The effects of chamomile extract on sleep quality among elderly people: A clinical trial

Effects of chamomile oil inhalation on sleep quality in young adults with insomnia: A randomized controlled trial

OBJECTIVE

Insomnia is characterized by difficulty falling asleep, staying sleep, or both. Aromatherapy is a commonly used complementary and alternative medicine practice by persons with insomnia. Previous studies have shown that use of chamomile oil during massage therapy improves the quality of sleep (QoS). However, to our knowledge, no randomized controlled trials have examined the effects of chamomile oil inhalation on the treatment of insomnia. The present study evaluated the effect of chamomile oil inhalation on QoS and insomnia severity in persons with insomnia.

METHODS

A total of 80-participants ages 18-35 with insomnia were randomly allocated to aromatherapy group (AG; n = 40) or a control group (CG; n = 40). Those in the AG group received chamomile oil inhalation, while those in the CG engaged in their normal routine for 10 minutes a day, daily for 15 days. The Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) were administered before and after the intervention.

RESULTS

Within-group analysis showed a significant reduction both in PSQI and ISI scores among those in the AG (P < 0.001 for both scores), whereas the CG reported a significant reduction in PSQI score (P = 0.033) and no significant changes in ISI score (P = 0.068). The between groups analysis after the intervention demonstrated a significant reduction in PSQI and ISI scores in the AG group (P < 0.001 for both) compared to the CG. No participant in either group reported adverse events during or after the study.

CONCLUSION

Fifteen days of chamomile oil inhalation before bedtime reduced insomnia severity and enhanced the quality of sleep for young adults suffering from insomnia. Further studies are needed to replicate the results of this study using an active control group.

Effects of chamomile (Matricaria chamomilla L.) on sleep: A systematic review and meta-analysis of clinical trials

OBJECTIVE

We aimed to investigate the effects of chamomile (Matricaria chamomilla L.) on sleep in this systematic review and meta-analysis of clinical trials.

METHODS

PubMed, Scopus, Web of Science, and Cochrane Library were searched until August 2023. All clinical trials that investigated the effects of chamomile on sleep, either in healthy or diseased adults, were eligible to enter the study. The quality of studies was assessed using the Cochrane tool. Random-effects meta-analysis was used to pool weighted mean differences (WMD) and 95 % CI for the outcomes assessed by at least three studies with relatively consistent participants.

RESULTS

The systematic review included ten studies (772 participants). Meta-analysis was conducted for the Pittsburgh Sleep Quality Index (PSQI) score and sleep length. A significant reduction in PSQI score (WMD: -1.88, 95 %CI: -3.46, -0.31, I2: 88.4 %, n = 5) was found. For other outcomes, meta-analysis was not conducted. Sleep onset latency or ease of getting to sleep were improved in three of the four studies. Daytime functioning measures, including fatigue severity index or postpartum fatigue scale, did not change in all three studies. Sleep efficiency did not change in two studies and deteriorated in one. The number of awakenings after sleep or staying asleep was improved in two of the three studies. No adverse events were reported in any of the studies although passive surveillance was used to assess adverse effects except in one study. Only one study surveyed the blinding success and tested the purity and/or potency of the used products.

CONCLUSION

Chamomile improved sleep, especially the number of awakenings after sleep or staying asleep; however, it did not lead to an improvement in the duration of sleep, percentage of sleep efficiency, and daytime functioning measures. Future studies are suggested to assess objective measures.

Herbal and Natural Supplements for Improving Sleep: A Literature Review

OBJECTIVE

Herbal and natural supplements have gained popularity as alternative treatments to insomnia and sleep disorders due to their perceived safety and potential effectiveness. This literature review summarizes the current evidence on the efficacy, safety, and mechanisms of action of commonly used supplements for sleep, including valerian, hops, kava, German chamomile, cherry, tryptophan, theanine, melatonin, magnesium, and zinc.

METHODS

We conducted literature review of clinical research on herbal and supplements for sleep reported to date. We summarized key findings and reviewed outcomes related to clinical efficacy and side effects.

