The effects of aromatherapy essential oil inhalation on stress, sleep quality and immunity in healthy adults: Randomized controlled trial

Virtual reality improves sleep quality and associated symptoms in patients with chronic insomnia

PURPOSE

The present study aimed to explore the effectiveness of virtual reality (VR) therapy on sleep quality and associated symptoms, such as depression and anxiety, cognitive decline and autonomic nervous dysfunction, in chronic insomnia patients.

METHODS

Sixty-three chronic insomnia patients were randomly divided into VR group (n = 32) and control group (n = 20) based on a standard drug therapy. Patients were instructed to use VR at home once a day at evening for 6-week treatment. All participants received evaluations of subjective sleep quality measured with the Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI), and the Epworth Sleepiness Scale (ESS), depression and anxiety symptoms measured with the Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA), cognitive function, and objective sleep structure and autonomic nerve function examination measured with the sleep respiration monitoring device at baseline and after 6-week treatment. The main objective of this study was sleep quality assessment as the primary outcome.

RESULTS

After 6-week treatment, the decreases in PSQI score (-5.60 ± 2.37 vs -4.10 ± 1.80, P = 0.020) and ISI score (-8.81 ± 4.52 vs -6.35 ± 2.89, P = 0.038) of the VR group were significantly greater compared with the control group. The VR group showed more reduction in HAMD score (-9.96 ± 4.41 vs -7.50 ± 2.89, P = 0.035) and HAMA score (-8.96 ± 3.80 vs -6.80 ± 3.22, P = 0.046), and more increase in processing speed (0.54 ± 0.60 vs 0.00 ± 0.79, P = 0.011) than the control group. Moreover, the low-frequency coupling (-10.00 ± 17.40 vs. 8.25 ± 20.03, P = 0.001) was lowered and the high-frequency coupling (9.99 ± 17.40 vs. -8.24 ± 20.03, P = 0.001) was elevated in the VR group relative to the control group.

CONCLUSION

Our findings offered preliminary evidence that VR therapy enhanced sleep quality and also lessened depressive and anxious symptoms, and improved cognitive and autonomic functioning in patients with chronic insomnia.

Assessing the Anxiolytic and Relaxation Effects of Cinnamomum camphora Essential Oil in University Students: A Comparative Study of EEG, Physiological Measures, and Psychological Responses

Background

Cinnamomum camphora is a commercially important tree species in China, and it's also a common native tree in the forests of southern China. However, literature on the impact of Cinnamomum camphora essential oil (CCEO) on human psychophysiological activity is scarce. Hence, the primary objective of this study was to examine the effect of exposure to CCEO on the functioning of the human autonomic nervous system, electroencephalographic (EEG) activity, and emotional state.

Methods

Forty-three healthy university students participated. The data collected included heart rate (HR), blood pressure (BP), pulse rate, blood oxygen saturation (SpO2), electroencephalographic (EEG) activity, and the results of the Profile of Mood States (POMS) test.

Results

A drop in diastolic pressure (DBP) and pulse rate was also noticed after participants inhaled CCEO. Furthermore, EEG studies have demonstrated notable reductions in absolute beta (AB), absolute gamma (AG), absolute high beta (AHB), and relative gamma (RG) power spectra during exposure to CCEO. Conversely, the relative theta (RT) and power spectra values showed a significant increase. Additionally, the finding from POMS indicated that the fragrance evoked positive emotions and suppressed negative feelings.

Conclusion

The results suggest that exposure to CCEO may promote mental and physical relaxation, facilitate cognitive processes such as memory and attention, and enhance mood states.

The effect of lavender and rosemary aromatherapy application on cognitive functions, anxiety, and sleep quality in the elderly with diabetes

OBJECTIVE

This study aimed to determine the effects of aromatherapy use on cognitive function, anxiety, and sleep quality in the elderly with diabetes.

METHODS

The study was conducted with 63 participants aged 65 and over. Participants were randomly divided into three groups: lavender, rosemary and control groups. The intervention continued for four weeks. Data was collected using the Blessed Orientation Concentration Test, State-Trait Anxiety Scale, and Pittsburgh Sleep Quality Scale. Data were analyzed using One-Way ANOVA, Mann-Whitney U/Kruskal-Wallis, Wilcoxon and Friedman tests.

RESULTS

In both intervention groups, the 4th week scores of cognitive functions, anxiety, and sleep quality after aromatherapy were significant compared to the baseline scores. In the control group, state anxiety scores were significantly higher in the 2nd and 4th weeks compared to the initial scores.

CONCLUSIONS

Inhaling lavender and rosemary has been observed to improve cognitive function and sleep quality and reduce anxiety levels. The effects of the essential oils used in the research were evaluated over four weeks. It is thought that studying for a longer period and with more samples would be beneficial. There is a need for studies examining its effects, especially in the elderly with diabetes.

An upcycled fraction of Melaleuca alternifolia essential oil regenerates the skin through the skin melatonin pathway and improves sleep quality

BACKGROUND

Sleep is one of the most important factors affecting overall health. During the night, the skin repairs damage caused by daily stresses. Melatonin plays a key role in this process. Toxins are removed, and cellular repair and growth hormone production are increased. Inter alia, this also decreases signs of intrinsic aging.

AIMS

The current study was intended to demonstrate the impact of a unique fraction of Melaleuca alternifolia (FMA) essential oil, on sleep and skin quality.

METHODS

The effect of FMA was investigated in vitro on skin cells, evaluating its antioxidant and anti-inflammatory properties, and in an ex-vivo study on human skin biopsies treated with FMA following stress induction. In addition, two clinical studies were performed on volunteers with life-style-related sleep complaints. In one study, sleep was measured using a noncontact monitoring device (SleepScore Labs, Max). A second study was conducted to assess skin anti-aging effects.

