The best route of administration of lavender for anxiety: a systematic review and network meta-analysis

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.

The effect of aromatherapy on patients with acute coronary syndrome: A systematic review and meta-analysis

OBJECTIVE

To systematically investigate the efficacy of aromatherapy in patients with acute coronary syndrome (ACS).

METHODS

We conducted a comprehensive search for papers published until November 2023 using the following databases: PubMed, Embase, and Cochrane Library. This study was conducted following the PRISMA and Cochrane Guidelines. The inclusion criteria were randomized controlled trials (RCTs) performed to assess the comparative effectiveness of inhalation aromatherapy versus controls in individuals diagnosed with ACS. The Jadad rating method was used to assess the quality of the included studies, and a meta-analysis was performed using the RevMan 5.4 software. Heterogeneity was quantified using the Higgins I2 (%) test.

RESULTS

A total of 12 RCTs with 476 patients with ACS were included. Aromatherapy has been shown to reduce anxiety scores significantly (standard mean difference [SMD]: -1.18, 95 % confidence interval [CI]: -1.33 to -1.03; P < 0.00001) along with reduction in systolic blood pressure (MD = -8.78, 95 % CI [-13.92, -3.65], P = 0.008); diastolic blood pressure (MD = -7.76, 95 % CI [-11.39, -4.12], P < 0.001); mean artery pressure MD = -9.68, 95 % CI [-13.93.-5.44]; P < 0.0001). However, no significant effects were reported on the heart rate (MD = -6.98, 95 % CI [-15.46, 1.50], P = 0.11) and respiratory rate (MD = -0.67, 95 % CI [-2.52, 1.19], P = 0.48). A greater frequency of aromatherapy was associated greater anxiety -1.80 incidence, with 95 % CI [-2.04, -1.56]. Citrus essential oils exhibited the strongest effect (SMD = -1.97, 95 % CI [-3.34, -0.60], P = 0.005) in reducing anxiety levels.

CONCLUSION

Aromatherapy appears to be an effective non-pharmacological intervention for reducing blood pressure and anxiety in individuals with ACS. This suggests that aromatherapy more than twice a day is effective in reducing anxiety levels. However, aromatherapy had no statistically significant impact on the heart or respiratory rates. Moreover, additional high-quality RCTs should be conducted to verify these results and explore the efficacy and mechanism of aromatherapy in patients with ACS.

The effect of lavender foot baths on postoperative pain and sleep quality in comparison with foot baths with warm water only-A prospective randomized controlled study

INTRODUCTION

The aim of the study was to investigate the effect of warm water (WW) foot bath with or without lavender oil for pain and sleep quality in the patients who undergone abdominal surgeries.

MATERIALS AND METHOD

This study was designed as a prospective randomized controlled. The three study groups were defined as the control group (n = 44), the WW foot bath group (n = 46), WW foot bath with the lavender group (n = 40). Foot baths were done for 20 min with 40 °C every night for 3 days after surgery. Visual Analogue Scale and Richard-Campbell Sleep Questionnaire were used during data collection.

RESULTS

A total of 130 patients, mean age 55.99 ±  ± 13.05 years, 66 male (51 %), 103 of whom underwent abdominal surgery, were included in the study. When the patients during the postoperative three days were evaluated, decreased pain score and increased sleep quality both the WW and WW foot bath with lavender groups (p < 0.001). Noise-related sleep quality was detected to be lesser in the control group patients on the 3rd day (p < 0.001).

CONCLUSION

WW foot bath with or without lavender oil is an uncomplicated, economical, and effective complementary therapy to reduce postoperative pain and improve sleep quality. WW foot baths with essential oils are optionally available in clinics and can be used according to patients' preferences.

Effect of Lavender Oil on Preoperative Anxiety: Systematic Review and Meta-analysis

PURPOSE

Surgical interventions are known to induce anxiety in patients due to the associated risks and potential complications. Various methods are employed to alleviate preoperative anxiety. This study aimed to investigate the impact of lavender oil application on the anxiety levels of patients scheduled for surgical procedures.

DESIGN

Systematic review and meta-analysis.

METHODS

Studies were accessed using the keywords "preoperative and lavender oil and stress" in Turkish and English between July 1 and 30, 2022, through PubMed (including MEDLINE), Cochrane, EBSCOhost, Web of Science, YÖK National Thesis Center, and Google Scholar. The standardized mean difference was calculated using random-effects models, and the Cochrane Collaboration tool was used to assess the risk of bias in each study. The study was prepared according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis checklist.