RESULTS

Findings suggest that certain supplements, particularly valerian, hops, and melatonin, could be effective in improving sleep quality and reducing insomnia symptoms through modulation of neurotransmitter systems and regulation of sleep-wake cycles. However, the strength of the evidence varies with unestablished optimal dosages, formulations, and treatment durations. Although generally considered safe, these supplements are not without risks, such as rare but serious adverse effects associated with kava and potential interactions with prescription medications. The quality and purity of supplements also vary widely due to a lack of strict regulations.

CONCLUSION

Healthcare providers should remain informed about the latest research and work closely with patients to develop personalized treatment plans. Herbal and natural supplements may offer promising alternatives or adjunct treatments for insomnia and sleep disorders, but their use should be guided by the best available evidence and individual patient requirements. Larger, well-designed clinical trials are needed to establish the efficacy and safety of these supplements for clinical decision-making.

Flower Power: An Overview on Chemistry and Biological Impact of Selected Essential Oils from Blossoms

Natural raw materials such as essential oils have received more and more attention in recent decades, whether in the food industry, as flavorings and preservatives, or as insecticides and insect repellents. They are, furthermore, very popular as fragrances in perfumes, cosmetics, and household products. In addition, aromatherapy is widely used to complement conventional medicine. This review summarizes investigations on the chemical composition and the most important biological impacts of essential oils and volatile compounds extracted from selected aromatic blossoms, including Lavandula angustifolia, Matricaria recutita, Rosa x damascena, Jasminum grandiflorum, Citrus x aurantium, Cananga odorata, and Michelia alba. The literature was collected from PubMed, Google Scholar, and Science Direct. Blossom essential oils discussed in this work are used in a wide variety of clinical issues. The application is consistently described as safe in studies and meta-analyses, although there are notes that using essential oils can also have side effects, especially dermatologically. However, it can be considered as confirmed that essential oils have positive influences on humans and can improve quality of life in patients with psychiatric disorders, critically ill patients, and patients in other exceptional situations. Although the positive effect of essential oils from blossoms has repeatedly been reported, evidence-based clinical investigations are still underrepresented, and the need for research is demanded.

Prophylactic effect of chamomile on post-dural puncture headache in women undergoing elective cesarean section: A randomized, double blind, placebo-controlled clinical trial

BACKGROUND

Post-dural puncture headache (PDPH) is a common complication after spinal anesthesia, affecting patient recovery. This study evaluated the prophylactic effect of topical chamomile ointment on PDPH in women undergoing elective cesarean section.

METHODS

In a randomized, double-blind, placebo-controlled clinical trial 148 pregnant women were randomized into two parallel groups and received 3cc of the chamomile or the placebo ointment on the forehead of the participants 20 minutes before the start of spinal anesthesia, and then 2 and 4 hours after that. The primary outcomes were the incidence rate of headache, and its severity assessed by a numeric rating scale (NRS), while secondary outcomes included analgesic consumption, frequency of nausea/vomiting, and adverse events.

RESULTS

Chamomile ointment exhibited significant preventive effects on PDPH incidence compared to placebo. The chamomile group demonstrated lower rates of PDPH at 6 hours (3.5% vs. 7.18%, p = 0.021) and 12 hours (7.6% vs. 20%, p = 0.028) after spinal anesthesia. Analgesic consumption, frequency of nausea/vomiting, and adverse events were comparable between the groups.

CONCLUSION

Topical chamomile ointment demonstrated significant preventive effects on PDPH incidence compared to placebo. Chamomile ointment could be a promising adjunctive approach to prevent PDPH, enhancing patient comfort and potentially reducing the need for analgesics. Further investigation is needed to explore its mechanisms and broader applications.

