, Universität Goce Delcev, Stip, Stip, Nordmazedonien
| | - Helmut Frohnhofen
- Fakultät für Gesundheit, Universität Witten Herdecke, Witten, Deutschland
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Nami M, Mehrabi S, Kamali AM, Kazemiha M, Carvalho J, Derman S, Lakey-Betia J, Vasquez V, Kosagisharaf R. A New Hypothesis on Anxiety, Sleep Insufficiency, and Viral Infections; Reciprocal Links to Consider in Today's "World vs. COVID-19" Endeavors. Front Psychiatry 2020; 11:585893. [PMID: 33250794 PMCID: PMC7674554 DOI: 10.3389/fpsyt.2020.585893] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 09/24/2020] [Indexed: 12/19/2022] Open
Abstract
In today's ever-growing concerns about the coronavirus disease (COVID-19) pandemic, many experience sleep insufficiencies, such as difficulty falling or staying asleep, sleep-related behavioral symptoms, and out-of-phase circadian rhythmicity despite the lack of history of earlier such symptoms. Meanwhile, the disruption in sleep bioparameters is experienced more in people with a history of sleep disorders. The behavioral sleep disorders in the current situations are prevalent given the today's amount of anxiety everyone is feeling about COVID-19. On the other hand, evidences indicated that the cross-link between impaired sleep efficiency and disrupted innate immunity makes people susceptible to viral infections. The present brief review highlights the links between psychosocial stress, sleep insufficiency, and susceptibility to viral infections in relevance to COVID-19 situation. The stress management measures, including addressing sleep-related disorders and sleep hygiene, will have a notable impact by harnessing immune response and thus reducing the susceptibility to viral infections.
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Affiliation(s)
- Mohammad Nami
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran.,Dana Brain Health Institute, Iranian Neuroscience Society-Fars Chapter, Shiraz, Iran.,Academy of Health, Senses Cultural Foundation, Sacramento, CA, United States.,Neuroscience Center, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP), Panama City, Panama.,Sleep Disorders Laboratory, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Samrad Mehrabi
- Sleep Disorders Laboratory, Namazi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.,Division of Pulmonology, Department of Internal Medicine, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali-Mohammad Kamali
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran.,Dana Brain Health Institute, Iranian Neuroscience Society-Fars Chapter, Shiraz, Iran
| | - Milad Kazemiha
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran.,Dana Brain Health Institute, Iranian Neuroscience Society-Fars Chapter, Shiraz, Iran
| | | | - Sabri Derman
- Sleep Disorders Unit, American Hospital, Koc Foundation, Istanbul, Turkey
| | - Johant Lakey-Betia
- Centre for Biodiversity and Drug Discovery, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP), Panama City, Panama
| | - Velmarini Vasquez
- Neuroscience Center, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP), Panama City, Panama
| | - Rao Kosagisharaf
- Neuroscience Center, Instituto de Investigaciones Científicas y Servicios de Alta Tecnología (INDICASAT AIP), Panama City, Panama
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Efficacy and safety of non-benzodiazepine and non-Z-drug hypnotic medication for insomnia in older people: a systematic literature review. Eur J Clin Pharmacol 2019; 76:363-381. [DOI: 10.1007/s00228-019-02812-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 11/27/2019] [Indexed: 12/17/2022]
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Doremus JM, Stith SS, Vigil JM. Using recreational cannabis to treat insomnia: Evidence from over-the-counter sleep aid sales in Colorado. Complement Ther Med 2019; 47:102207. [DOI: 10.1016/j.ctim.2019.102207] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/20/2019] [Accepted: 09/30/2019] [Indexed: 12/18/2022] Open
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Koriem KMM, Arbid MS, El-Attar MA. Acute and subacute toxicity of Ammi visnaga on rats. Interdiscip Toxicol 2019; 12:26-35. [PMID: 32189984 PMCID: PMC7061450 DOI: 10.2478/intox-2019-0004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 06/17/2019] [Indexed: 12/16/2022] Open
Abstract
Ammi visnaga (Av) is a source of khellin where a tea made from the fruit of this plant was used as herbal medicine for kidney stones in Egypt. In the present research, the acute and subacute toxicity studies with oral intake of 150, 300 and 600 mg/kg of Av seed ethanolic extract in rats were done. In acute toxicity test, 4 groups of rats (n = 6/group: 3 males and 3 females) were chosen and the first control group received tap water, while the other three groups received Av seed ethanolic extract dissolved in tap water at doses of 150, 300, and 600 mg/kg, and general behavior, adverse effects, and mortality were recorded for up to 14 days. In subacute toxicity study, 72 rats (36 males and 36 females) were divided into 4 major groups; group I received tap water (control group), while animals in groups II, III, and IV (test groups) received oral intake of Av seed ethanolic extract dissolved in tap water at doses of 150, 300 and 600 mg/ kg bwt, respectively. Each of this major group was subdivided consequently into 3 subgroups (n = 6/group: 3 males and 3 females) where brain tissue, blood sample, body and organs weights were recorded at the beginning and then after two and four weeks of the experiment for the determination of hematological, biochemical and histopathological changes in tissues (liver, kidney, brain, spleen, heart, testis and ovary). With regard to acute toxicity, Av seed ethanolic extract did not induce any toxic effects or death or any organ toxicity. In subacute toxicity study; oral intake with Av seed ethanolic extract did not reveal any change in body and organs weights, hematological parameters, serum glucose and cholesterol, brain neurotransmitters, liver and kidney functions, male and female hormones. In conclusion, Av seed ethanolic extract is nontoxic to liver, kidney, brain, spleen, heart, testis and ovary.
