Insomnia Research
Alternative
& Complementary Therapies
Medical Herbalism
& Insomnia
Medical herbalism is today a sophisticated system of
natural medicine using plant extracts and herbs to help treat physical and mental
disorders.
Valerian Root: - Valerian root has been traditionally used by herbalists as a
calmative and relaxant to help soothe the nervous system and ease tension. However, two
recent research studies have demonstrated that valerian root may be particularly helpful
to people who suffer with insomnia and other sleep disorders.
In Switzerland (1), researchers surveyed 128 people who
were each given 9 separate samples to test (3 containing placebo, 3 containing 400 mg
aqueous extract of valerian root and 3 containing a proprietary
over-the-counter valerian preparation.
The results revealed that the subjects stated that the
valerian extract produced a significant improvement in their quality of sleep as well as
in the ease in getting to sleep. The best scores came from those people who had considered
themselves poor or irregular sleepers prior to the study. The study confirmed that
valerian root extract is considered by users to be an effective aid to sleep which
improves the quality of sleep and the regularity of sleep patterns.
Another study(2), this time in Germany, the efficacy and
tolerance of a phyto-therapeutic compound called ‘Novo-Baldriparan’ which
contains valerian root, hops and balm was investigated on 225 patients all of whom were
suffering from difficulties falling asleep and sleeping through the night and/or states of
nervous agitation.
The patients were given Novo-Baldriparan for a period of
two weeks and their symptoms were recorded afterwards. The results showed that the herbs
produced a significant improvement in the severity and frequency of all of the principal
symptoms. Both the nervous unrest, which was the underlying cause of the sleep disorders,
as well as the sleep disorders themselves were significantly reduced. The difficulties
falling asleep improved in 89% of the patients, the difficulties sleeping through the
night improved in 80% and the states of nervous unrest improved in 82% of the patients.
The quantity of sleep was also considerably increased , while the patients noted that
external stressors which had previously caused considerable distress were much less
distressing during the period when they were taking the herbal compound.
Interestingly, the results also revealed that there were
improvements in other stress-related symptoms such as headaches, dizziness, and
cardiovascular or gastrointestinal discomfort. Heart rate and blood pressure improved and
this was accompanied as a whole by a noticeable improvement in the patients' general well
being.
The tolerability of Novo-Baldriparan was rated positively
by both the doctors and patients - 96.9% of the physicians and 96.4% of the patients gave
the rating 'very good' or 'good'.
These studies, although not double-blind, provide strong
evidence that valerian root extract offers appreciable and significant benefits not just
for those people who suffer with sleeping disorders, but for anyone who is having problems
triggered or augmented by stress.
(1) Leathwood P.D.; Chauffard F.; Heck E.; Munoz-Box
R. Aqueous extract of valerian root (Valeriana officinalis L.) improves sleep quality in
man. Nestle Res. Lab., 1814 La Tour-de-Peilz SWITZERLAND PHARMACOL. BIOCHEM. BEHAV. (USA)
, 1982, 17/1 (65-70)
(2)Orth-Wagner S.; Ressin W.J.; Friederich I.Phytosedative for sleeping disorders
containing extracts from valerian root, hop grains, and balm leaves.
Dorfstrasse 27d, 77797 Ohlsbach Germany Zeitschrift fur
Phytotherapie (Germany) , 1995, 16/3 (147-152+155-156)
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Massage
& Insomnia
Massage Therapy and
Relaxation
Critically
ill patients are deprived of sleep and its potential healing qualities,
although many receive medications to promote sleep. However, no one has
adequately evaluated holistic non-pharmacological techniques designed to
promote sleep in critical care practice.
Researchers determined the effects of (1) a back
massage and (2) combined muscle relaxation, mental imagery, and a music
audiotape on the sleep of older men with a cardiovascular illness who were
hospitalized in a critical care unit.