RESULTS

In vitro application of FMA reduced IL-8 and reactive oxygen species (ROS) generation in skin cells. This was confirmed ex vivo through a decrease in inflammatory markers and an increase in antioxidant enzymes after stress induction. Interestingly, FMA also upregulated melatonin-associated genes. Real-world sleep tracking revealed that FMA significantly improved sleep quality, relative to unscented control. In vivo applications also showed a reduction in signs of aging.

CONCLUSION

These results provide initial data to suggest that this unique FMA delivers skin anti-aging benefits via a two-pronged mode of action, improving sleep quality, and reducing skin inflammatory and oxidative stress.

Peanut oil odor enhances the immunomodulatory effect on immunosuppressed mice by regulating the cAMP signaling pathway via the brain-spleen axis

The role of sniffing relative to immune function has attracted considerable attention. The present study investigated the immunomodulatory effects of peanut oil odor on cyclophosphamide (CTX)-induced immunosuppressed mice. The subset of mice subjected to prolonged (8 h) sniffing peanut oil odor (PL) demonstrated significantly elevated levels of agouti-related peptide, neuropeptide Y, and glutamate (p < 0.05), whereas it significantly down-regulated the level of γ-aminobutyric acid in the brain (p < 0.05). Furthermore, immunohistochemistry results indicated significantly increased expression of mGluR1/5 and decreased expression of GABABR in the hippocampus and hypothalamus (p < 0.05) of the PL group. Additionally, the PL group had significantly up-regulated expression levels of cAMP, Epac, Rap1, ERK1/2 and PKA (p < 0.05) and remarkably increased phosphorylation of CREB in the cAMP signaling pathway (p < 0.05), which influenced the central nervous system. Moreover, compared with CTX-induced mice, the percentages of peripheral blood T lymphocytes (CD3+CD4+ and CD3+CD8+) and the levels of splenic cytokines (IL-2, IL-4, and TNF-α) were significantly increased following PL treatment (p < 0.05). The PL group also showed significantly up-regulated expression levels of cAMP, p-p65, and p-IκBα in the spleen (p < 0.05) by western blot analysis. In summary, PL intervention significantly up-regulated the expression levels of cAMP in the brain (p < 0.05), with subsequent transfer of cAMP to the spleen which promoted phosphorylation of p65 and IκBα. This series of events enhanced the immunity of mice, which confirmed the regulatory effect of PL on the cAMP signaling pathway, thereby enhancing immune function via the brain-spleen axis.

Efficacy of non-pharmacological interventions on improving sleep quality in depressed patients: A systematic review and network meta-analysis

OBJECTIVE

Depression and sleep are closely related and tend to affect each other. To improve the sleep quality in depressed patients and the depression severity, there is an urgent need to find safer and more effective treatments - non-pharmacological interventions. This network meta-analysis aimed to investigate the effects of non-pharmacological interventions on improving sleep quality of patients with depression.

METHODS

All published literature were searched from four databases (Pubmed, Embase, Cochrane, Web of Science) as of November 2022. The risk of bias of the included studies was assessed using the Cochrane Systematic Review Manual 2.0 bias risk assessment tool. The primary outcome was sleep quality and, the secondary outcome was depression severity.

RESULTS

This study included 26 randomized controlled trials, involving 11 interventions and 3748 depressed patients. Cognitive-behavioral therapy (CBT) (SMD: 2.80; 95% CI: 1.63,3.96), aromatherapy (SMD: 3.95; 95% CI: 0.71,7.19), and acupuncture (SMD:3.49; 95% CI: 0.88,6.10) statistically and significantly improved sleep quality, compared to education only. CBT and acupuncture both were significantly more effective than education in depression severity. The cluster analysis showed that acupuncture, exercise, and cognitive-behavioral therapy were considered to be more effective non-pharmacological interventions.

CONCLUSION

Non-pharmacological interventions are promising in the daily care of depressed patients. In future research, we should value the need for psychological and social aspects of psychiatric care and make better use of nonpharmacological interventions through the biopsychosocial model. (PROSPERO registration number: CRD42023402316).

Benefit of inhalation aromatherapy as a complementary treatment for stress and anxiety in a clinical setting – A systematic review

OBJECTIVE

The purpose of this systematic review is to ascertain the impact of inhalation aromatherapy on stress and anxiety in clinical settings.

METHODS

A search strategy was developed using various databases. Randomised Controlled Trials (RCTs) as well as single and double-blind pilot clinical studies (non-RCT) using inhalation aromatherapy with an essential oil blend or a single essential oil were examined. All studies included a control intervention and use of a validated measurement tool. The time period under review was years 2000-2021. Due to the high level of heterogeneity and element of bias, a narrative synthesis was conducted.

RESULTS

The search strategy initially retrieved 628 studies and through application of the selection criteria and the removal of duplicates, 76 studies were selected for review with a total of 6539 patients. In 42% of the RCTs, physiological measures including vital signs and/or salivary cortisol were used in addition to questionnaires. Over 70% of the studies reported a positive effect on anxiety levels in the aromatherapy intervention groups compared with the control. However, in many cases this is limited by the absence of safety data, imprecise reporting of plant species and dosage of essential oil.

CONCLUSION

Inhalation aromatherapy has the potential to reduce stress and anxiety with data emerging to further support this result across a wide modality of clinical treatments. However, there is a clear need for the development of standard protocols for research in this area, generating measurable results which will create the opportunity for more rigorous evidence-based outcomes.