The Role of Dietary Ingredients in Mental Energy - A Scoping Review of Randomized Controlled Trials

Low mental energy can contribute to decreased productivity, altered life balance, decreased physical performance, and ultimately affect quality of life. As such, there is a great demand for food and beverage products that positively impact mental energy. Numerous products claim to alter mental energy making continued review of the scientific evidence critical. The objective of this study was to conduct a scoping review of randomized controlled trials to evaluate the effect of 18 dietary ingredients on mental energy outcomes in adults without severe disease. Methods: A literature search, completed using PubMed, resulted in the identification of 2261 articles, 190 of which met eligibility from initial abstract review. Full-text review was completed on the 190 studies which resulted in 101 articles that fully met eligibility for inclusion in this study. The search strategy for two ingredients did not yield any eligible studies, leaving studies for 16 ingredients that were extracted and summarized by reported significantly improved outcomes for cognition, mood and perceived feelings, and sleep assessments. The preliminary results for several dietary ingredients directionally suggested a mental energy benefit (≥20% of outcomes), including ashwagandha, chamomile, dark chocolate, ginseng, green tea, lavender, lion's mane mushroom, maca, tart cherries, turmeric, and valerian root. The results of this scoping review suggest that of the 16 dietary ingredients reviewed, 11 may be promising for further exploration on their potential benefits in supporting mental energy. Given consumer demand and market growth for food and beverage products that positively impact mental energy; continued efforts in assessment method alignment and additional evaluation in well-designed trials is warranted.KEY TEACHING POINTSOf the 16 dietary ingredients reviewed, 11 (ashwagandha, chamomile, dark chocolate, ginseng, green tea, lavender, lion's mane mushroom, maca, melatonin foods, turmeric, and valerian root) may be promising for further exploration on their potential mental energy benefits.Dark chocolate, ginseng, ashwagandha, and lion's mane mushroom were the most promising ingredients for further evaluation in the cognition domain of the ingredients evaluated.Turmeric, maca, lavendar, and ashwagandha were the most promising ingredients for further evaluation in the mood and perceived feelings domain of the ingredients evaluated.Ashwagandha, chamomile, green tea, melatonin foods, valerian root were the most promising ingredients for further evaluation in the sleep domain of the ingredients evaluated.Additional, well-designed, consistent, clinical trials and systematic reviews are warranted as the challenge of heterogeneity in mental energy study design remains.

Exploring the short-term influence of a proprietary oil extract of black cumin (Nigella sativa) on non-restorative sleep: a randomized, double-blinded, placebo-controlled actigraphy study

Background

Nigella sativa (black cumin, or black seed) is popularly known as the seed of blessings in the Arab system of medicine. Though not widely recommended for sleep, a unique proprietary black cumin extract (BlaQmax®/ThymoDream™; BCO-5) has been shown to be helpful in the management of stress and sleep issues.

Methods

This randomized, double-blind, placebo-controlled trial aimed to investigate the efficacy of BCO-5 on the sleep quality of volunteers characterized with a self-reported non-restorative sleep disorder. Healthy male and female participants (n = 70), aged 18-65 years (BMI 22-28 Kg/m2) were randomized to either placebo or BCO-5 (n = 35/group). Both interventions were supplemented at 200 mg/day for seven days. Actigraphy and a validated restorative sleep questionnaire (RSQ-W) were used to monitor the influence of BCO-5 on sleep.

Results

Compared to placebo, BCO-5 significantly improved sleep quality, as evidenced by both intra-group and inter-group analyses of the actigraphy data. The relative improvements observed were sleep efficiency (7.8%, p < 0.001), total sleep time (19.1%, p < 0.001), sleep onset latency (35.4%; p < 0.001), and wake-after-sleep-onset (22.5%; p < 0.001) compared with placebo. BCO-5 also improved sleep by 75.3% compared to baseline (p < 0.001) and by 68.9% compared to placebo (p < 0.001), when monitored by RSQ-W. BCO-5 was well-tolerated with no reports of side effects or toxicity.

Conclusion

BCO-5 significantly improved non-restorative sleep in seven days, indicating its potential role as a natural sleep aid.

Effects of aromatherapy with Matricaria chamomile essential oil on anxiety and hemodynamic indices in patients with acute coronary syndrome, 2021: a randomized controlled trial

BACKGROUND

Patients with Acute Coronary Syndrome (ACS) experience high levels of anxiety that may cause instability of hemodynamic indices, increased risk of ischemia, myocardial infarction and poor quality of life. Aromatherapy can affect patients' anxiety levels and improve hemodynamic indices. This study aimed to evaluate the efficacy of aromatherapy on anxiety and hemodynamic indices in ACS patients.