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Affiliation(s)
- Khaled M M Koriem
- Department of Medical Physiology, Medical Research Division, National Research Centre, Dokki, Cairo, Egypt
| | - Mahmoud S Arbid
- Department of Pharmacology, Medical Research Division, National Research Centre, Dokki, Cairo, Egypt
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Rice bran extract supplement improves sleep efficiency and sleep onset in adults with sleep disturbance: A randomized, double-blind, placebo-controlled, polysomnographic study. Sci Rep 2019; 9:12339. [PMID: 31451704 PMCID: PMC6710429 DOI: 10.1038/s41598-019-48743-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 08/07/2019] [Indexed: 11/30/2022] Open
Abstract
We previously reported that rice bran extract supplement (RBS) administration to mice decreased sleep latency and induced non-rapid eye movement (NREM) sleep via inhibition of the histamine H1 receptor. Based on this, we performed the first clinical trial to investigate whether RBS would be beneficial to subjects with disturbed sleep. We performed a randomized, double‐blinded, placebo‐controlled, 2-week study. Fifty subjects with sleep disturbance were enrolled and received either RBS (1,000 mg/day) or placebo. Polysomnography was performed, and Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale (ESS), and Fatigue Severity Scale were administered at the initiation and termination of the study. Compared with the placebo, RBS led to significant polysomnographic changes, including decreased sleep latency (adjusted, P = 0.047), increased total sleep time (P = 0.019), and improved sleep efficiency (P = 0.010). Additionally, the amount of stage 2 sleep significantly increased in the RBS group. When adjusted for caffeine intake, wakefulness after sleep onset, total wake time, and delta activity tended to decrease in the RBS group. RBS administration decreased ESS scores. There were no reported serious adverse events in both groups. RBS improved sleep in adults with sleep disturbance. Trial registration: WHO ICTRP, KCT0001893.
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47
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A Double-Blind, Randomized, Placebo-Controlled Crossover Clinical Study of the Effects of Alpha-s1 Casein Hydrolysate on Sleep Disturbance. Nutrients 2019; 11:nu11071466. [PMID: 31252661 PMCID: PMC6682925 DOI: 10.3390/nu11071466] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 06/19/2019] [Accepted: 06/23/2019] [Indexed: 12/20/2022] Open
Abstract
This study evaluated the effects of alpha-s1 casein hydrolysate (ACH; Lactium®) on the subjective and objective sleep profiles of a community-based sample of Koreans with poor sleep quality. We performed a double-blind, randomized crossover trial with 48 participants (49.0 ± 1.7 years old, 65% female) who exhibited a mild to moderate degree of sleep disturbance. Either ACH or placebo was administered for the initial four weeks, and the counterpart was administered in precisely the same manner after a four-week washout period. Sleep disturbance scales, daytime functioning, and psychiatric aspects showed a similar tendency to improve during both ACH and placebo phases without significant group differences. Overall perceived sleep profiles in sleep diaries were significantly improved during the ACH phase, represented by increased total sleep time and sleep efficiency (SE), as well as decreased sleep latency and wake after sleep onset (WASO). Interestingly, actigraphy demonstrated significantly increased SE after continuous use of ACH for four weeks, clearly more improved when compared to two weeks of use. The polysomnography measures showed a similar tendency without statistically significant group differences. Our findings suggest that refined ACH was well tolerated and could improve sleep quality, with possible cumulative beneficial effects with long-term administration.