A Comparative Study on Chemical Compositions and Biological Activities of Four Amazonian Ecuador Essential Oils: Curcuma longa L. (Zingiberaceae), Cymbopogon citratus (DC.) Stapf, (Poaceae), Ocimum campechianum Mill. (Lamiaceae), and Zingiber officinale Roscoe (Zingiberaceae)

Essential oils (EOs) and their vapour phase of Curcuma longa (Zingiberaceae), Cymbopogon citratus (Poaceae), Ocimum campechianum (Lamiaceae), and Zingiber officinale (Zingiberaceae) of cultivated plants grown in an Amazonian Ecuador area were chemically characterised by Gas Chromatography-Flame Ionization Detector (GC-FID), Gas Chromatography-Mass Spectrometry (GC-MS), and Head Space-Gas Chromatograph-Flame Ionization Detector-Mass Spectrometry (HS-GC-FID-MS).figure The EOs analyses led to the identification of 25 compounds for C. longa (99.46% of the total; ar-turmerone: 23.35%), 18 compounds for C. citratus (99.59% of the total; geraniol: 39.43%), 19 compounds for O. campechianum (96.24% of the total; eugenol: 50.97%), and 28 for Z. officinale (98.04% of the total; α-Zingiberene: 15.45%). The Head Space fractions (HS) revealed C. longa mainly characterised by limonene and 1,8-cineole (37.35%) and α-phellandrene (32.33%); Z. officinale and C. citratus showed camphene (50.39%) and cis-Isocitral (15.27%) as the most abundant compounds, respectively. O. campechianum EO revealed a higher amount of sesquiterpenes (10.08%), mainly characterised by E-caryophyllene (4.95%), but monoterpene fraction remained the most abundant (89.94%). The EOs were tested for antioxidant, antimicrobial, and mutagen-protective properties and compared to the Thymus vulgaris EO as a positive reference. O. campechianum EO was the most effective in all the bioactivities checked. Similar results emerged from assaying the bioactivity of the vapour phase of O. campechianum EO. The antioxidant and antimicrobial activity evaluation of O. campechianum EO were repeated through HP-TLC bioautography assay, pointing out eugenol as the lead compound for bioactivity. The mutagen-protective evaluation checked through Ames's test properly modified evidenced a better capacity of O. campechianum EO compared with the other EOs, reducing the induced mutagenicity at 0.1 mg/plate. However, even with differences in efficacy, the overall results suggest important perspectives for the functional use of the four studied EOs.

Essential Oils and COVID-19

Herbal products are a major source of herbal medicines and other medicines. Essential oils have shown various pharmacological activities, such as antiviral activity, and therefore are proposed to have potential activity against SARS-CoV-2. Due to their lipophilicity, essential oils can easily penetrate the viral membrane and cause the viral membrane to rupture. In addition, crude essential oils usually have many active constituents that can act on different parts of the virus including its cell entry, translation, transcription, and assembly. They have further beneficial pharmacological effects on the host's respiratory system, including anti-inflammatory, immune regulation, bronchiectasis, and mucolytics. This review reported potential essential oils which could be promising drugs for COVID-19 eradication. Essential oils have many advantages because they are promising volatile antiviral molecules, making them potential drug targets for the prevention and treatment of COVID-19, whether used alone or in combination with other chemotherapeutic drugs. The aim of the current review is to shed light on the potential essential oils against enveloped viruses and their proposed activity against SARS-CoV-2 which is also an enveloped virus. The objectives were to present all data reflecting the promising activities of diverse essential oils against enveloped viruses and how they could contribute to the eradication of COVID disease, especially in indoor places. The data collected for the current review were obtained through the SciFinder database, Google scholar, PubMed, and Mendeley database. The data of the current review focused on the most common essential oils which are available in the pharmaceutical market and showed noticeable activities against enveloped viruses such as HSV and influenza.

The Effectiveness of a Multi-Sensory Sleep-Promotion Program on Sleep Quality among Hospitalized Older Adults of Thailand: A Quasi-Experimental Study

BACKGROUND/OBJECTIVE

Older adults suffer from sleep disturbances, especially during hospitalization, affecting their health condition, recovery, and in-hospital mortality. Therefore, we aimed to explore the effectiveness of a multi-sensory sleep-promotion program on sleep quality among hospitalized Thai older adults.

METHODS

In a quasi-experimental study, the 52 eligible older adults in a private medical ward were equally assigned into two groups. The experimental group received a sleep quality assessment after the first night of admission, the 60-minute multi-sensory sleep-promotion program for three nights, and an outcome evaluation on the last night after the intervention. In contrast, the control group received routine care for the same period. Sleep quality was measured by the Verran and Snyder-Halpern Sleep Scale (Thai version). In addition, independent and paired samples t-tests compared the sleep quality between and within the two groups.

RESULTS

The older adults in the experimental group had better sleep quality than those who did not (p < .001). Those who participated in the multi-sensory sleep-promotion program markedly improved their sleep quality over five days (p < .001).

CONCLUSION

A multi-sensory sleep-promotion program can promote the sleep quality of older adults. The five alternative methods to promote sleep are effective without the deleterious effects of hypnotics and sedatives often experienced among older adults. Therefore, nurses and other healthcare professionals can implement this program as standard practice. In addition, they may adjust it to fit the acuity level and care dependencies of older adults in other cultures to promote sleep quality.

