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Sutanto CN, Xia X, Heng CW, Tan YS, Lee DPS, Fam J, Kim JE. The impact of 5-hydroxytryptophan supplementation on sleep quality and gut microbiota composition in older adults: A randomized controlled trial. Clin Nutr 2024; 43:593-602. [PMID: 38309227 DOI: 10.1016/j.clnu.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 12/26/2023] [Accepted: 01/12/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND & AIMS Sleep quality is a pivotal part of health and there is growing evidence on the association between gut microbiota composition and sleep quality. 5-Hydroxytryptophan (5-HTP) is known as a precursor of the sleep regulating neurotransmitter and hormone. However, efficacy of 5-HTP supplementation for improving sleep quality in older adults is unclear. Hence, the aim of this study is to assess the impact of 5-HTP supplementation on sleep quality and gut microbiota composition in older adults. METHODS This is a single-blinded, 12-week parallel randomized controlled trial. Thirty older adults (66 ± 3 years) in Singapore were randomly assigned to either consume or not consume 100 mg 5-HTP daily. Every 4 weeks, sleep quality was assessed via both subjective (Pittsburg Sleep Quality Index) and objective (actigraphy watch) measures. A global sleep score (GSS) was obtained from the PSQI, where a GSS>5 defines as poor sleeper while a GSS≤5 defines as good sleeper. Blood serotonin level, urine melatonin concentration, gut microbiota composition and stool short chain fatty acids (SCFA) content were assessed at week 0 and 12. This study was registered in clinicaltrials.gov as NCT04078724 (https://clinicaltrials.gov/ct2/show/NCT04078724). RESULTS 5-HTP supplementation showed an overall favorable effect on certain sleep quality components and an increase in serum serotonin concentration. In particular, at week 12, not good sleepers but poor sleepers with 5-HTP supplementation were able to significantly improve subjective GSS (ΔSL5-HTP: -2.80 ± 1.10 min, p-value = 0.005). In addition, they showed an increase in microbiota diversity (Simpson5-HTP vs. SimpsonControl: 0.037 ± 0.032 a.u. vs. -0.007 ± 0.022 a.u.; pinteraction: 0.013) and relative abundance of SCFA producing bacteria in the gut. CONCLUSIONS 5-HTP supplementation can improve certain sleep quality components in older adults and this benefit was more prominently observed in poor sleepers. 5-HTP was also able to improve the gut microbiota composition in poor sleepers.
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Affiliation(s)
- Clarinda Nataria Sutanto
- Department of Food Science and Technology, Faculty of Science, National University of Singapore, Science Drive 2, Singapore 117542, Singapore.
| | - Xuejuan Xia
- Department of Food Science and Technology, Faculty of Science, National University of Singapore, Science Drive 2, Singapore 117542, Singapore.
| | - Chin Wee Heng
- Department of Food Science and Technology, Faculty of Science, National University of Singapore, Science Drive 2, Singapore 117542, Singapore.
| | - Yue Shuian Tan
- Department of Food Science and Technology, Faculty of Science, National University of Singapore, Science Drive 2, Singapore 117542, Singapore.
| | - Delia Pei Shan Lee
- Department of Food Science and Technology, Faculty of Science, National University of Singapore, Science Drive 2, Singapore 117542, Singapore.
| | - Johnson Fam
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, 1E Kent Ridge Road Level 11, Singapore 119228, Singapore; Department of Psychiatry, Singapore General Hospital, Singhealth Academia Level 3, 20 College Road, Singapore 169856, Singapore.
| | - Jung Eun Kim
- Department of Food Science and Technology, Faculty of Science, National University of Singapore, Science Drive 2, Singapore 117542, Singapore.
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Ekambaram V, Owens J. Medications Used for Pediatric Insomnia. Psychiatr Clin North Am 2024; 47:87-101. [PMID: 38302215 DOI: 10.1016/j.psc.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Pediatric insomnia can affect physical and mental health and cause cognitive deficits, social deficits and decrease quality of life. There are no Food and Drug Administration approved medications approved for pediatric insomnia. Pharmacologic interventions derive mostly from adult data or pediatric case reports. This review focuses on Food and Drug Administration approved prescription drugs (in adults), over-the-counter drugs, and off-label pediatric insomnia drugs. This review helps the clinician learn general principles, practice guidelines, and pharmacologic considerations for medication selection in the pediatric population. Pharmacologic management should be considered in combination with behavior therapy, which is proven to have long-lasting outcomes.
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Affiliation(s)
- Vijayabharathi Ekambaram
- Department of Psychiatry, University of Central Florida, HCA Florida Healthcare Program, 8383 N. Davis Hwy, Pensacola, FL 32514, USA.