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Bongartz U, Tan BK, Seibt S, Bothe G, Uebelhack R, Chong PW, Wszelaki N. Sleep Promoting Effects of IQP-AO-101: A Double-Blind, Randomized, Placebo-Controlled Exploratory Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2019; 2019:9178218. [PMID: 31186669 PMCID: PMC6521387 DOI: 10.1155/2019/9178218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 03/18/2019] [Accepted: 04/08/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The purpose of this study was to explore the clinical benefit and tolerability of IQP-AO-101 in healthy subjects with sleep complaints. METHODS This double-blind, randomized, placebo-controlled trial involved fifty subjects with sleep complaints. Subjects with a Pittsburgh Sleep Quality Index (PSQI) score between 6 and 15 were randomized to receive either IQP-AO-101 or placebo for 6 weeks, following a run-in period of one week. Sleep parameters were assessed at baseline and after 1, 4, and 6 weeks using the modified Athens Insomnia Scale (mAIS). Subjects were also instructed to wear an activity tracker and keep a sleep diary during the study. Other questionnaires administered were the Frankfurt Attention Inventory (FAIR-2) and the Profile of Mood States (POMS-65). Blood samples for safety laboratory parameters were taken before and at the end of the study. RESULTS After 6 weeks, subjects who consumed IQP-AO-101 reported significant improvements in mAIS scores compared with placebo, including mAIS total score (11.76 ± 6.85 vs 4.00 ± 4.80; p < 0.001); night parameters composite score (5.20 ± 3.80 vs 2.04 ± 3.16; p = 0.001); and day parameters composite score (6.56 ± 4.10 vs 1.96 ± 2.65; p < 0.001). All individual parameters (Items 1 to 8) were also significantly improved from baseline after 6 weeks of IQP-AO-101 intake. Analysis of variance with baseline values as covariates showed statistically significant improvements across all individual parameters for IQP-AO-101 when compared to placebo. The measurements using the activity tracker, sleep diary, FAIR-2, and POMS did not reveal any significant differences between groups. No adverse effects related to the intake of IQP-AO-101 were reported. Tolerability was rated as very good by all the subjects and by the investigator for all cases. CONCLUSIONS In this study, IQP-AO-101 was well tolerated and efficacious for promoting sleep and enhancing daytime performance in subjects with moderate sleep disturbances. CLINICAL TRIAL REGISTRATION This trial is registered with ClinicalTrials.gov, no. NCT03114696.
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Affiliation(s)
- Udo Bongartz
- Analyze & Realize GmbH, Weißenseer Weg 111, 10369 Berlin, Germany
| | - Bee-Kwan Tan
- InQpharm Group Sdn Bhd, E-16 Plaza Mont Kiara, 2 Jalan Kiara, 50480 Kuala Lumpur, Malaysia
| | | | - Gordana Bothe
- Analyze & Realize GmbH, Waldseeweg 6, 13467 Berlin, Germany
| | - Ralf Uebelhack
- Analyze & Realize GmbH, Weißenseer Weg 111, 10369 Berlin, Germany
| | - Pee-Win Chong
- Zaluvida Corporate Sdn Bhd, E-16 Plaza Mont Kiara, 2 Jalan Kiara, 50480 Kuala Lumpur, Malaysia
| | - Natalia Wszelaki
- Zaluvida Corporate Sdn Bhd, E-16 Plaza Mont Kiara, 2 Jalan Kiara, 50480 Kuala Lumpur, Malaysia
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Abdellah SA, Berlin A, Blondeau C, Guinobert I, Guilbot A, Beck M, Duforez F. A combination of Eschscholtzia californica Cham. and Valeriana officinalis L. extracts for adjustment insomnia: A prospective observational study. J Tradit Complement Med 2019; 10:116-123. [PMID: 32257874 PMCID: PMC7109475 DOI: 10.1016/j.jtcme.2019.02.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 02/15/2019] [Accepted: 02/24/2019] [Indexed: 12/30/2022] Open
Abstract
Eschscholtzia californica Cham. and Valeriana officinalis L. have long been used for the management of sleep disorders and anxiety. Use of a fixed combination of these two plant extracts (Phytostandard® d’Eschscholtzia et de Valériane, PiLeJe Laboratoire, France) was investigated in an observational study. Adults with adjustment insomnia according to the criteria of the International Classification of Sleep Disorders and with an insomnia severity index (ISI) score >7 enrolled by GPs took a maximum of four tablets of the eschscholtzia and valerian combination every night for four weeks. Within one month, ISI score decreased by approximately 30% (from 16.09 ± 3.67 at inclusion (V1) to 11.32 ± 4.78 at 4 weeks (V2); p < 0.0001). Night sleep duration significantly increased between the first and the fourth week of supplement intake, sleep efficiency increasing from 78.4% ± 12.5 to 84.6% ± 10.2 (p = 0.002). There was no improvement in sleep latency. The number of awakenings decreased by approximately 25% and their total duration by approximately 25 min. Anxiety score significantly decreased by 50% from 13.9 ± 7.3 at V1 to 6.7 ± 6.3 at V2 (p < 0.0001). The supplement was well tolerated. These results suggest that the tested combination of eschscholtzia and valerian extracts could be beneficial for the management of insomnia in adults and deserves further investigation.