Aromatherapy on Psycho-Emotional Symptoms and Fatigue in Nursing Professionals in the COVID-19 Setting

Objective: To compare the effectiveness of aromatherapy with lavender essential oil (EO) versus an EO synergy on psycho-emotional symptoms and fatigue of nursing professionals in the COVID-19 setting. Materials and Methods: This is a quasi-experimental pilot study conducted in 2020. The professionals were randomized in Group 1 — lavender, and in Group 2 — lavender and other EOs synergy. The instruments were validated in Brazil, namely the Self-Reporting Questionnaire (SRQ-20) and the Fatigue Pictogram, which were applied at three moments: before the intervention, after 21 days of intervention, and three weeks after the end of the intervention follow-up. The data were evaluated using Pearson’s x2 test or Fisher’s exact test (dichotomous variables) and Student’s t-test or Mann-Whitney test (continuous variables). Results: A total of 18 professionals participated, and both groups presented improved SRQ-20 scores (p < 0.010), which was maintained in the follow-up for Group 1 compared to the pre-intervention moment (p = 0.033). There was a significant decrease in fatigue in professionals in both groups (p = 0.010), but no difference was observed in the improvement of the impact of fatigue on daily life. Conclusions: There was a reduction in psycho-emotional symptoms and fatigue in nursing professionals who used aromatherapy during the COVID-19 pandemic in both groups.

Effectiveness of Aromatherapy Yoga in Stress Reduction and Sleep Quality Improvement among Chinese Female College Students: A Quasi-Experimental Study

College students, particularly female students, often suffer from severe stress and poor sleep. Aromatherapy yoga has become a popular exercise in recent years and may help reduce stress and improve sleep quality, although empirical evidence is limited. We investigated the effectiveness of aromatherapy yoga intervention in reducing stress and improving sleep quality among Chinese female college students. A total of 89 participants—44 in the experimental group (aromatherapy yoga) and 45 in the control group (yoga)—with an average age of 19.88 ± 1.13 years, were enrolled in this quasi-experimental study. Interventions were performed in the respective groups once a week for 12 weeks, for 90 min each time. The Wilcoxon signed-rank test and Mann–Whitney U test (including effect size) were used to test the differences in stress reduction and sleep quality before and after the intervention. From the findings of the current research, both therapies did not help female students’ stress levels or sleep hygiene significantly. However, aromatherapy yoga has the potential to improve sleep disturbances experienced by female college students. Additionally, there was no difference in the amount of stress or the quality of sleep between the aromatherapy yoga groups and the regular yoga groups before and after therapy.

Visualizing Research Trends and Identifying Hotspots of Traditional Chinese Medicine (TCM) Nursing Technology for Insomnia: A 18-Years Bibliometric Analysis of Web of Science Core Collection

Objective

To explore the research hotspot and frontier direction of TCM nursing of insomnia and provide reference for the follow-up study of the optimal scheme of TCM nursing of insomnia.

Background

Insomnia is a common sleep-wake disorder, affects 6–10% of adults and was associated with independent higher risks of cardiovascular disease and diabetes. TCM Nursing Techniques of insomnia has a long history and has shown a definite impact. However, it's still lack of analysis in the field of the most commonly used and effective techniques, as well as the co-morbidities associated with insomnia. Therefore, the database was searched and analyzed to find effective TCM Nursing Techniques for insomnia and related diseases related to insomnia.

Method

Randomized controlled trials on the intervention of TCM Nursing Techniques in insomnia were retrieved from Web of Science Core Collection and imported into CiteSpace 5.6.R5 visualization software. The works of literature were co-cited by keywords authors and institutions for visual analysis, and the co-morbidities associated with insomnia of TCM Nursing Techniques in literature was extracted manually. The symptoms of co-morbidities associated with insomnia were imported into Cytoscape 3.9.0 software and clustered by CytoHubba.

Result

As of October 20, 2021, the literature published in the last 20 years from Web of Science Core Collection was screened, and the publication period of the included literature was from 2004 to 2021. From 2016 to now, the total number of articles has been increasing. A total of 146 articles were included, and the highest production year was 2020. There is little cooperation between states, institutions, and authors. China (including Hong Kong and Taiwan) and Hong Kong Polytech University are leading countries and institutions in this area. MYUNGHAENG HUR is the most cited author, and J ALTERN COMPLEM MED is the most cited journal. According to cluster analysis and keyword frequency, auricular therapy, aromatherapy, and acupressure are the three most commonly used techniques. While the top five co-morbidities are fatigue, anxiety, depression, pain and hemodialysis. The three frontier topics and the main research directions are sleep quality, comorbid insomnia and clinical trial design.

Conclusion

We found that acupressure, aromatherapy, and auricular acupoint therapy are the most commonly used nursing methods of TCM to intervene in insomnia. However, these studies have limitations such as small sample size, lack of objectivity in evaluating sleep quality, and high heterogeneity of intervention measures, which are not conducive to forming TCM clinical nursing guidelines. Therefore, it is necessary to adopt objectified sleep quality evaluation methods, select suitable acupoints according to TCM theories, and design multi-center large-sample clinical trials based on the safety principle of randomized blind control. This study provides an in-depth perspective for insomnia research on TCM Nursing Techniques and includes information for follow-up research on TCM Nursing Techniques of insomnia.