| | - Judith Owens
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
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3
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Nobari H, Azarian S, Saedmocheshi S, Valdés-Badilla P, García Calvo T. Narrative review: The role of circadian rhythm on sports performance, hormonal regulation, immune system function, and injury prevention in athletes. Heliyon 2023; 9:e19636. [PMID: 37809566 PMCID: PMC10558889 DOI: 10.1016/j.heliyon.2023.e19636] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 08/21/2023] [Accepted: 08/29/2023] [Indexed: 10/10/2023] Open
Abstract
Objectives This study was a narrative review of the importance of circadian rhythm (CR), describes the underlying mechanisms of CR in sports performance, emphasizes the reciprocal link between CR, endocrine homeostasis and sex differences, and the unique role of the circadian clock in immune system function and coordination. Method As a narrative review study, a comprehensive search was conducted in PubMed, Scopus, and Web of Science (core collection) databases using the keywords "circadian rhythm", "sports performance", "hormonal regulation", "immune system", and "injury prevention". Inclusion criteria were studies published in English and peer-reviewed journals until July 2023. Studies that examined the role of CR in sports performance, hormonal status, immune system function, and injury prevention in athletes were selected for review. Results CR is followed by almost all physiological and biochemical activities in the human body. In humans, the superchiasmatic nucleus controls many daily biorhythms under solar time, including the sleep-wake cycle. A body of literature indicates that the peak performance of essential indicators of sports performance is primarily in the afternoon hours, and the evening of actions occurs roughly at the peak of core body temperature. Recent studies have demonstrated that the time of day that exercise is performed affects the achievement of good physical performance. This review also shows various biomarkers of cellular damage in weariness and the underlying mechanisms of diurnal fluctuations. According to the clock, CR can be synchronized with photonic and non-photonic stimuli (i.e., temperature, physical activity, and food intake), and feeding patterns and diet changes can affect CR and redox markers. It also emphasizes the reciprocal links between CR and endocrine homeostasis, the specific role of the circadian clock in coordinating immune system function, and the relationship between circadian clocks and sex differences. Conclusion The interaction between insufficient sleep and time of day on performance has been established in this study because it is crucial to balance training, recovery, and sleep duration to attain optimal sports performance.
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Affiliation(s)
- Hadi Nobari
- Faculty of Sport Sciences, University of Extremadura, 10003, Cáceres, Spain
- Department of Exercise Physiology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, 56199-11367, Iran
| | - Somayeh Azarian
- Department of Exercise Physiology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, 56199-11367, Iran
| | - Saber Saedmocheshi
- Department of Physical Education and Sport Sciences, Faculty of Humanities and Social Sciences, University of Kurdistan, Sanandaj, 66177-15175, Iran
| | - Pablo Valdés-Badilla
- Department of Physical Activity Sciences, Faculty of Education Sciences, Universidad Católica del Maule, Talca, 3530000, Chile
- Sports Coach Career, School of Education, Universidad Viña del Mar, Viña del Mar, 2520000, Chile
| | - Tomás García Calvo
- Faculty of Sport Sciences, University of Extremadura, 10003, Cáceres, Spain
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4
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Mulder F, Löwinger D, Jenkinson SP, Kaiser E, Scharf T, Maire M, Duss S, Bassetti C, Heinzer R, Auer R, Meyer-Massetti C. Counselling for Chronic Insomnia in Swiss Pharmacies: A Survey Study Based on Case Vignettes. PHARMACY 2023; 11:105. [PMID: 37368431 DOI: 10.3390/pharmacy11030105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 05/22/2023] [Accepted: 06/12/2023] [Indexed: 06/28/2023] Open
Abstract
(1) Introduction: Chronic insomnia (CI) reduces quality of life and may trigger depression and cardiovascular diseases. The European Sleep Research Society recommends cognitive behavioural therapy (CBT-I) as the first-line treatment. Because a recent study in Switzerland demonstrated that this recommendation was inconsistently followed by primary care physicians, we hypothesised that pharmacists also deviate from these guidelines. The aim of this study is to describe current treatment practices for CI recommended by pharmacists in Switzerland, compare them to guidelines and examine their attitudes towards CBT-I. (2) Methods: A structured survey was sent to all the members of the Swiss Pharmacists Association, containing three clinical vignettes describing typical CI pharmacy clients. Treatments had to be prioritised. The prevalence of CI, and the pharmacists' knowledge and interest in CBT-I were assessed. (3) Results: Of 1523 pharmacies, 123 pharmacists (8%) completed the survey. Despite large variations, valerian (96%), relaxation therapy (94%) and other phytotherapies (85%) were most recommended. Although most pharmacists did not know about CBT-I (72%) and only 10% had recommended it, most were very interested (64%) in education. Missing financial compensation hampers the recommendation of CBT-I. (4) Conclusions: Contrary to existing European guidelines, community pharmacists in Switzerland mostly recommended valerian, relaxation therapy and other phytotherapies for treating CI. This might be connected to the client's expectation of pharmacy services, e.g., medication dispensing. While pharmacists recommend sleep hygiene regularly, most did not know of CBT-I as an overarching concept but were willing to learn. Future studies should test the effects of dedicated training about CI and changes in the financial compensation for counselling for CI in pharmacies.