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Affiliation(s)
| | - Aurélie Berlin
- Groupe PiLeJe, 37 quai de Grenelle, 75015, Paris Cedex 15, France
| | - Claude Blondeau
- Groupe PiLeJe, 37 quai de Grenelle, 75015, Paris Cedex 15, France
| | | | - Angèle Guilbot
- Groupe PiLeJe, 37 quai de Grenelle, 75015, Paris Cedex 15, France
| | - Marc Beck
- 1 avenue Cornaudric, 31240, L'Union, France
| | - François Duforez
- Hotel-Dieu de Paris, Centre du Sommeil et de la Vigilance, 1 Place du parvis Notre-Dame, 75181, Paris Cedex, France
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Abad VC, Guilleminault C. Insomnia in Elderly Patients: Recommendations for Pharmacological Management. Drugs Aging 2018; 35:791-817. [PMID: 30058034 DOI: 10.1007/s40266-018-0569-8] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Chronic insomnia affects 57% of the elderly in the United States, with impairment of quality of life, function, and health. Chronic insomnia burdens society with billions of dollars in direct and indirect costs of care. The main modalities in the treatment of insomnia in the elderly are psychological/behavioral therapies, pharmacological treatment, or a combination of both. Various specialty societies view psychological/behavioral therapies as the initial treatment intervention. Pharmacotherapy plays an adjunctive role when insomnia symptoms persist or when patients are unable to pursue cognitive behavioral therapies. Current drugs for insomnia fall into different classes: orexin agonists, histamine receptor antagonists, non-benzodiazepine gamma aminobutyric acid receptor agonists, and benzodiazepines. This review focuses on Food and Drug Administration (FDA)-approved drugs for insomnia, including suvorexant, low-dose doxepin, Z-drugs (eszopiclone, zolpidem, zaleplon), benzodiazepines (triazolam, temazepam), and ramelteon. We review the indications, dosing, efficacy, benefits, and harms of these drugs in the elderly, and discuss data on drugs that are commonly used off-label to treat insomnia, and those that are in clinical development. The choice of a hypnotic agent in the elderly is symptom-based. Ramelteon or short-acting Z-drugs can treat sleep-onset insomnia. Suvorexant or low-dose doxepin can improve sleep maintenance. Eszopiclone or zolpidem extended release can be utilized for both sleep onset and sleep maintenance. Low-dose zolpidem sublingual tablets or zaleplon can alleviate middle-of-the-night awakenings. Benzodiazepines should not be used routinely. Trazodone, a commonly used off-label drug for insomnia, improves sleep quality and sleep continuity but carries significant risks. Tiagabine, sometimes used off-label for insomnia, is not effective and should not be utilized. Non-FDA-approved hypnotic agents that are commonly used include melatonin, diphenhydramine, tryptophan, and valerian, despite limited data on benefits and harms. Melatonin slightly improves sleep onset and sleep duration, but product quality and efficacy may vary. Tryptophan decreases sleep onset in adults, but data in the elderly are not available. Valerian is relatively safe but has equivocal benefits on sleep quality. Phase II studies of dual orexin receptor antagonists (almorexant, lemborexant, and filorexant) have shown some improvement in sleep maintenance and sleep continuity. Piromelatine may improve sleep maintenance. Histamine receptor inverse agonists (APD-125, eplivanserin, and LY2624803) improve slow-wave sleep but, for various reasons, the drug companies withdrew their products.
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Affiliation(s)
- Vivien C Abad
- Division of Sleep Medicine, Department of Psychiatry and Behavioral Sciences, Stanford Outpatient Medical Center, Stanford University, 450 Broadway St. Pavilion C 2nd Floor MC 5704, Redwood City, CA, 94063, USA
| | - Christian Guilleminault
- Division of Sleep Medicine, Department of Psychiatry and Behavioral Sciences, Stanford Outpatient Medical Center, Stanford University, 450 Broadway St. Pavilion C 2nd Floor MC 5704, Redwood City, CA, 94063, USA.
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