Aromatherapy in Nursing and Midwifery Practice: A Scoping Review of Published Studies Since 2005

Background: Since the 1990's aromatherapy has been a popular adjunct to nursing and midwifery care in a variety of health care settings. Objective: The scoping review seeks to identify and confirm the benefits of incorporating aromatherapy into holistic nursing and midwifery practice Design: A scoping review using PRISMA-ScR of experimental studies where care is provided to the patient by a registered nurse or midwife. Settings and participants: Any health care setting where nurses or midwives provide care. Review Methods: A multi- engine search using a range of MeSH and non-MeSH terms with the Boolean search [AND]. Inclusion criteria were; publication date from 2005-2021, study involved aromatherapy as an intervention, conducted in a clinical nursing or midwifery environment and the published article is available in full in English. Excluded were; single patient cases, animal studies, in vitro studies, use of essential oils internally or a whole plant extract was used or use was non-nursing/midwifery related. Results: 124 studies met the inclusion criteria (n = 19188), classified into seven themes. Conclusion: The evidence supports the use of aromatherapy within a range of nursing and midwifery practices enhancing a holistic model of care. Impact: This scoping review contributes evidence to support the inclusion of aromatherapy into holistic nursing and midwifery practice.

Protective effect of orange essential oil on the formation of non-alcoholic fatty liver disease caused by high-fat diet

The purpose of this study was to investigate the protective effect of sniffing orange essential oil (OEO) on the formation of non-alcoholic fatty liver disease (NAFLD) caused by a high-fat diet. The results confirmed that sniffing OEO could reduce obesity caused by a high-fat diet (HFD) by reducing the levels of triglycerides (TGs), total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C). In addition, the observation of liver tissue sections showed that sniffing OEO could reduce lipid accumulation in liver cells. Further analysis by western blot analysis showed that OEO treatment made the expression levels of acetyl-CoA carboxylase (ACC) and Cytochrome P450 2E1 (CYP2E1) down-regulated and the expression levels of peroxisome proliferator-activated receptor-α (PPAR-α) and carnitine palmitoyltransferase-1 (CPT-1) up-regulated. These results indicate that the treatment of sniffing OEO could enhance the antioxidant capacity of mice and reduce liver damage caused by a high-fat diet. Furthermore, sniffing OEO could inhibit lipid synthesis and oxidative stress stimulated by a high-fat diet. Overall, OEO treatment had a certain protective effect on NAFLD-related diseases caused by a high-fat diet. Therefore, aromatherapy may be introduced as a treatment of long-term chronic diseases.

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.

Effect of aromatherapy with Melissa essential oil on stress and hemodynamic parameters in acute coronary syndrome patients: A clinical trial in the emergency department

Stress and hemodynamic changes are among the most significant symptoms and signs that could be observed in patients with acute coronary syndrome (ACS) upon admission to the emergency department. The present study was conducted to determine the effect of the fragrance of lemon balm (Melissa Officinalis) essential oil on stress level and hemodynamic parameters in patients with ACS in the emergency department.

METHODS

In this double-blind clinical trial, 72 patients were allocated to two groups of Melissa and placebo based on stratified block random sampling. The Melissa group inhaled two drops of Melissa essential oil, whereas the placebo group inhaled two drops of sunflower oil in two aromatherapy phases for 10 min with 90-min intervals. Stress level was measured using the depression, anxiety and stress scale (DASS-21), and hemodynamic parameters were measured and recorded in six time points by a cardiac monitoring system. Data analysis was carried out using descriptive statistics and ANOVA statistical tests, Chi-square test, independent t-test, and post-hoc Tukey's test.

RESULTS

Interaction between the time and group indicated the significant decrease in the mean score of stress and heart rate in the time points 2 and 5 (5 min after every occasion of aromatherapy) (p < 0.001) and also the remarkable decrease in the mean arterial pressure (MAP) in the time point 2 in the Melissa group in comparison with the placebo group (p < 0.001). There were no significant differences between the mean changes in stress, heart rate and MAP in the two group (P > 0.05).

CONCLUSION

Aromatherapy via the inhalation of Melissa essential oil with temporary impacts on certain time points could relieve stress and regulate hemodynamic changes in patients with ACS in emergent and acute conditions.

A garlic oil-based organo-hydrogel for use in pH-sensitive drug release

In this study, six different organo-hydrogels containing agar-glycerol (AG)-based garlic oil (GO) were synthesized using two different crosslinkers (N,N, methylenebisacrylamide (MBA), glutaraldehyde (GA)) to ensure the controlled release of ceftriaxone (Ce) and carboplatin (Cp). Synthesized organo-hydrogels were characterized by FT-IR. Afterward, swelling behaviors were investigated in DI, tap water, ethanol, acetone, ethanol/DI water (1:1), acetone/DI water (1:1) and gasoline environments and different pH. As a result of hemolysis, blood clotting and antioxidant analysis, organo-hydrogels have been shown to have blood compatibility and antioxidant properties. Ce and Cp release properties of the prepared organo-hydrogels were also determined. The highest Ce release rate was obtained to be 37.8% for p (AG-g-GO)³ at pH 8.0 after 7 days. However, the highest Cp release rate was found to be 95.4% for p (AG-g-GO)³ at pH 7.4 after 1 day.

Impact of inhalation aromatherapy with Damask Rose (Rosa damascena) on stress, anxiety and hemodynamic parameters of patients undergoing coronary angiography: a single blind randomized clinical trial

OBJECTIVES

Coronary arteries angiography is used commonly for diagnosing cardiovascular diseases. In spite of the low risk of coronary artery angiography method, it could lead to stress, anxiety and consequently hemodynamic changes in patients. This study aimed to assess the effects of inhalation aromatherapy with Rosa damascena on stress, anxiety, and hemodynamic parameters of patients undergoing coronary angiography.

METHODS

A single-blind randomized clinical trial was conducted on 98 patients in Besat Educational Hospital, Hamadan, Iran. Before coronary angiography, patients at aromatherapy group inhaled five drops of 40% Rosa damascena for 20 min and in the control group, patients inhaled distilled water. Stress, anxiety, and hemodynamic parameters were measured before and after the intervention using DASS-21 questionnaire and checklist.