METHODS

This study was a double-blind, randomized clinical trial conducted on 154 ACS patients. The participants were classified into two equal groups of intervention and placebo through the block randomization method. The data collection tools consisted of demographic information, a shortened 6-item version of the Spielberger questionnaire and a form of hemodynamic indices. For two consecutive nights, the intervention group inhaled 7 drops of the chamomile essential oil (%10) and the placebo group inhaled 7 drops of the sesame oil poured on a sterile cotton ball. The hemodynamic indices were collected half an hour before, one and four hours after the intervention until the next morning. The Spielberger questionnaire was completed once before the intervention and once after the end of the intervention, by the researcher through an interview. The number of heart rate (HR) was counted for a full minute. Also, the blood pressure (BP) of all the samples was measured by the researcher. Data analysis was done using Chi-square, paired t-test, and analysis of variance (ANOVA) in SPSS22.

RESULTS

The mean and standard deviation of the age of patients were 58/2 ± 11.6 and 59.7% of them were female. The results of ANOVA showed a significantly lower anxiety score as well as systolic blood pressure (SBP), diastolic blood pressure (DBP) and HR in the intervention group compared to those of the placebo group (P < 0.001). The decrease in anxiety score after the intervention, in the intervention and placebo groups was (5.2 ± 1.9) and (1 ± 1. 18) respectively. In the intervention group, the SBP and DBP after the intervention, was significant (P < 0.05). Also, the HR was significant (P < 0.001) after the intervention.

CONCLUSIONS

Aromatherapy could reduce anxiety and improve hemodynamic indices in ACS patients.

TRIAL REGISTRATION

IRCT20080825001083N11.

Management of long-COVID-19 patients with sleep disorders: practical advice to general practitioners

Given the high prevalence of sleep disorders (e.g. insomnia) among long-COVID-19 patients (LC19Ps), approaches to tackle these disorders should not only depend on sleep specialists, but they should also involve general practitioners (GPs). Indeed, according to the World Health Organization, GPs should be on the front line in the management of LC19Ps. However, in real practice, little data with regard to the management of LC19Ps are available for GPs, which represents an embarrassing situation. Thus, the main aim of this correspondence was to provide GPs with some advice related to the management of sleep disorders in LC19Ps. The pieces advice presented in this correspondence are related to: i) Early and accurate recognition of sleep disorders, ii) General recommendations to manage sleep disorders in LC19Ps (e.g. encouraging vaccination against the virus); and iii) Specific recommendations, such as improving sleep hygiene (patients' behavior and diet), psychological or behavioral therapies (stimulus control therapy, relaxation, sleep restriction), promising tools (heart coherence, neurofeedback), and pharmacological treatment. The authors of this correspondence deeply believe that given the undesirable side effects associated with the use of hypnotics, the pharmacological approach must only be a "last resort". The authors believe that an important percentage of pharmacological prescriptions could be avoided if more focus is put on educating GPs to provide LC19Ps with more tools to deal with sleep disorders. The pieces advice presented in this correspondence are indispensable to resume the normal life of LC19Ps and to promote their mental health recovery.

Mexican traditional medicines for women's reproductive health

Like China, Mexico has a traditional system of medicine dating back almost 5000 years that incorporates the healing practices of pre-Columbian civilizations, including the Maya and Aztec. Mexican Traditional Medicine (MTM) women depend on MTM practices and herbal medicines for their primary healthcare needs as limited access and high costs of Western medicine is a significant problem. The aims of this work were to determine the medicinal plants more commonly used in MTM for women's reproductive health issues and assess the clinical data supporting their use. Data from multiple sources was compiled and information on plants commonly used by women in Mexico MTM for the treatment of fertility and menstruation issues, pregnancy, and menopause was analyzed. Analysis of the data show that 185 species of plants representing > 60 families were used for a wide range of reproductive health issues. Some of these plants have been used in MTM for fertility regulation in women of which 35 species were used as emmenagogues and abortifacients. Approximate 40 species were used for the symptoms of premenstrual syndrome, heavy menstrual bleeding, and dysmenorrhea. In terms of pregnancy, 35 species were used for postpartum care and to facilitate breastfeeding, 16 species were used as oxytocic agents to induce labor and speed birth, and six plant species were used to prevent miscarriage. Fourteen plant species were reported to treat infertility or promote fertility, and seven species were used to treat uterine prolapse. Three plants species were reported to treat menopause and two plants were used for osteoporosis. Analysis of the clinical data for commonly used medicinal plants showed some clinical support for the use of these plants in MTM. In Mexico, women use medicinal plants for almost every aspect of reproductive health. While some plants have clinical data, most medicinal plants used in MTM have no safety or efficacy data available and could serve as the basis of future investigations.