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Affiliation(s)
- Fanny Mulder
- Institute of Primary Health Care (BIHAM), University of Bern, 3012 Bern, Switzerland
- Graduate School of Health sciences GHS, University of Bern, 3012 Bern, Switzerland
| | - Dimitri Löwinger
- Institute of Primary Health Care (BIHAM), University of Bern, 3012 Bern, Switzerland
| | - Stephen P Jenkinson
- Institute of Primary Health Care (BIHAM), University of Bern, 3012 Bern, Switzerland
| | - Estelle Kaiser
- Institute of Primary Health Care (BIHAM), University of Bern, 3012 Bern, Switzerland
| | - Tamara Scharf
- Institute of Primary Health Care (BIHAM), University of Bern, 3012 Bern, Switzerland
- Graduate School of Health sciences GHS, University of Bern, 3012 Bern, Switzerland
| | - Micheline Maire
- Institute of Primary Health Care (BIHAM), University of Bern, 3012 Bern, Switzerland
- Department of Internal Medicine, Cantonal Hospital of Zug, 6340 Baar, Switzerland
| | - Simone Duss
- Interdisciplinary Sleep-Wake-Epilepsy-Center and Swiss Sleep House Bern, Inselspital-University Hospital of Bern, University of Bern, 3010 Bern, Switzerland
| | - Claudio Bassetti
- Interdisciplinary Sleep-Wake-Epilepsy-Center and Swiss Sleep House Bern, Inselspital-University Hospital of Bern, University of Bern, 3010 Bern, Switzerland
| | - Raphaël Heinzer
- Service for Pneumology and Sleep Research Center (CIRS), Lausanne University Hospital (CHUV), 1011 Lausanne, Switzerland
| | - Reto Auer
- Institute of Primary Health Care (BIHAM), University of Bern, 3012 Bern, Switzerland
- Centre for Primary Care and Public Health (Unisanté), 1011 Lausanne, Switzerland
| | - Carla Meyer-Massetti
- Institute of Primary Health Care (BIHAM), University of Bern, 3012 Bern, Switzerland
- Clinical Pharmacology and Toxicology, Department of General Internal Medicine, Inselspital-University Hospital of Bern, 3010 Bern, Switzerland
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5
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White B, Snyder HS, Patel MVB. Evaluation of Medications Used for Hospitalized Patients With Sleep Disturbances: A Frequency Analysis and Literature Review. J Pharm Pract 2023; 36:126-138. [PMID: 34096384 DOI: 10.1177/08971900211017857] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE Poor sleep during hospitalization is common and implicated in worse patient outcomes. Despite implementation of non-pharmacologic techniques, medications are still frequently required. The study objective is to assess the frequency of new medications administered for sleep in hospitalized patients and to review literature evaluating these drug therapies in the inpatient setting. METHODS This retrospective study included adult inpatients if they received a new medication for sleep during a 5-day period. Patients were excluded if the medication was continued from home or if sleep was not the documented indication. For the literature review, a MEDLINE search was conducted to identify studies pertaining to pharmacotherapy for sleep in hospitalized patients. RESULTS Of 1,968 patient-days reviewed, a medication for sleep was given for 166 patient-days (8.4%) in 78 patients. Melatonin was most commonly received (70.5%), followed by benzodiazepines (9.6%). A review of antihistamines, benzodiazepines, melatonin, quetiapine, trazodone, and Z-drugs (non-benzodiazepine hypnotics) was conducted and 23 studies were included. CONCLUSIONS Despite widespread use of pharmacotherapy for sleep, there is a paucity of data evaluating use in the inpatient setting. Although there is significant heterogeneity among studies, melatonin has the strongest evidence for use and is an attractive option given its lack of adverse reactions and drug interactions. Benzodiazepines and Z-drugs were also frequently utilized; however, their reduced clearance in the elderly and potential for compounded sedative effects should be weighed heavily against potential sleep benefits. Antipsychotic agents cannot be recommended for routine use due to limited data and the potential for significant adverse effects.
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Affiliation(s)
- Brittany White
- Department of Pharmacy, Erlanger Health-System, Chattanooga, TN, USA.,Department of Internal Medicine, The University of Tennessee Health Science Center College of Medicine-Chattanooga, TN, USA
| | - Heather S Snyder
- Department of Pharmacy, Emory University Hospital, Atlanta, GA, USA
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Huang S, Huang Q, Zhou Z, Zhang J, Zhan Y, Liang Z. The Efficacy of V. odorata Extract in the Treatment of Insomnia: A Systematic Review and Meta-Analysis. Front Neurol 2022; 13:730311. [PMID: 35734476 PMCID: PMC9207380 DOI: 10.3389/fneur.2022.730311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 04/28/2022] [Indexed: 11/13/2022] Open
Abstract
Aim This systematic review and meta-analysis was performed to assess the effect of Viola odorata (V. odorata) extract in the treatment of insomnia. Methods PubMed, EMBASE, and Cochrane Library databases, as well as references of related articles, were searched. Finally, four articles with five clinical trials including 224 patients were included in the analysis. Results The obtained results indicated a greater improvement in total PSQI scores (MD,−4.67; P = 0.0002), subjective sleep quality score (MD,−0.91; P = 0.003), sleep duration score (MD,−0.77; P < 0.00001), and ISI score (MD,−6.30; P = 0.009) in the Viola extract group compared with the placebo group. However, the Viola extract group did not significantly differ in sleep latency (MD,−0.85; P = 0.08), habitual sleep efficiency (MD,−0.61; P = 0.21), sleep disturbances (MD,−0.36; P = 0.11), and daytime dysfunction (MD,−0.94; P = 0.12) from the placebo group. Conclusions Viola extract supplement led to a greater improvement in total PSQI scores, subjective sleep quality score, sleep duration score, and ISI score compared with the placebo group of patients with chronic insomnia.