RESULTS

Data were analysed by SPSS 16 software using descriptive and inferential statistics such as paired t-test and non-parametric tests. There were significant differences in terms of stress and anxiety severity in patients at aromatherapy group (p=0.005) and control group (p=0.001). There were significant differences in terms of hemodynamic parameters such as heart rate (p=0.001), mean arterial pressure (p=0.001), systolic (p=0.003) and diastolic blood pressure (p=0.001) and SpO₂ (p=0.02).

CONCLUSIONS

Inhalation aromatherapy with Rosa damascena can significantly decrease stress and anxiety severity and improve hemodynamic parameters of patients undergoing coronary angiography.

REGISTRY NUMBER

This study has registered with the number IRCT201702019759N8 at Iranian Registry Clinical Trial.

Determinants of Serum Immunoglobulin Levels: A Systematic Review and Meta-Analysis

Background

An up-to-date overview of determinants of serum immunoglobulins in adults is pivotal for clinical practice and research, but currently lacking. We therefore performed a systematic review and meta-analysis to identify determinants of serum immunoglobulin levels.

Methods

Embase, Web of Science, Medline, Cochrane, and Google Scholar were searched from inception to July 11th, 2019 for articles reporting on determinants of serum immunoglobulin A, G or M (IgA, IgG or IgM) in adult humans. Random and fixed effect models were applied to obtain pooled mean differences (MDs) and 95% confidence intervals (CIs) for the association of age and sex with serum immunoglobulins.

Results

We retrieved 117 articles reporting on determinants of serum immunoglobulins, of which 28 could be meta-analyzed. Older compared to younger individuals had higher IgA (MD: 0.38; CI: 0.18 - 0.58), but lower IgM levels (MD: -0.40; 95%: -0.66 - -0.14). Men had higher IgA (MD: 0.22; CI: 0.03 - 0.42), but lower IgM levels (MD: -0.21; CI: -0.32 - -0.10) than women. Age and sex did not influence IgG. Caucasian ethnicity was associated with lower IgA, IgG, and IgM. Smoking and corticosteroid use were associated with lower IgG. Positive associations were reported of probiotics with IgG, alcohol with IgA, hypertension with IgA and IgG, and acute psychological stress with IgA, IgG, and IgM.

Conclusions

Older age and male sex are associated with higher IgA, but lower IgM, and urge investigation of age- and sex-specific reference ranges of immunoglobulins. Other identified determinants were ethnicity, diet, lifestyle and cardio-metabolic factors.

Exploring the Potential of Aromatherapy as an Adjuvant Therapy in Cancer and its Complications: A Comprehensive Update

BACKGROUND

Aromatherapy is a traditional practice of employing essential oils for the therapeutic purposes, currently headed under the category of complementary and adjuvant medicine.

OBJECTIVE

The aim of this review article is to summarize the potential health benefits of aromatic essential oil from traditional times till the present. It also proposed some mechanisms which can be utilized as basis for using aromatherapy in cancer and cancer linked complications.

METHODS

To find out the relevant and authentic data, several search engines like Science direct, Pubmed, research gate, etc. were thoroughly checked by inserting key words like aromatherapy, complementary, adjuvant therapy etc. to collect the relevant material in context of article. Also, the chemical components of essential oil were classified based on the presence of functional groups, which are further explored for their cytotoxic potential.

RESULTS

The result depicted the anti-cancer potential of chemical constituents of essential oil against different types of cancer. Moreover, the essential oils show promising anti-inflammatory, anti-microbial, anti-oxidant and anti-mutagenic potential in several studies, which collectively can form the basis for initiation of its anti-cancer utility.

CONCLUSION

Aromatherapy can serve as adjuvant economic therapy in cancer after the standardization of protocol.

Integrating complementary and alternative therapies into professional psychological practice: An exploration of practitioners' perceptions of benefits and barriers

BACKGROUND AND PURPOSE

Although Complementary and Alternative Therapies (CATs) are currently incorporated into psychotherapy, scepticism remains among professional and practicing psychologists about integration of CATs into professional practice. This research explored perceived benefits and barriers to integrating CATs into psychology practice with individual clients.

MATERIALS AND METHODS

We used a qualitative framework informed by Transpersonal Psychology to explore benefits and barriers to integrative psychology practice. We conducted semi-structured interviews with six practitioners trained or training in psychology and CATs and analysed verbatim transcripts using thematic analysis.

RESULTS

Participants reported personal, career-based, and epistemological benefits and barriers to integrative psychology practice. Benefits were improved therapeutic relationships, specialisation options, and a time reflective psychology. Barriers included stigma and bias, regulations, and dominance of the scientist-practitioner model. Superordinate themes were holism, connectedness, and governance.

CONCLUSION

Results activate conversation about the importance of a transpersonally oriented integrative psychological practice for the 21st century.

Combination of 3-Dimensional Virtual Reality and Hands-On Aromatherapy in Improving Institutionalized Older Adults' Psychological Health: Quasi-Experimental Study

Background

In Taiwan, which has one of the most rapidly aging populations in the world, it is becoming increasingly critical to promote successful aging strategies that are effective, easily usable, and acceptable to institutionalized older adults. Although many practitioners and professionals have explored aromatherapy and identified its psychological benefits, the effectiveness of combining 3-dimensional (3D) virtual reality and hands-on aromatherapy remains unknown.

Objective

A quasi-experimental trial was designed to evaluate the effectiveness of this combination in lowering perceived stress and promoting happiness, sleep quality, meditation experience, and life satisfaction among institutionalized older adults in Taiwan.