FINDINGS

Twenty studies were included in the analysis. The anxiety level of the experimental group to which lavender oil was applied before the surgical intervention was significantly lower than that of the control group (standardized mean difference:-5.40; 95% CI: -8.76 to -2.04).

CONCLUSION

Preoperative lavender oil application was found to be an effective method for relieving patients' anxiety. Lavender oil is thought to be a potential standalone treatment for preoperative anxiety.

Anxiety-Reducing Effects of Lavender Essential Oil Inhalation: A Systematic Review

Anxiety disorders are the most prevalent and disabling mental disorders, causing health-related burdens. With the increasing demand for and interest in safe and acceptable anxiolytics, several studies report the anxiolytic effects of lavender aromatherapy, providing evidence of its physiological and psychological effects. However, existing reviews comprehensively cover the effects of different modes of delivering aromatherapy. Therefore, this review assesses the efficacy of lavender essential oil inhalation in reducing anxiety. The titles and abstracts of relevant articles published over the last five years were searched in PubMed, Web of Science, and Scopus databases. This review only included clinical trials that utilized lavender inhalation for anxiety treatment. Eleven studies comprising 972 participants were included. Of these, 10 reported significantly decreased anxiety levels after lavender oil inhalation. The physiological measures of vital signs, including blood pressure, heart rate, respiratory rate, pulse, and saturation, were conducted in three trials, showing that lavender oil inhalation could physiologically affect anxiety levels. Lavender oil inhalation is a safe and feasible anxiolytic intervention for treating people with diverse types of anxiety. Data from further studies with a high-quality design and accurate information are necessary to confirm the validity of these findings and elucidate the anxiety-reducing mechanisms of lavender inhalation.

Efficacy of Silexan in patients with anxiety disorders: a meta-analysis of randomized, placebo-controlled trials

INTRODUCTION

We report on a meta-analysis of Silexan, a proprietary active substance produced from Lavandula angustifolia, in subthreshold anxiety, mixed anxiety and depressive disorder (MADD), and generalized anxiety disorder (GAD).

METHODS

The present analyses are based on all currently completed 5 double-blind, randomized, placebo-controlled trials investigating Silexan in adult out-patients who received Silexan 1 × 80 mg/day or placebo for ten weeks according to random assignment (n = 1213). Efficacy was assessed based on the Hamilton Anxiety Rating Scale (HAMA), several anxiety self-rating scales, the Clinical Global Impression (CGI) scale, and the Short Form-36 (SF-36) health status questionnaire.

RESULTS

After ten weeks' treatment, Silexan was significantly superior to placebo in reducing the HAMA total score (including the psychic and somatic anxiety sub-scores) and self-rated anxiety. Based on a ≥ 50% HAMA total score reduction, the responder rate ratio was 1.34 favoring Silexan, and the rate ratio of subjects much or very much improved according to the CGI was 1.51. Silexan was also significantly superior in improving the physical and mental health summary scores of the SF-36. There were no significant between-group differences concerning the occurrence of adverse events (AEs), serious AEs, and premature withdrawal due to AEs.

CONCLUSIONS

This meta-analysis demonstrates that Silexan exerts significant anxiolytic effects in subthreshold anxiety, GAD and MADD that were consistently reflected in investigator ratings and patient-reported outcomes, including improvement of health-related life-quality, while showing favorable tolerability and safety.

Aromatherapy for the brain: Lavender's healing effect on epilepsy, depression, anxiety, migraine, and Alzheimer's disease: A review article