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Affiliation(s)
- Shuangfeng Huang
- The Second Clinical Medical College, Binzhou Medical University, Yantai, China
| | - Qianqian Huang
- Department of Gastroenterology, People's Hospital of Jimo District, Qingdao, China
| | - Zhongbao Zhou
- Beijing TianTan Hospital, Capital Medical University, Beijing, China
| | - Junliang Zhang
- Department of Neurology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Yan Zhan
- Department of Neurology, Yantai Affiliated Hospital of Binzhou Medical University, The Second Clinical Medical College of Binzhou Medical University, Yantai, China
- Yan Zhan
| | - Zhigang Liang
- Department of Neurology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
- *Correspondence: Zhigang Liang
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7
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Kelmanson IA. [Pharmacotherapy of sleep disturbances in pre-school and elementary school children]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:158-164. [PMID: 34184493 DOI: 10.17116/jnevro2021121041158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Sleep disturbance in pre-school and elementary school children is a common clinical situation. These disturbances may require pharmacotherapeutic approaches in certain cases. Major forms of sleep disturbances in children and data on known pharmacotherapeutic means of their treatment are considered.
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Affiliation(s)
- I A Kelmanson
- Institute for Medical Education of the Almazov National Medical Research Center, St. Petersburg, Russia.,St. Petersburg State Institute for Psychology and Social Work, St. Petersburg, Russia
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8
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Use of Nutraceutical Ingredient Combinations in the Management of Tension-Type Headaches with or without Sleep Disorders. Nutrients 2021; 13:nu13051631. [PMID: 34067959 PMCID: PMC8152287 DOI: 10.3390/nu13051631] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 05/09/2021] [Accepted: 05/10/2021] [Indexed: 12/29/2022] Open
Abstract
Headache is the most common pain complaint in the pediatric population, with tension type headache (TTH) having a prevalence of 10–15% in children. Up to 70% of pediatric patients with chronic headache also experience sleep disruption, with a likely bidirectional relationship between headache and poor sleep. Treatment options include specific pharmacological approaches as well as non-pharmacological alternatives; nutraceuticals have the advantage of a relative lack of side effects. Exogenous melatonin has been shown to be useful and safe in improving sleep-wake cycles and quality of sleep in children, helping to regulate the circadian rhythm, with a secondary positive impact on headache. Supplementation with other nutraceutical ingredients, such as tryptophan, magnesium, and B vitamins, can have significant additional effects in children with primary headache, with or without sleep disorders. Tryptophan may reduce night awakenings and improve the efficiency of sleep. Primary headache has been related to low amounts of magnesium in serum, and integration with magnesium appears to be effective in reducing headache attacks without adverse effects. There are different observational reports and uncontrolled studies suggesting a possible synergistic effect for these nutraceuticals, but there is now a need for high-quality randomized controlled trials in order to confirm these positive preliminary findings.
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9
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Bruni O, Ferini-Strambi L, Giacomoni E, Pellegrino P. Herbal Remedies and Their Possible Effect on the GABAergic System and Sleep. Nutrients 2021; 13:nu13020530. [PMID: 33561990 PMCID: PMC7914492 DOI: 10.3390/nu13020530] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 01/29/2021] [Accepted: 02/02/2021] [Indexed: 01/22/2023] Open
Abstract
Sleep is an essential component of physical and emotional well-being, and lack, or disruption, of sleep due to insomnia is a highly prevalent problem. The interest in complementary and alternative medicines for treating or preventing insomnia has increased recently. Centuries-old herbal treatments, popular for their safety and effectiveness, include valerian, passionflower, lemon balm, lavender, and Californian poppy. These herbal medicines have been shown to reduce sleep latency and increase subjective and objective measures of sleep quality. Research into their molecular components revealed that their sedative and sleep-promoting properties rely on interactions with various neurotransmitter systems in the brain. Gamma-aminobutyric acid (GABA) is an inhibitory neurotransmitter that plays a major role in controlling different vigilance states. GABA receptors are the targets of many pharmacological treatments for insomnia, such as benzodiazepines. Here, we perform a systematic analysis of studies assessing the mechanisms of action of various herbal medicines on different subtypes of GABA receptors in the context of sleep control. Currently available evidence suggests that herbal extracts may exert some of their hypnotic and anxiolytic activity through interacting with GABA receptors and modulating GABAergic signaling in the brain, but their mechanism of action in the treatment of insomnia is not completely understood.
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Affiliation(s)
- Oliviero Bruni
- Department of Developmental and Social Psychology, Sapienza University, 00185 Rome, Italy
- Correspondence: ; Tel.: +39-33-5607-8964; Fax: +39-06-3377-5941
| | - Luigi Ferini-Strambi
- Department of Neurology, Ospedale San Raffaele Turro, 20127 Milan, Italy;
- Sleep Disorders Center, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Elena Giacomoni
- Department of Medical Affairs, Sanofi Consumer HealthCare, 20158 Milan, Italy; (E.G.); (P.P.)
| | - Paolo Pellegrino
- Department of Medical Affairs, Sanofi Consumer HealthCare, 20158 Milan, Italy; (E.G.); (P.P.)