Methods

A total of 60 institutionalized elderly participants either received the combined intervention or were in a control group. Weekly 2-hour sessions were implemented over 9 weeks. The outcome variables were happiness, perceived stress, sleep quality, meditation experience, and life satisfaction, which were assessed at baseline and after the intervention.

Results

Generalized estimating equation (GEE) analyses indicated that the experimental group showed significant post-intervention improvements in terms of scores for happiness, perceived stress, sleep quality, meditation experience, and life satisfaction (n=48; all P<.001). Another GEE analysis showed that the significant improvements in the 5 outcome variables persisted in participants aged 80 years and older (n=35; all P<.001).

Conclusions

This is the first trial to explore the effectiveness of a combination of 3D virtual reality and hands-on aromatherapy in improving older adults’ psychological health. The results are promising for the promotion of psychological health in institutionalized older adults.

Trial Registration

ClinicalTrials.gov NCT04324216; https://clinicaltrials.gov/ct2/show/NCT04324216.

Turning up the heat on COVID-19: heat as a therapeutic intervention

Enveloped viruses such as SAR-CoV-2 are sensitive to heat and are destroyed by temperatures tolerable to humans. All mammals use fever to deal with infections and heat has been used throughout human history in the form of hot springs, saunas, hammams, steam-rooms, sweat-lodges, steam inhalations, hot mud and poultices to prevent and treat respiratory infections and enhance health and wellbeing. This paper reviews the evidence for using heat to treat and prevent viral infections and discusses potential cellular, physiological and psychological mechanisms of action. In the initial phase of infection, heat applied to the upper airways can support the immune system's first line of defence by supporting muco-ciliary clearance and inhibiting or deactivating virions where they first lodge. This may be further enhanced by the inhalation of steam containing essential oils with anti-viral, mucolytic and anxiolytic properties. Heat applied to the whole body can further support the immune system's second line of defence by mimicking fever and activating innate and acquired immune defences and building physiological resilience. Heat-based treatments also offer psychological benefits and enhanced mental wellness by focusing attention on positive action, enhancing relaxation and sleep, inducing 'forced-mindfulness', and invoking the power of positive thinking and 'remembered wellness'. Heat is a cheap, convenient and widely accessible therapeutic modality and while no clinical protocols exist for using heat to treat COVID-19, protocols that draw from traditional practices and consider contraindications, adverse effects and infection control measures could be developed and implemented rapidly and inexpensively on a wide scale. While there are significant challenges in implementing heat-based therapies during the current pandemic, these therapies present an opportunity to integrate natural medicine, conventional medicine and traditional wellness practices, and support the wellbeing of both patients and medical staff, while building community resilience and reducing the likelihood and impact of future pandemics.

Turning up the heat on COVID-19: heat as a therapeutic intervention

Enveloped viruses such as SAR-CoV-2 are sensitive to temperature and are destroyed by temperatures tolerable to humans. All mammals use fever to deal with infections and heat has been used throughout human history in the form of hot springs, saunas, hammams, steam-rooms, sweat-lodges, steam inhalations, hot mud and poultices to prevent and treat respiratory infections and enhance health and wellbeing. This paper reviews the evidence for using heat to treat and prevent viral infections and discusses potential cellular, physiological and psychological mechanisms of action. In the initial phase of infection, heat applied to the upper airways can support the immune system's first line of defence by supporting muco-ciliary clearance and inhibiting or deactivating virions in the place where they first lodge. This may be further enhanced by the inhalation of steam containing essential oils with anti-viral, mucolytic and anxiolytic properties. Heat applied to the whole body can further support the immune system's second line of defence by mimicking fever and activating innate and acquired immune defences and building physiological resilience. Heat-based treatments also offer psychological benefits by directing focus on positive action, enhancing relaxation and sleep, inducing 'forced-mindfulness', and invoking the power of positive thinking and remembered wellness. Heat is a cheap, convenient and widely accessible therapeutic modality and while no clinical protocols exist for using heat to treat COVID-19, protocols that draw from traditional practices and consider contraindications, adverse effects and infection control measures could be developed and implemented rapidly and inexpensively on a wide scale. While there are significant challenges in implementing heat-based therapies during the current pandemic, these therapies present an opportunity to integrate natural medicine, conventional medicine and traditional wellness practices, and support the wellbeing of both patients and medical staff, while building community resilience and reducing the likelihood and impact of future pandemics.

Individual differences in personality predict the use and perceived effectiveness of essential oils

Essential oil (EO) use is growing in popularity and ostensibly used for treating or preventing various ailments or conditions. Despite the increase in use, there is a paucity of research on psychosocial predictors of EO use and their perceived effectiveness. However, several psychosocial characteristics are associated with health-promoting behavior and a tendency to believe in homeopathic cures. In the current study, we examined a variety of individual differences in the use and perceived effectiveness of essential oils in a sample of 1,202 participants (Mage = 31.33, SD = 13.77; 61.7% women, 75.6% Caucasian). We found that receptivity to pseudo-profound fabricated statements and religiosity were the most consistent predictors of greater use of, perceived effectiveness of, and a willingness to spend more money on EOs.

Antidepressant-like Effect of Citrus sinensis (L.) Osbeck Essential Oil and Its Main Component Limonene on Mice

The present study investigated the antidepressant-like effects of navel orange [Citrus sinensis (L.) Osbeck] essential oil (OEO) and its main components using the chronic unpredictable mild stress (CUMS) model mice and explored its possible mechanisms. The results indicated that OEO inhalation significantly ameliorated the depression-like behaviors of CUMS mice with decreased body weight, sucrose preference, curiosity, and mobility as well as shortened immobile time and attenuated dyslipidemia. Limonene was the most abundant compound in the sniffing OEO environment and mice brain after sniffing, and it was not metabolized immediately in the brain. In addition, limonene inhalation significantly restored CUMS-induced depressive behavior, hyperactivity of hypothalamic-pituitary-adrenal axis, and the decrease of monoamine neurotransmitter levels, with downregulation of brain-derived neurotrophic factor and its receptor expression in the hippocampus. Thus, the study indicates that the improvements in neuroendocrine, neurotrophic, and monoaminergic systems are related to the antidepressant effects of limonene.