Neurological diseases affect the nervous system, including the brain, spinal cord, cranial nerves, nerve roots, autonomic nervous system, neuromuscular junctions, and muscles. Herbal medicine has long been used to cure these diseases. One of these plants is lavender, which is composed of various compounds, including terpenes, such as linalool, limonene, triterpenes, linalyl acetate, alcohols, ketones, polyphenols, coumarins, cineole, and flavonoids. In this review, the literature was searched using scientific search engines and databases (Google Scholar, Science Direct, Scopus, and PubMed) for papers published between 1982 and 2020 via keywords, including review, lavender, and neurological disorders. This plant exerts its healing effect on many diseases, such as anxiety and depression through an inhibitory effect on GABA. The anti-inflammatory effects of this plant have also been documented. It improves depression by regulating glutamate receptors and inhibiting calcium channels and serotonergic factors, such as SERT. Its antiepileptic mechanism is due to an increase in the inhibitory effect of GABA and potassium current and a decrease in sodium current. Therefore, many vegetable oils are also used in herbal medicine. In this review, the healing effect of lavender on several neurological disorders, including epilepsy, depression, anxiety, migraine, and Alzheimer's disease was investigated. All findings strongly support the traditional uses of lavender. More clinical studies are needed to investigate the effect of the plants' pharmacological active constituents on the treatment of life-threatening diseases in humans. The limitations of this study are the low quality and the limited number of clinical studies. Different administration methods of lavender are one of the limitations of this review.

Phytotherapy of mood disorders in the light of microbiota-gut-brain axis

BACKGROUND

Clinical research in natural product-based psychopharmacology has revealed a variety of promising herbal medicines that may provide benefit in the treatment of mild mood disorders, however failed to unambiguously indicate pharmacologically active constituents. The emerging role of the microbiota-gut-brain axis opens new possibilities in the search for effective methods of treatment and prevention of mood disorders.

PURPOSE

Considering the clinically proven effectiveness juxtaposed with inconsistencies regarding the indication of active principles for many medicinal plants applied in the treatment of anxiety and depression, the aim of the review is to look at their therapeutic properties from the perspective of the microbiota-gut-brain axis.

METHOD

A literature-based survey was performed using Scopus, Pubmed, and Google Scholar databases. The current state of knowledge regarding Hypericum perforatum, Valeriana officinalis, Piper methysticum, Passiflora incarnata, Humulus lupulus, Melissa officinalis, Lavandula officinalis, and Rhodiola rosea in terms of their antimicrobial activity, bioavailability, clinical effectiveness in depression/anxiety and gut microbiota - natural products interaction was summarized and analyzed.

RESULTS

Recent studies have provided direct and indirect evidence that herbal extracts and isolated compounds are potent modulators of gut microbiota structure. Additionally, some of the formed postbiotic metabolites exert positive effects and ameliorate depression-related behaviors in animal models of mood disorders. The review underlines the gap in research on natural products - gut microbiota interaction in the context of mood disorders.

CONCLUSION

Modification of microbiota-gut-brain axis by natural products is a plausible explanation of their therapeutic properties. Future studies evaluating the effectiveness of herbal medicine and isolated compounds in treating mild mood disorders should consider the bidirectional interplay between phytoconstituents and the gut microbiota community.

Relaxing effects of music and odors on physiological recovery after cognitive stress and unexpected absence of multisensory benefit

Several studies have described, often separately, the relaxing effects of music or odor on the autonomic nervous system (ANS) activity. Only a few studies compared the presentation of these stimuli and their interaction within a same experimental protocol. Here, we examined whether relaxing music (slow-paced classical pieces) and odor (lavender essential oil) either presented in isolation or in combination would facilitate physiological recovery after cognitive stress. We continuously recorded the electrocardiogram to assess the high-frequency component of heart rate variability (HF-HRV), an index of parasympathetic activity, and electrodermal activity (EDA), an index of sympathetic activity, 10 min before, during and 30 min after a cognitive stress (i.e., completing timely constrained cognitively demanding tasks) in 99 participants allocated to four recovery conditions (control N = 26, music N = 23, odor N = 24, music+odor N = 26). The stressing event triggered both a significant increase in EDA and decrease in HF-HRV (compared to baseline). During the recovery period, the odor elicited a greater decrease in EDA compared to an odorless silent control, whereas no difference in HRV was observed. Conversely, during this period, music elicited a greater increase in HF-HRV compared to control whereas no difference in EDA was observed. Strikingly, in the multimodal music+odor condition, no beneficial effect was observed on ANS indexes 30 min after stress. Overall, our study confirms that both olfactory and musical stimuli have relaxing effects after stress on ANS when presented separately only, which might rely on distinct neural mechanisms and autonomic pathways.