Medicinal Plants for Insomnia Related to Anxiety: An Updated Review

Sleep disorders are common among the general population and can generate health problems such as insomnia and anxiety. In addition to standard drugs and psychological interventions, there are different complementary plant-based therapies used to treat insomnia and anxiety. This review aimed to find and examine the most recent research on the use of herbal medicines for treating anxiety and insomnia as compiled from clinical trials, as well as to assess the safety and efficacy of these medicines and to elucidate their possible mechanisms of action. The process entailed a search of PubMed, Scopus, and the Cochrane Library databases from 2010 to 2020. The search terms included "sleep disorder", "insomnia", "sedative", "hypnotic", "anxiety", "anxiolytic", and "clinical trial", combined with the search terms "herbs" and "medicinal plants", in addition to individual herbal medicines by both their common and scientific names. This updated review, which focuses mainly on clinical trials, includes research on 23 medicinal plants and their combinations. Essential oils and their associations have also been reviewed. The efficacy of medicinal plants depends on treatment duration, types of study subjects, administration route, and treatment method. More clinical trials with an adequate, standardized design are necessary, as are more preclinical studies to continue studying the mechanisms of action. As a result of our work, we can conclude that the 3 plants with the most potential are valerian, passionflower, and ashwagandha, with the combination of valerian with hops and passionflower giving the best results in the clinical tests.

Antioxidant and anticancer potentials of edible flowers: where do we stand?

Edible flowers are attracting special therapeutic attention and their administration is on the rise. Edible flowers play pivotal modulatory roles on oxidative stress and related interconnected apoptotic/inflammatory pathways toward the treatment of cancer. In this review, we highlighted the phytochemical content and therapeutic applications of edible flowers, as well as their modulatory potential on the oxidative stress pathways and apoptotic/inflammatory mediators, resulting in anticancer effects. Edible flowers are promising sources of phytochemicals (e.g., phenolic compounds, carotenoids, terpenoids) with several therapeutic effects. They possess anti-inflammatory, anti-diabetic, anti-microbial, anti-depressant, anxiolytic, anti-obesity, cardioprotective, and neuroprotective effects. Edible flowers potentially modulate oxidative stress by targeting erythroid nuclear transcription factor-2/extracellular signal-regulated kinase/mitogen-activated protein kinase (Nrf2/ERK/MAPK), reactive oxygen species (ROS), nitric oxide (NO), malondialdehyde (MDA) and antioxidant response elements (AREs). As the interconnected pathways to oxidative stress, inflammatory mediators, including tumor necrosis factor (TNF)-α, nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), interleukins (ILs) as well as apoptotic pathways such as Bcl-2-associated X protein (Bax), Bcl-2, caspase and cytochrome C are critical targets of edible flowers in combating cancer. In this regard, edible flowers could play promising anticancer effects by targeting oxidative stress and downstream dysregulated pathways.