Sixty-nine subjects were randomly assigned to a
6-minute back massage (n=24); a teaching session on relaxation and a
7.5-minute audiotape at bedtime consisting of muscle relaxation, mental
imagery, and relaxing background music (n=28); or the usual nursing care
(controls, n=17). Polysomnography was used to measure 1 night of sleep for
each patients. Sleep efficiency index was the primary variable of
interest. One-way analysis of variance was used to test for difference in
the index among the 3 groups.
Descriptive statistics showed improved quality of
sleep among the back-massage group. Initial analysis showed a significant
difference among the 3 groups in sleep efficiency index. Post hoc testing
with the Duncan procedure indicated a significant difference between the
back-massage group and the control group; patients in the back-massage
group slept more than 1 hour long than patients in the control group.
However, the variance was significantly different among the 3 groups, and
reanalysis of data with only 17 subjects in each group revealed no
difference among groups.
The report concluded that back massage is useful
for promoting sleep in critically ill older men.
Am J Crit Care 1998
Jul;7(4):288-99
Richards KC. University of Arkansas College of
Nursing, Little Rock, USA.
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Aromatherapy
& Insomnia
Do the odours of aromatherapy essential oils have any measurable
physiological effects on us while we sleep? That is the question that
researchers at the Psychology Department, Bowling Green State University,
Ohio, USA (1) recently asked.
The researchers monitored ten participants (average age = 22.8 years)
every three minutes to see whether any physiological changes could occur.
The participants were given three-minute periods of either air alone or a
peppermint odour during stage 2 sleep. The odour was delivered through a
system comprising of an aquarium pump, Teflon and TYGON tubing, oxygen mask,
filtering, and air flow valves. The responses, which were evaluated,
included behavioural changes (i.e. awakening or other changes), changes
affecting the autonomic nervous system (ie. heart rate, EMG, respiration
rate), and changes relating to the central nervous system (EEG) components.
The results revealed conclusively that humans do react
behaviourally,
autonomically and centrally to the odour of the essential oil of peppermint
administered while sleeping. Significant differences in responsivity to
odour periods versus non-odour periods were found in eight of the ten
participants for EEG, EMG, and heart rate as well as behavioural changes.
(1) Badia P; Wesensten N; Lammers W;
Culpepper J; Harsh J. Responsiveness to olfactory stimuli presented in
sleep. Psychology Department, Bowling Green State University, OH 43403.
Physiol Behav (UNITED STATES) Jul 1990, 48 (1) p87-90
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Yoga
& Insomnia
Yoga is a complete science, focusing on breathing, movement,
posture and meditation. Specific exercises are taught consisting mainly of simple
stretching, breathing and relaxation. There is a wealth of scientific research available
confirming that advanced yogis have remarkable control over the functioning of their
nervous system, heart and lungs. Subjects have demonstrated their ability to drastically
reduce their heart beat and respiration for hours at a time under clinical studies. In one
study involving 3,000 yoga students carried out by the Yoga Bio-Medical Trust (Cambridge,
England) revealed that yoga did in fact help all participants to sleep better. Those who
had previously had insomnia were , 84% of those people who were suffering from
hyper-tension (and there were 150 in number), claimed that they had
benefited from the
practice of yoga. Controlled trials have confirmed that yoga promotes vitality and is
effective in management of stress and treatment of insomnia.
The Natural Doctor - Dr Andrew
Stanway, Centaury 1987
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Meditation
& Relaxation
& Insomnia
It is commonly accepted that people who are chronically tense
and who cannot relax are prime candidates for all cardio-vascular disorders, including
hypertension.
Researchers have shown that relaxation techniques are
demonstrably effective in stress control and in the treatment of insomnia. For example, Dr
Chandra patel, author of 'The Complete Guide to Stress Management' (Optima 1992) reported
several controlled studies in which patients with high blood pressure had significantly
improved (1).