Beneficial effects of Silexan on co-occurring depressive symptoms in patients with subthreshold anxiety and anxiety disorders: randomized, placebo-controlled trials revisited

Silexan is a proprietary active substance produced from Lavandula angustifolia, with proven anxiolytic efficacy in subthreshold and generalized anxiety disorder as well as in mixed anxiety and depressive disorder with beneficial impact on anxiety-related sleep disturbances. The pharmacological profile and clinical observations suggest that Silexan may also have an antidepressant effect. To investigate the effect of Silexan on co-occurring depressive symptoms, we present a meta-analysis of the five placebo-controlled clinical trials hitherto performed with Silexan in subthreshold anxiety (n = 3) and anxiety disorders (n = 2). Patients of all trials received Silexan 1 × 80 mg/day or placebo for 10 weeks according to random assignment. Assessment of the antidepressant effect was based on item 'depressed mood' from the Hamilton Anxiety Rating Scale (HAMA) administered in all trials and on the total scores of the Montgomery Åsberg Depression Rating Scale (MADRS) or the Hamilton Depression Rating Scale (HAMD) used in three trials. After 10-week treatment, patients receiving Silexan showed significantly more pronounced score reduction for HAMA item 'depressed mood' than those in the placebo group (p = 0.01). Significant superiority of Silexan over placebo could also be shown for mean MADRS or HAMD total score reduction (three studies; p < 0.01). Silexan-treated patients with more severe depressive symptoms at baseline showed more pronounced improvements than those with milder symptoms. Our meta-analysis clearly shows that Silexan has a beneficial effect on co-occurring depressive symptoms in patients with subthreshold anxiety and anxiety disorders and may, hence, lead to important therapeutic implications for depressive disorders.

THE EFFECT OF LAVENDER AROMATHERAPY ON THE LEVEL OF INTRAOPERATIVE ANXIETY IN CAESAREAN CASE UNDER SPINAL ANESTHESIA: A RANDOMIZED CONTROLLED TRIAL

BACKGROUND

Preoperative anxiety can be reduced by aromatherapy. This study aimed to evaluate the effect of lavender aromatherapy in reducing intraoperative anxiety in patients undergoing caesarean section (CS) under spinal anesthesia.

METHODS

This study was two-armed and randomized controlled trial. A total of 96 patients who were scheduled for CS were randomly divided into two groups: the aromatherapy (A) group (n=48), comprising patients who were randomized to receive lavender aromatherapy with mask oxygen after the birth of the baby, and the control (C) group (n=48), comprising patients who inhaled carrier oil. During the preoperative period, baseline anxiety levels and Visual Analog Scale (VAS) pain scores were recorded using the State-Trait Anxiety Inventory (STAI-I) scale. After birth, two drops of oil were inhaled in an oxygen mask for 5 min. After 5 min, the Ramsey Sedation Scale was evaluated, and patients with a score of 1 received 2 mg of intravenous midazolam for sedation. The STAI-I and VAS pain scores were re-evaluated at the third postoperative hour.

RESULTS

The primary outcome was the significant reduction in the need for midazolam brought about by lavender aromatherapy, and the secondary outcomes included postoperative third-hour STAI-I scores, intraoperative complications and patient satisfaction.

CONCLUSION

The effectiveness of lavender aromatherapy, which reduced the need for intraoperative anxiolytics, can be offered as an alternative for pregnant women who undergo CS under spinal anesthesia.

Effects of olfactory stimulation on cognitive function and behavior problems in older adults with dementia: A systematic literature review

The aim of this study was to examine the effects of olfactory stimulation on both cognitive and behavioral symptoms in neurodegenerative diseases. The criteria for selection of participants in the study included neurodegenerative disease, interventions using olfactory stimulation, and measured cognitive or psychological symptoms. 5301 articles were identified, excluding duplicate papers. Seven original articles were selected according to the full article review and eligibility criteria. The final selected studies were all quasi-experimental studies and were published between 2002 and 2015. To assess the risk of bias, we used Cochrane Collaboration's tool, Non-randomized Studies-of Interventions (ROBINS-I). Although olfactory stimulation reported various effects on behavioral and psychological symptoms, it is still in its infancy. We propose standardization of olfactory stimulation and olfactory training. In patients with neurodegenerative diseases, it is necessary to consider the symptoms and severity of olfactory stimulation.

Evaluation of an integrated yoga program in patients with inflammatory bowel disease: A pilot study

BACKGROUND

The effects of integrated yoga programs on mental health outcomes in inflammatory bowel disease (IBD) have not been well explored. To explore the acceptability, implementation and effectiveness of an integrated eight-week yoga program plus aromatherapy massage in patients with IBD.