Nutraceuticals as Potential Targets for the Development of a Functional Beverage for Improving Sleep Quality

Functional beverages can be a valuable component of the human diet with the ability to not only provide essential hydration but to deliver important bioactive compounds that can contribute to chronic disease treatment and prevention. One area of the functional beverage market that has seen an increase in demand in recent years are beverages that promote relaxation and sleep. Sleep is an essential biological process, with optimal sleep being defined as one of adequate duration, quality and timing. It is regulated by a number of neurotransmitters which are, in turn, regulated by dietary intake of essential bioactive compounds. This narrative review aimed to evaluate the latest evidence of the sleep promoting properties of a selection of bioactive compounds (such as L-theanine and L-tryptophan) for the development of a functional beverage to improve sleep quality; and the effectiveness of traditional sleep promoting beverages (such as milk and chamomile). Overall, the bioactive compounds identified in this review, play essential roles in the synthesis and regulation of important neurotransmitters involved in the sleep-wake cycle. There is also significant potential for their inclusion in a number of functional beverages as the main ingredient on their own or in combination. Future studies should consider dosage; interactions with the beverage matrix, medications and other nutraceuticals; bioavailability during storage and following ingestion; as well as the sensory profile of the developed beverages, among others, when determining their effectiveness in a functional beverage to improve sleep quality.

Use of Plant-Derived Natural Products in Sleep Disturbances

Sleep disorders have a high prevalence both in the general population and especially in specific populations such older adults and oncologic patients. Impacting on quality of life, they often translate in drug prescription, with consequent increased risk of drug-drug interactions and adverse drug reactions. In the last years several products derived from plants have been developed with the aim of treating insomnia with lower risk of side effects. Despite several studies have been performed with this aim, the available evidence is inconclusive, and reviews summarizing the most recent evidences on the effectiveness of plant-derived products in treating insomnia are lacking.This narrative review aims at summarizing the evidences of the mechanism of action, effectiveness and safety of the most commonly used plant-derived products for the treatment of sleep disorders (Valerian, Lemon balm, Passionflower, Chamomile, Hops, and Jujube).

Sleeping without Prescription: Management of Sleep Disorders in Children with Autism with Non-Pharmacological Interventions and Over-the-Counter Treatments

Autism Spectrum Disorders (ASD) are lifelong neurodevelopmental conditions characterized by abnormal social interaction, communication, and behavior. Sleep disturbances represent a common comorbidity in children and adolescents with ASD, with prevalence ranging from 50 to 80%. It has been proved that sleep disruption worsens the symptoms of autism and results in challenging behaviors. Improving sleep should therefore be a primary therapeutic goal. Treatment options range from lifestyle modifications to pharmacological therapy. Several reviews have been written on pharmacological treatments, but very few on the beneficial effects of non-pharmacological interventions, over-the-counter drugs, and nutritional supplements. This study consists of a narrative review of the literature, presenting the available evidence on the following treatments: sleep education, behavioral interventions, complementary and alternative medicine (special mattresses and blankets, massage, aromatherapy, yoga, physical activity), and commonly used over-the-counter medications and supplements (antihistamines, melatonin, tryptophan, carnosine, iron, vitamins, and herbal remedies). For some treatments—such as melatonin and behavioral interventions—effectiveness in ASD is well established in the literature, while other interventions appear of benefit in clinical practice, even if specific studies in children and adolescents with ASD are lacking. Conversely, other treatments only seem to show anecdotal evidence supporting their use.

Plant Extracts for Sleep Disturbances: A Systematic Review

Background

Sleep complaints are common health issues in the general population. These conditions are associated with poorer physical and psychological activity, and they may have important social, economic, and personal consequences. In the last years, several food supplements with different plant extracts have been developed and are currently taken for improving sleep. Study Objectives. The aim of this study is to systematically review recent literature on oral plant extracts acting on sleep disorders distinguishing their action on the different symptoms of sleep complaints: difficulty in initiating or maintaining sleep, waking up too early, and quality of sleep.

Methods

We searched the PubMed database up to 05/03/2020 based on data from randomized, double-blind, placebo-controlled trials, noncontrolled trials, and cohort studies conducted in children and adult subjects. The search words used contained the following terms: oral food supplement and sleep disorders and the like. The most studied compounds were further analyzed with a second search using the following terms: name of the compound and sleep disorders. We selected 7 emerging compounds and 38 relevant reports.

Results

Although nutraceutical natural products have been used for sleep empirically, there is a scarcity of evidence on the efficacy of each product in clinical studies. Valerian and lavender were the most frequently studied plant extracts, and their use has been associated (with conflicting results) with anxiolytic effects and improvements in quality and duration of sleep.