Natural Monoterpenes: Much More than Only a Scent

Terpenes are a widespread group of secondary metabolites that can be found in various family plants such as the Lamiaceae. In view of their numerous valuable biological activities, the industrial production of concrete terpenes and essential oils rich in the substances is intensively studied. Monoterpenes constitute a significant part of the whole group of the aforementioned secondary metabolites. This is due to their numerous biological activities and their ability to permeate the skin. Despite the fact that these substances have gain popularity, they are not comprehensively characterized. The presented review is based on studies of the biological activities of the most important monoterpenes and the essential oils rich in these compounds. The authors focused attention on antioxidant activity, inhibition towards acetyl- and butyrylcholinesterase, and α-amylase and α-glucosidase, antifungal, hepatoprotective, sedative properties, and their skin permeation enhancement.

The effect of aromatherapy with lavender (Lavandula angustifolia) on serum melatonin levels

OBJECTIVE

Physiologically, blood melatonin levels decrease as a person ages and the older adult commonly presents with insomnia and other types of sleep disorders. Alternative therapies can be used to attenuate sleep disturbances. The aim of the present study was to analyze the effect of aromatherapy with lavender on serum melatonin levels in the noninstitutionalized older adult (OA).

DESIGN AND SETTING

A pre-experimental, quantitative study with a pre-test - post-test design was conducted on 67 OAs that included both sexes.

MAIN OUTCOME MEASURES

Serum melatonin levels were measured before and after eight sessions of aromatherapy with lavender that lasted 4 weeks. The results were expressed as mean ± standard deviation of melatonin levels (pg/ml). The differences were compared using the Student's t-test and statistical significance was set at a p ≤ 0.05.

RESULTS

Blood melatonin levels significantly increased in the total population after the intervention with aromatherapy (pg/ml): 102.3 ± 33.4 VS 132.5 ± 42.3, p = 0.000004. There were significant differences in the pre-test and post-test phases in the women and men measured as separate groups (p = 0.00005 and p = 0.026), respectively. However, those differences were not observed when the measurements were compared between the two sexes, before (p = 0.64) or after (p = 0.31) the intervention.

CONCLUSION

Aromatherapy with lavender essential oil similarly favors an increase in blood melatonin levels in both older adult men and women.

Microcapsules based on octenyl succinic anhydride (OSA)-modified starch and maltodextrins changing the composition and release property of rose essential oil

Octenyl succinic anhydride (OSA)-modified starch and maltodextrins (MDs) are important carbohydrate polymers as wall materials. However, few studies have shown whether these two wall materials affect the composition of core materials. In this work, we investigated the effects of OSA-modified starch and MD on the release property of essential oils. Results showed that among the seven characteristic aroma components (CACs) of rose essential oil (REO), the esters released the fastest, followed by the alcohols, while the release of the phenols was the slowest. Environmental factors such as temperature and relative humidities (RHs) had significant influences on the release kinetics of CACs in REO. This work provides new insights into the use of OSA-modified starch and MDs as wall materials for encapsulating complex and bioactive components.

Effect of eugenol, neridol and piperine feed supplement on the thigh muscle fat profile of broiler chickens

The purpose of this study was to investigate of the broiler chicken thigh muscle fat profile after feeding a commercial supplement based on eugenol, nerolidol and piperine applied in feeding mixtures. Broiler chickens Ross 308 were reared in a pen equipped with a straw deep litter and placed into 2 groups. One group was designated as control and the second as experimental. Difference between control and experimental groups was in using of feed supplement in experimental feeding mixtures. Experimental supplement is a commercial powder product which was used in an amount of 10 g per 100 kg of feeding mixtures. Chickens of body weight of 1800.0 g were selected from each group, human killed and technologically processed to carcass. Samples were measured according to Fourier Transform Infrared Spectroscopy (FTIR) using the Nicolet 6700 instrument. Infrared area near middle was chosen for determining fat and fatty acids. Mean fat content was found slightly higher value 1.53 g.100g-1 in experimental group opposite 1.49 g.100g-1 in control group showing no statistically significant difference (p >0.05). Ratio among saturated fatty acids (SFAs), monounsaturated fatty acids (MUFAs) and polyunsaturated fatty acids (PUFAs) was 4.24:5.89:1 in experimental group and 3.75:5.13:1 in control group. Omega-3 PUFAs content was reached 0.54% in experimental group and 0.58% in control group showing no statistically significant (p >0.05). Near-perfect correlation was found between total PUFAs and omega-6 PUFAs as well in the experimental group and control group showing linear, positive and statistically significant relation (p <0.01, p <0.001). Ratio between omega-3 and omega-6 PUFAs was statistically significant (p <0.05) closer in experimental group 1:14.65 opposite ratio 1:16.78 in control group. Conclusion: comparable fat profile in the thigh muscle was achieved, showing no statistically significant difference (p >0.05), in addition to the correlation between total PUFAs and omega-6 PUFAs, which was statistically significant in control (p <0.001) and experimental groups (p <0.01), and statistically significant (p <0.05) closer relation between omega-3 and omega-6 PUFAs in experimental group.