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10
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Abstract
Pediatric insomnia can affect physical and mental health and cause cognitive deficits, social deficits and decrease quality of life. There are no Food and Drug Administration approved medications approved for pediatric insomnia. Pharmacologic interventions derive mostly from adult data or pediatric case reports. This review focuses on Food and Drug Administration approved prescription drugs (in adults), over-the-counter drugs, and off-label pediatric insomnia drugs. This review helps the clinician learn general principles, practice guidelines, and pharmacologic considerations for medication selection in the pediatric population. Pharmacologic management should be considered in combination with behavior therapy, which is proven to have long-lasting outcomes.
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Affiliation(s)
- Vijayabharathi Ekambaram
- Department of Psychiatry, Touro University, Touro University Medical Group, 1805 North California Street, Suite 201, Stockton, CA 95204, USA.
| | - Judith Owens
- Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
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11
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Kelmanson IA. [Pharmacotherapy of sleep disturbances in pre-school and elementary school children]. Zh Nevrol Psikhiatr Im S S Korsakova 2020; 120:55-61. [PMID: 33076646 DOI: 10.17116/jnevro202012009255] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Sleep disturbance in pre-school and elementary school children is a common clinical situation. These disturbances may require pharmacotherapeutic approaches in certain cases. Major forms of sleep disturbances in children and data on known pharmacotherapeutic means of their corrections are considered.
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Affiliation(s)
- I A Kelmanson
- Institute for Medical Education Almazov National Medical Research Centre, St. Petersburg, Russia.,Saint-Petersburg State Institute for Psychology and Social Work, St. Petersburg, Russia
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12
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Low energy intake and dietary quality are associated with low objective sleep quality in young Japanese women. Nutr Res 2020; 80:44-54. [PMID: 32682178 DOI: 10.1016/j.nutres.2020.06.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 04/28/2020] [Accepted: 06/01/2020] [Indexed: 11/23/2022]
Abstract
Literature reports suggest that subjective sleep quality is associated with nutrient intake in elderly people and workers. However, few studies have suggested an association between objective sleep quality and dietary intake in adolescents and young women. We hypothesized that objective sleep quality is associated with dietary intake in adolescents and young women. We evaluated the association between energy and nutrient intake and objective sleep quality in adolescents and young Japanese women. In a cross-sectional study of 80 women aged 18-27 years, dietary intake was assessed using the self-administered diet history questionnaire. Objective sleep quality was assessed by actigraphy. Lifestyle characteristics, dietary habits, and mental health were assessed using specific questionnaires. Subjects were classified into 3 groups according to sleep efficiency (SE <80%, 80%-85%, and ≥85%), and the relationships between dietary intake and objective sleep quality were statistically evaluated. No significant differences occurred in lifestyle characteristics, physical activity levels, eating behavior, and mental health status among the 3 SE groups. Energy intake was significantly lower in the low-SE group than in the middle- (P = .004) and high- (P = .015) SE groups. Protein intake was significantly lower in the low-SE group than in the high-SE group (P = .034). The mean energy-adjusted intakes of vitamin K, vitamin B2, potassium, magnesium, iron, zinc, copper, and tryptophan were significantly lower in the low-SE group than in the high-SE group. Adequate energy intake and a high-quality diet including vitamins, minerals, and tryptophan may result in high sleep quality and help prevent sleep problems.
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Esposito D, Belli A, Ferri R, Bruni O. Sleeping without Prescription: Management of Sleep Disorders in Children with Autism with Non-Pharmacological Interventions and Over-the-Counter Treatments. Brain Sci 2020; 10:brainsci10070441. [PMID: 32664572 PMCID: PMC7407189 DOI: 10.3390/brainsci10070441] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/07/2020] [Accepted: 07/09/2020] [Indexed: 12/18/2022] Open
Abstract
Autism Spectrum Disorders (ASD) are lifelong neurodevelopmental conditions characterized by abnormal social interaction, communication, and behavior. Sleep disturbances represent a common comorbidity in children and adolescents with ASD, with prevalence ranging from 50 to 80%. It has been proved that sleep disruption worsens the symptoms of autism and results in challenging behaviors. Improving sleep should therefore be a primary therapeutic goal. Treatment options range from lifestyle modifications to pharmacological therapy. Several reviews have been written on pharmacological treatments, but very few on the beneficial effects of non-pharmacological interventions, over-the-counter drugs, and nutritional supplements. This study consists of a narrative review of the literature, presenting the available evidence on the following treatments: sleep education, behavioral interventions, complementary and alternative medicine (special mattresses and blankets, massage, aromatherapy, yoga, physical activity), and commonly used over-the-counter medications and supplements (antihistamines, melatonin, tryptophan, carnosine, iron, vitamins, and herbal remedies). For some treatments—such as melatonin and behavioral interventions—effectiveness in ASD is well established in the literature, while other interventions appear of benefit in clinical practice, even if specific studies in children and adolescents with ASD are lacking. Conversely, other treatments only seem to show anecdotal evidence supporting their use.