Conclusions

Sleep aids based on plant extracts are generally safe and well tolerated by the population. More high-quality research is needed to confirm the effectiveness of food supplements containing plant extracts in sleep complaints; in particular, it would be interesting to evaluate the association between plant extracts and sleep hygiene guidelines and to identify the optimal products to be used in a specific symptom of sleep complaint, giving more appropriate tools to the medical doctor.

The Role of medicinal herbs in treatment of insulin resistance in patients with Polycystic Ovary Syndrome: A literature review

Background Polycystic Ovary Syndrome (PCOS) is one of the most common endocrine abnormalities in women. Due to the side effects of drugs, the tendency to use natural antioxidants and anti-inflammatory agents to regulate metabolism, hyperinsulinemia, and hyperlipidemia in PCOS patients has been increased. This review aimed to investigate the role of herbal substances on the treatment of PCOS. Methods The present review was carried out using keywords such as polycystic ovary syndrome and/or PCOS and/or herb. Databases including Web of Science, PubMed, and Science Direct were used to collect all related articles published from 1990 to 2019. We excluded studies unrelated to the PCOS and medical herbs. Results Overall, 361 records were identified through database searching. After primary screening and the full-texts assessment, 323 records were excluded, and 38 articles were finally included. The results indicate that some medicinal herbs may have a key role in treating PCOS. The compounds in these medical herbs can affect lipid profiles (Aloe vera, chamomile, and cinnamon), insulin resistance (cinnamon, chamomile, Aloe vera, and Camellia sinensis), blood glucose (Aloe vera, cinnamon, and Camellia sinensis), hormones (Aloe vera, silymarin, chamomile, fenugreek, Camellia sinensis, Heracleum persicum, Potentilla, Mentha spicata, Foeniculum vulgar, licorice, and Marrubium), and ovarian tissue (Aloe vera, chamomile, Camellia sinensis, Mentha spicata, and silymarin). Conclusion Natural substances such as Aloe vera, cinnamon, green tea, fenugreek, and silymarin can be used as a new supportive care for PCOS. Further clinical trials are warranted to confirm their benefits and safety.

Sleep Promoting Effect of Luteolin in Mice via Adenosine A1 and A2A Receptors

Luteolin, a widespread flavonoid, has been known to have neuroprotective activity against various neurologic diseases such as epilepsy, and Alzheimer’s disease. However, little information is available regarding the hypnotic effect of luteolin. In this study, we evaluated the hypnotic effect of luteolin and its underlying mechanism. In pentobarbital-induced sleeping mice model, luteolin (1, and 3 mg/kg, p.o.) decreased sleep latency and increased the total sleep time. Through electroencephalogram (EEG) and electromyogram (EMG) recording, we demonstrated that luteolin increased non-rapid eye movement (NREM) sleep time and decreased wake time. To evaluate the underlying mechanism, we examined the effects of various pharmacological antagonists on the hypnotic effect of luteolin. The hypnotic effect of 3 mg/kg of luteolin was not affected by flumazenil, a GABAA receptor-benzodiazepine (GABAAR-BDZ) binding site antagonist, and bicuculine, a GABAAR-GABA binding site antagonist. On the other hand, the hypnotic effect of 3 mg/kg of luteolin was almost completely blocked by caffeine, an antagonist for both adenosine A1 and A2A receptor (A1R and A2AR), 8-Cyclopentyl-1,3-dipropylxanthine (DPCPX), an A1R antagonist, and SCH-58261, an A2AR antagonist. From the binding affinity assay, we have found that luteolin significantly binds to not only A1R but also A2AR with IC₅₀ of 1.19, 0.84 μg/kg, respectively. However, luteolin did not bind to either BDZ-receptor or GABAAR. From these results, it has been suggested that luteolin has hypnotic efficacy through A1R and A2AR binding.

Comparing acupressure with aromatherapy using Citrus aurantium in terms of their effectiveness in sleep quality in patients undergoing percutaneous coronary interventions: A randomized clinical trial

INTRODUCTION

Poor sleep quality is prevalent in candidates for percutaneous coronary interventions (PCIs). The present study was conducted to compare aromatherapy with acupressure in terms of their effectiveness in sleep quality in patients undergoing PCIs.