METHODS

Nine participants with documented IBD were recruited from a gastroenterology clinic in Calgary, Alberta, Canada to participate in an integrated yoga program weekly for eight weeks with outcomes assessed at baseline and week 8. Primary outcomes were assessed using Theory of Planned Behaviour as a guiding theory to identify salient beliefs from qualitative analysis of a semi-structured interview, survey items measuring the strength of beliefs and a daily log was used to capture adherence and adverse events. Secondary outcomes were collected using validated survey tools examining anxiety, depression, stress, sleep quality, and physical and mental quality of life.

RESULTS

Attitude, subjective norm and perceived behavioral control beliefs pertinent to the yoga intervention and daily practice were identified. Participants reported feeling the intervention was very helpful; however, felt guilt about not completing daily practices which decreased confidence and intention to continue with the practice. An average of 55.6% of in-person sessions were attended and decreased over time. Participants practiced on average of 5.4 days per week. Depression and mental health scores improved at week 8 from baseline.

CONCLUSIONS

We were able to identify key salient beliefs of IBD patients in regard to an integrated yoga plus aromatherapy massage intervention. This intervention appears to be acceptable and further research should explore its potential to improve mental and physical health outcomes including IBD symptoms.

Salivary Proteome Changes in Response to Acute Psychological Stress Due to an Oral Exam Simulation in University Students: Effect of an Olfactory Stimulus

The autonomic nervous system (ANS) plays a crucial role both in acute and chronic psychological stress eliciting changes in many local and systemic physiological and biochemical processes. Salivary secretion is also regulated by ANS. In this study, we explored salivary proteome changes produced in thirty-eight University students by a test stress, which simulated an oral exam. Students underwent a relaxation phase followed by the stress test during which an electrocardiogram was recorded. To evaluate the effect of an olfactory stimulus, half of the students were exposed to a pleasant odor diffused in the room throughout the whole session. Saliva samples were collected after the relaxation phase (T0) and the stress test (T1). State anxiety was also evaluated at T0 and T1. Salivary proteins were separated by two-dimensional electrophoresis, and patterns at different times were compared. Spots differentially expressed were trypsin digested and identified by mass spectrometry. Western blot analysis was used to validate proteomic results. Anxiety scores and heart rate changes indicated that the fake exam induced anxiety. Significant changes of α-amylase, polymeric immunoglobulin receptor (PIGR), and immunoglobulin α chain (IGHA) secretion were observed after the stress test was performed in the two conditions. Moreover, the presence of pleasant odor reduced the acute social stress affecting salivary proteome changes. Therefore, saliva proteomic analysis was a useful approach to evaluate the rapid responses associated to an acute stress test also highlighting known biomarkers.

The Immediate Effects of Lavender Aromatherapy Massage versus Massage in Work Stress, Burnout, and HRV Parameters: A Randomized Controlled Trial

Background

Occupational stress is a common issue faced by workers in every discipline. Complementary and alternative medicine (CAM) therapies, such as aromatherapy massage or massage, have antistress effects in the literature. The purpose of this randomized clinical trial with triple blinds is to evaluate the immediate effects of lavender aromatherapy massage for improving work stress, burnout, and HRV parameters of female employees in a university.

Methods

A total of 53 subjects in experimental group whereas 57 subjects in control group completed interventions and measurement and led to power of 0.98. Inferential statistics, as independent t-test, paired t-test, and Chi-Square test, were performed to verify the expected relationships.

Results

The present study found that subjects in experimental group reported a lower role stress and less inclined to type A personality trait after aromatherapy massage with lavender. For control group, only less inclined to type A personality trait was reported after receiving massage. For burnout, a significant lower personal burnout and work-related burnout were reported after aromatherapy massage whereas only increased client-related burnout was reported in control group. For HRV, both the experimental and control groups reported higher SDNN and RMSSD in time domain after intervention. Contradictory HRT and PSI in time domain were significantly lower after intervention. In frequency domain of HRV, both groups reported significantly higher value in VLF and HF. In addition, the experimental group reported significantly higher value in TP and LF after intervention.

Conclusions

Both the lavender aromatherapy massage and massage did show immediate effect on different dimensions of work stress, burnout, and HRV. These two interventions can be applied as routine leisure activities by personal preference to reduce stresses occurring in work environment.