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Affiliation(s)
- Dario Esposito
- Child Neurology and Psychiatry Unit, Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (D.E.); (A.B.)
| | - Arianna Belli
- Child Neurology and Psychiatry Unit, Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy; (D.E.); (A.B.)
| | - Raffaele Ferri
- Sleep Research Centre, Oasi Research Institute–IRCCS, 94018 Troina, Italy;
| | - Oliviero Bruni
- Department of Developmental and Social Psychology, Sapienza University of Rome, 00185 Rome, Italy
- Correspondence:
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14
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Plant Extracts for Sleep Disturbances: A Systematic Review. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:3792390. [PMID: 32382286 PMCID: PMC7191368 DOI: 10.1155/2020/3792390] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 03/06/2020] [Accepted: 03/31/2020] [Indexed: 12/26/2022]
Abstract
Background Sleep complaints are common health issues in the general population. These conditions are associated with poorer physical and psychological activity, and they may have important social, economic, and personal consequences. In the last years, several food supplements with different plant extracts have been developed and are currently taken for improving sleep. Study Objectives. The aim of this study is to systematically review recent literature on oral plant extracts acting on sleep disorders distinguishing their action on the different symptoms of sleep complaints: difficulty in initiating or maintaining sleep, waking up too early, and quality of sleep. Methods We searched the PubMed database up to 05/03/2020 based on data from randomized, double-blind, placebo-controlled trials, noncontrolled trials, and cohort studies conducted in children and adult subjects. The search words used contained the following terms: oral food supplement and sleep disorders and the like. The most studied compounds were further analyzed with a second search using the following terms: name of the compound and sleep disorders. We selected 7 emerging compounds and 38 relevant reports. Results Although nutraceutical natural products have been used for sleep empirically, there is a scarcity of evidence on the efficacy of each product in clinical studies. Valerian and lavender were the most frequently studied plant extracts, and their use has been associated (with conflicting results) with anxiolytic effects and improvements in quality and duration of sleep. Conclusions Sleep aids based on plant extracts are generally safe and well tolerated by the population. More high-quality research is needed to confirm the effectiveness of food supplements containing plant extracts in sleep complaints; in particular, it would be interesting to evaluate the association between plant extracts and sleep hygiene guidelines and to identify the optimal products to be used in a specific symptom of sleep complaint, giving more appropriate tools to the medical doctor.
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Zhang L, Tang Y, Hui R, Zheng H, Deng Y, Shi Y, Xiao X, Zheng Q, Zhou S, Yu S, Cao W, Liu Y, Hu Y, Li Y. The effects of active acupuncture and placebo acupuncture on insomnia patients: a randomized controlled trial. PSYCHOL HEALTH MED 2020; 25:1201-1215. [PMID: 32167794 DOI: 10.1080/13548506.2020.1738015] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The purpose of this study was to observe and compare the clinical efficacy of active acupuncture and placebo acupuncture in the treatment of insomnia and mood disorders. 96 patients with insomnia in Chengdu were randomly divided into two groups (1:1). The active acupuncture group (AA group n = 48) received the tube of Park sham device with deep needle insertion. The placebo acupuncture group (PA group n = 48) received the tube of Park sham device with a retractable needle shaft and a blunt tip. The same acupuncture points and treatment cycles were used in both groups. The overall score for the Pittsburgh Sleep Quality Index (PSQI) is the primary outcome. Secondary outcomes recorded sleep rate, self-reported depression scale (SDS), self-assessment anxiety scale (SAS), the 'six component' scores of PSQI, and 'Deqi' scale scores. Eventually, 90 patients completed the study. After 2 weeks of treatment, the total score of PSQI in the AA group was 4.6 ± 2.4 and in the PA group was 12.9 ± 1.8 (ES = 3.91, p < .1). The SAS, SDS score in the AA group were 39.9 ± 5.6/39.9 ± 5.9 and in the PA group were 59.7 ± 6.1/61.2 ± 4.4 (ES = 3.38/4.9, p < .1). The sleep rate were 93.8% and 25.0% (p < .1). During the 1 month follow-up period, the PSQI total score in the AA group (5.2 ± 1.9) was superior to the PA group (13.1 ± 1.8) (ES = 4.27, p < .1). The SAS, SDS score in the AA group were 40.4 ± 5.1/42.7 ± 6.6 and in the PA group were 63.7 ± 6.6/63.5 ± 4.8 (ES = 3.95/3.60, p < .1). Throughout the study period, the 'six component' scores of PSQI in the AA group was superior to the PA group (each p < .1). Except for tingling and cooling, other acupuncture sensations were significant differences (each p < .1). Compared to the placebo acupuncture, active acupuncture can significantly improve insomnia, and clinical efficacy is maintained for at least 6 weeks.