MATERIALS AND METHODS

The present study was conducted on 85 patients undergoing PCIs and randomly assigned, using block randomization, to five groups, namely (1)aromatherapy, (2)placebo aromatherapy, (3)acupressure, (4)placebo acupressure (acupressure applied to a point not traditionally associated with improving sleep) and (5)control. The intervention groups received aromatherapy or acupressure or placebo from 10pm to 8am the following day. The control group received only routine care. Sleep quality was measured in the patients using a visual analog scale (VAS) that was completed by them before and after the intervention.

RESULTS

The mean pretest score of sleep quality was 2.91 ± 0.53 in the aromatherapy group, 2.84 ± 0.47 in the placebo aromatherapy group, 2.98 ± 0.59 in the acupressure group, 2.75 ± 0.41 in the placebo acupressure group and 2.88 ± 0.41 in the controls. ANOVA suggested no significant differences among these groups in the pretest (P = 0.746). The mean posttest score of sleep quality was 3.72 ± 1.84 in the aromatherapy group, 3.70 ± 1.83 in the placebo aromatherapy group, 7.35 ± 0.99 in the acupressure group, 2.67 ± 0.41in the placebo acupressure group and 2.72 ± 0.34 in the controls, suggesting significant differences among the five groups based on the ANOVA results showed significant differences among the five groups (P < 0.001). The mean posttest score of sleep quality was higher than the pretest score by 4.37 in the acupressure group compared to in the other groups (P < 0.001).

CONCLUSION

The present findings provided scientific evidence for the benefits of using different methods, including acupressure, for sleep quality in patients undergoing PCIs.

IRANIAN REGISTRY OF CLINICAL TRIALS NUMBER

IRCT201707248665N6.

[Sleep Disorders in Old Age]

Sleep Disorders in Old Age Abstract. Sleep disorders increase with age. Older patients rarely complain about sleep disorders, therefore it is important to ask about sleep problems. Insomnias, sleep-disordered breathing and restless legs syndrome tend to increase with older age. It is important to consider that sleep disorders may be the first symptom of a depression, anxiety disorder or neurodegenerative disorders such as dementias. Many factors can influence sleep in old age: it is important to inquire after sleeping habits including naps during the day, medication and comorbidity. Treatment depends on the causes. Insomnias should be treated mainly with non-pharmacological means such as cognitive behaviour therapy.

[Herbal medicines for psychiatric disorders]

BACKGROUND

In Germany herbal medicines are traditionally frequently used. They represent an important therapeutic option, especially in self-medication.

METHODS

Current systematic review articles and meta-analyses were evaluated and summarized with respect to the evidence of phytotherapeutic drugs for selected psychiatric indications.

RESULTS

Apart from the use of St. John's wort for depression, no other herb has so far shown convincing evidence.

CONCLUSION

Due to the promising effects and the low side effect potential within the existing studies, further randomized controlled trials (e. g. for Passiflora incarnata, Rhodiola rosea and Lavendula officinalis) are definitely indicated.

A novel sorbent based on carbon nanotube/amino-functionalized sol-gel for the headspace solid-phase microextraction of α-bisabolol from medicinal plant samples using experimental design

A novel sol-gel coating on a stainless-steel fiber was developed for the first time for the headspace solid-phase microextraction and determination of α-bisabolol with gas chromatography and flame ionization detection. The parameters influencing the efficiency of solid-phase microextraction process, such as extraction time and temperature, pH, and ionic strength, were optimized by the experimental design method. Under optimized conditions, the linear range was between 0.0027 and 100 μg/mL. The relative standard deviations determined at 0.01 and 1.0 μg/mL concentration levels (n = 3), respectively, were as follows: intraday relative standard deviations 3.4 and 3.3%; interday relative standard deviations 5.0 and 4.3%; and fiber-to-fiber relative standard deviations 6.0 and 3.5%. The relative recovery values were 90.3 and 101.4% at 0.01 and 1.0 μg/mL spiking levels, respectively. The proposed method was successfully applied to various real samples containing α-bisabolol.