Other investigators reported that relaxation techniques
including yoga, transcendental meditation and biofeedback have all been effective in
helping reduce high blood pressure. (2)
Medical journalist, Audry Carli also described research in
the American journal 'Bestways' in which 21 Hypertensive patients were divided into two
groups; one group was given drugs and the other received drugs plus relaxation lessons.
Interestingly the former group had an average reduction in systolic blood pressure of 1.1
whereas the group who did relaxation exercises had an average reduction of 13.6 points!
This suggests that relaxation can make other treatments and therapies as much as 12 times
more effective.
Added weight was given in two reports in the Lancet
(3)
which stated that transcendental meditation was effective in inducing relaxation, lowering
high blood pressure and helping insomnia, and other researchers have demonstrated that
Biofeedback has also been shown to be an effective tool in overcoming
insomnia(4). So
much so that Dr Stephen Fulder, author of the Complementary handbook wrote that
Biofeedback "is as good as other procedures in relieving stress-related conditions
such anxiety, insomnia,high blood pressure, tachycardia and tension headaches."
(1) A Holistic Approach to cardiovascular disease Dr C Patel - BJ Holistic Med 1984 1, 30
- 41 & Trial of Relaxation in reducing coronary risk BMJ 1985 290, 1103-6.
(2) New England Journal of Medicine 8/1/76
(3) 23/2/74 & 21/1/76
(4) Learning Visceral and Glandular responses - Science 163, 434-5 N.E.Miller ;
Insturmental conditioning of autonomically mediated behaviour- Psychological Bulletin 67,
337
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Music therapy
& Insomnia
It might seem surprising in the
age of the ghetto blaster and ‘acid music’ that music might be
associated as aiding people with insomnia, but a report earlier this year in
the Journal of Holistic Nursing revealed that the right music can actually
help induce sleep.
Twenty-five elderly people with self-reported sleep disturbances
participated in a pilot study. All of the participants were given classical
and New Age music to listen to before bedtime and whenever a sleep
disturbance was identified. The participants were asked to keep daily
records to assess the
efficacy of the music in inducing sleep. When the results were analysed
the researchers found that twenty-four (96%) of the participants reported
improved sleep after listening to the music.
Mornhinweg GC; Voignier RR. Music for sleep disturbance in the elderly. J
Holist Nurs (UNITED STATES) Sep 1995, 13 (3) p248-54
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Acupuncture
& Insomnia
Acupuncture treatment can aid sleep in healthy individuals, according to
French researchers.
Auto massage of ‘point 7
heart’ of acupuncture was studied in six healthy volunteers (average age
28 years) a randomised, double blind, and crossover protocol. Polygraph
measurements of the subjects’ night’s sleep between 11pm and 7am were
monitored whilst the subjects received two ‘PEBA’ cones (Polyet her
Block Amides; Isocones) fixed bilaterally at both of the ‘7 heart’
points (the active treatment) or on the back of the hand (the placebo
application). Two weeks later, the two groups switched treatment.
Cyclic alternating patterns
(CAP) were also analysed on the electroencephalogram during non-REM sleep.
Sleep efficiency increased in the active treatment group, due to a decrease
in wakefulness, and an increase in total sleep time due to an increase in
non-REM sleep. The number of CAP decreased in active treatment, as did the
number of CAP sequences and the ratio of CAP du-ration to total sleep time
(CAP rate) and to the duration of slow-wave sleep. These changes were not
observed in the placebo group.
The researchers concluded
that the application of Isocones at point 7 heart during the night could
improve sleep patterns of healthy individuals.