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Affiliation(s)
- Leixiao Zhang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine , Chengdu, China
| | - Yu Tang
- Department of Traditional Chinese Medicine Rehabilitation, Chongqing Emergency Medical Center , Chongqing, China
| | - Ruting Hui
- Rehabilitation Department, Chengdu First People's Hospital , Chengdu, China
| | - Hui Zheng
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine , Chengdu, China
| | - Yanli Deng
- Nephropathy Department, Sichuan Second Chinese Medicine Hospital , Chengdu, China
| | - Yunzhou Shi
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine , Chengdu, China
| | - Xianjun Xiao
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine , Chengdu, China.,Rehabilitation Department, The People's Hospital of Jianyang City , Jianyang, China
| | - Qianhua Zheng
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine , Chengdu, China
| | - Siyuan Zhou
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine , Chengdu, China
| | - Siyi Yu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine , Chengdu, China
| | - Wei Cao
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine , Chengdu, China
| | - Yin Liu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine , Chengdu, China
| | - Youping Hu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine , Chengdu, China
| | - Ying Li
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine , Chengdu, China
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Shayesteh M, Vaez-Mahdavi MR, Shams J, Kamalinejad M, Faghihzadeh S, Gholami-Fesharaki M, Gharebaghi R, Heidary F. Effects of Viola odorata as an Add-On Therapy on Insomnia in Patients with Obsession or Depression: A Pilot Randomized Double-Blind Placebo-Controlled Trial. J Altern Complement Med 2020; 26:398-408. [PMID: 32073874 DOI: 10.1089/acm.2019.0254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: The present study was conducted to investigate the effect of Viola odorata extracted syrup on the quality and patterns of sleep in patients with depression or obsessive-compulsive disorder (OCD) as add-on therapy. Design: A pilot double-blind randomized placebo-controlled trial. Settings/Location: Psychiatric Clinic of Imam Hossein Hospital, Tehran, Iran. Subjects: Participants were 16-15 years of age with mild and moderate depression or OCD having insomnia. Interventions: This pilot study was conducted on patients with insomnia divided into two groups with depression (40 patients) or OCD (43 patients). Each group randomly assigned into two arms with the same conditions at baseline. The intervention arm daily received 5 mL V. odorata syrup every 12 h for 4 weeks, and the control arm received 5 mL placebo syrup every 12 h for 4 weeks. None of the participants was deprived of their routine treatment for depression or OCD. Outcome measures: The scores of insomnia symptoms were evaluated using total score of the Pittsburgh Sleep Quality Index (PSQI) and the scores of its components, the depression score using the final Beck depression inventory-II (BDI-II) score, and OCD score using the Yale-Brown Obsessive-Compulsive Scale (YBOCS). Results: The total PSQI score was found to be improved significantly in the intervention arms with depression or OCD (p < 0.001) compared with the corresponding control arms. Significant improvements were also observed in the final mean difference of BDI-II (p = 0.009) and YBOCS (p = 0.001) scores in the intervention arms. Conclusions: V. odorata syrup significantly improved insomnia symptoms and the scores of depression and OCD.
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Affiliation(s)
- Maryam Shayesteh
- Department of Traditional Medicine, Faculty of Medicine, Shahed University, Tehran, Iran
| | | | - Jamal Shams
- Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Kamalinejad
- School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soghrat Faghihzadeh
- Department of Biostatistics and Epidemiology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | | | - Reza Gharebaghi
- International Virtual Ophthalmic Research Center, Tehran, Iran
| | - Fatemeh Heidary
- Immunoregulation Research Center, Shahed University, Tehran, Iran
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Sanlier N, Sabuncular G. Relationship between nutrition and sleep quality, focusing on the melatonin biosynthesis. Sleep Biol Rhythms 2020. [DOI: 10.1007/s41105-020-00256-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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18
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Association of Sleep Quality and Macronutrient Distribution: A Systematic Review and Meta-Regression. Nutrients 2020; 12:nu12010126. [PMID: 31906452 PMCID: PMC7019667 DOI: 10.3390/nu12010126] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 12/26/2019] [Accepted: 12/29/2019] [Indexed: 12/13/2022] Open
Abstract
Sleep is involved in metabolic, emotional and cognitive regulation and is therefore an essential part of our health. Although an association between sleep quality and macronutrient intake has been reported, studies on the effect of macronutrient distribution with sleep quality are limited, and available results are inconsistent. In this study, we aim to assess the association between sleep quality and macronutrient distribution in healthy adults from systematically reviewed cross-sectional studies and randomized controlled trials (RCTs). A total of 19 relevant articles were selected and it was observed that good sleepers (sleep duration ≥ 7 h, global sleep score ≤ 5, sleep latency ≤ 30 min and sleep efficiency >85%) had a higher energy distribution from dietary protein than poor sleepers. On the other hand, good sleepers showed a relatively lower percentage of energy from dietary carbohydrate and fat than poor sleepers. However, meta-regression analysis revealed no dose-dependent association between the macronutrient distributions and sleep duration. These results suggest that consuming a greater proportion of dietary protein may benefit on improving sleep quality in healthy adults. However, findings may be susceptible to reverse causality and additional RCTs are needed.
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Bobe JR, De Freitas JK, Glicksberg BS. Exploring the Potential for Collaborative Use of an App-Based Platform for n-of-1 Trials Among Healthcare Professionals That Treat Patients With Insomnia. Front Psychiatry 2020; 11:530995. [PMID: 33101072 PMCID: PMC7498693 DOI: 10.3389/fpsyt.2020.530995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 08/17/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND N-of-1 trials are single patient, multiple crossover, and comparative effectiveness experiments. Despite their rating as "level 1" evidence, they are not routinely used in clinical medicine to evaluate the effectiveness of treatments. OBJECTIVE We explored the potential for implementing a mobile app-based n-of-1 trial platform for collaborative use by clinicians and patients to support data-driven decisions around the treatment of insomnia. METHODS A survey assessing awareness and utilization of n-of-1 trials was administered to healthcare professionals that frequently treat patients with insomnia at the Icahn School of Medicine at Mount Sinai in New York City. RESULTS A total of 45 healthcare professionals completed the survey and were included in the analysis. We found that 64% (29/45) of healthcare professionals surveyed had not heard of n-of-1 trials. After a brief description of these methods, 75% (30/40) of healthcare professionals reported that they are likely or highly likely to use an app-based n-of-1 trial at least once in the next year if the service were free and easy to offer to their patients. CONCLUSIONS An app-based n-of-1 trials platform might be a valuable tool for clinicians and patients to identify the best treatments for insomnia. The lack of awareness of n-of-1 trials coupled with receptivity to their use suggests that educational interventions may address a current barrier to wider utilization of n-of-1 trials.