(1) Rust M, Cohen LA (1994)
Anaesthesia. 49 (supplement): 16-23
(2) Andrzejowski j, Woodward D. Semi-permanent acupuncture needles in the
prevention of post-operative nausea and vomiting. Acupuncture in Medicine
November 1996 Vol 14, No 2 68 70
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Relaxation
& Insomnia
This study explores the usefulness of relaxation and
gradual medication withdrawal in weaning insomniacs from sleep (hypnotic)
medication. We recruited 40 volunteers from the community who had insomnia,
half of whom were chronic users of hypnotics while the other half were
non-medicated. Half of all participants (10 medicated and 10 non-medicated)
received progressive relaxation. All medicated participants received a
standard gradual drug withdrawal program. Medicated participants reduced
sleep medication consumption by nearly 80%. Participants who received
relaxation obtained additional benefits in sleep efficiency, rated quality
of sleep, and reduced withdrawal symptoms. Medicated and non-medicated
participants attained comparable, improved sleep by post-treatment and
follow-up. Hypnotic withdrawal was accompanied by serious worsening of
insomnia, but this dissipated by the end of the withdrawal period. The
psychological treatment of hypnotic-dependent insomnia has high potential
for making an important clinical contribution.
Behav Modif 1999
Jul;23(3):379-402 Lichstein KL, Peterson BA, Riedel BW, Means MK, Epperson
MT, Aguillard RN Department of Psychology, University of Memphis, TN
38152, USA.
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Automassage
& Insomnia
To test the somnogenic properties of the automassage
of point 7 heart of acupuncture, polygraphic night sleep was studied in six
healthy volunteers from 23:00h to 07:00h. After one night of adaptation, two
PEBA cones (Polyether Block Amides; Isocones) were fixed bilaterally at both
points 7 heart (active application, AA) or on the back of hand (placebo
application, AP). The alternate application was used 2 weeks later, using a
randomized, double-blind, and cross-over protocol. Cyclic alternating
patterns (CAP) were also analysed on the electroencephalogram during non-REM
sleep. Sleep efficiency increased in AA, due to a decrease in wakefulness,
and an increase in total sleep time due to an increase in non-REM sleep. The
number of CAP decreased in AA, as did the number of CAP sequences and the
ratio of CAP duration to total sleep time (CAP rate) and to the duration of
slow-wave sleep. In conclusion, the application of Isocones at point 7 heart
during the night induced a decrease in wakefulness and an increase in
non-REM sleep during night sleep in healthy subjects.
Neurophysiol Clin 1995;25(2):78-83 Buguet A, Sartre
M, Le Kerneau J Centre de recherches du service de sante des Armees Emile-Parde,
La Tronche, France.
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Acupressure
& Insomnia in institutionalized residents.
BACKGROUND: Elderly people often suffer from disturbed sleep. Because
traditional Chinese medicine indicates that acupressure therapy may induce
sedation, testing the effectiveness of acupressure in enhancing the quality
of sleep of institutionalized residents with a well-designed scientific
study is needed.
METHODS: A randomized block experimental design was used. The Pittsburgh
Sleep Quality Index (PSQI) questionnaire was used as a screening tool to
select subjects with sleep disturbance. By matching the effects of
hypertension, hypnosis, naps, and exercise, subjects were randomly assigned
to an acupressure group, a sham acupressure group, and a control group. Each
group had 28 subjects for a total of 84 subjects. The same massage routine
was used in the acupressure group and the sham acupressure group, whereas
only conversation was employed in the control group.
RESULTS: There were significant differences in PSQI subscale scores of the
quality, latency, duration, efficiency, disturbances of sleep, and global
PSQI scores among subjects in the three groups before and after
interventions. Furthermore, there was a significant reduction in the
frequencies of nocturnal awakening and night wakeful time in the acupressure
group compared to the other two groups.
CONCLUSIONS: This study confirmed the effectiveness of acupressure in
improving the quality of sleep of elderly people and offered a
nonpharmacological therapy method for sleep-disturbed elderly people.
Publication Types:Br J
Anaesth 1999 Mar;82(3):387-90, Department of Nursing, National Taipei
Nursing College, Taiwan. Chen ML, Lin LC, Wu SC, Lin JG
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