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Affiliation(s)
- Jason R Bobe
- Department of Genetic and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Jessica K De Freitas
- Department of Genetic and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States.,Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Benjamin S Glicksberg
- Department of Genetic and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States.,Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Bruni O, Angriman M, Melegari MG, Ferri R. Pharmacotherapeutic management of sleep disorders in children with neurodevelopmental disorders. Expert Opin Pharmacother 2019; 20:2257-2271. [DOI: 10.1080/14656566.2019.1674283] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Oliviero Bruni
- Department of Developmental and Social Psychology, Sapienza University, Rome, Italy
| | - Marco Angriman
- Department of Pediatrics, Child Neurology and Neurorehabilitation Unit, Central Hospital of Bolzano, Bolzano, Italy
| | | | - Raffaele Ferri
- Sleep Research Centre; Department of Neurology I.C., Oasi Institute for Research on Mental Retardation and Brain Aging (IRCCS), Troina, Italy
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21
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Sedative and hypnotic effects of Vaccinium bracteatum Thunb. through the regulation of serotonegic and GABAA-ergic systems: Involvement of 5-HT1A receptor agonistic activity. Biomed Pharmacother 2019; 109:2218-2227. [DOI: 10.1016/j.biopha.2018.10.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 10/01/2018] [Accepted: 10/02/2018] [Indexed: 01/04/2023] Open
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22
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Lui MFG, Chow HKD, Wong WMK, Tsang WNW. Melatonin Affects Postural Control in Community-Dwelling Older Adults While Dual Tasking: A Randomized Observation Study. J Aging Phys Act 2018; 27:1-6. [PMID: 29809094 DOI: 10.1123/japa.2017-0312] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The effects of a single 3-mg dose of melatonin on the postural control and cognitive performance of community-dwelling older adults were documented. The testing involved stepping down while performing a cognitive task (a Stroop test). Thirty-four older adults were recruited. Immediately before and 1 hr after taking a dose of melatonin, they completed a single-leg standing task after stepping down with and without a simultaneous Stroop test, and a double-leg standing task. The findings indicated a statistically significant increase in sway area under the dual-tasking condition after taking melatonin (p = .04) and the double-leg standing task (p = .018). However, cognitive performance per se was not affected by the melatonin. Melatonin impairs postural control in older adults but not cognitive performance.
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Hein M, Senterre C, Lanquart JP, Montana X, Loas G, Linkowski P, Hubain P. Hyperarousal during sleep in untreated primary insomnia sufferers: A polysomnographic study. Psychiatry Res 2017; 253:71-78. [PMID: 28364590 DOI: 10.1016/j.psychres.2017.03.045] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 03/22/2017] [Accepted: 03/22/2017] [Indexed: 01/28/2023]
Abstract
Because some evidence favors the hyperarousal model of insomnia, we sought to learn more about the dynamics of this phenomenon during sleep. Polysomnographic data from 30 normative subjects and 86 untreated primary insomnia sufferers recruited from the database of the sleep laboratory were studied for whole nights and in terms of thirds of the night. Untreated primary insomnia sufferers had an increased sleep latency and excess of WASO, together with a deficit in REM and NREM sleep during the entire night. In terms of thirds of the night, they presented a major excess of WASO during the first and last thirds of the night but an excess of lesser importance during the middle third. A deficit in SWS was found during the first third of the night, but for REM, the deficit was present during both the first and last thirds. Primary insomnia sufferers had no SWS or REM deficit during the second third of the night. We found that the hyperarousal phenomenon occurs mainly during the sleep-onset period of the first and last thirds of the night and is less important during the middle third. These results open new avenues for understanding the pathophysiology of primary insomnia.
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Affiliation(s)
- Matthieu Hein
- Erasme Hospital, Free University of Brussels, Department of Psychiatry and Sleep Laboratory, Brussels, Belgium.
| | - Christelle Senterre
- School of Public Health SPU-ESP, Free University of Brussels, Department of Biostatistics, Brussels, Belgium
| | - Jean-Pol Lanquart
- Erasme Hospital, Free University of Brussels, Department of Psychiatry and Sleep Laboratory, Brussels, Belgium
| | - Xavier Montana
- Erasme Hospital, Free University of Brussels, Department of Psychiatry and Sleep Laboratory, Brussels, Belgium
| | - Gwénolé Loas
- Erasme Hospital, Free University of Brussels, Department of Psychiatry and Sleep Laboratory, Brussels, Belgium
| | - Paul Linkowski
- Erasme Hospital, Free University of Brussels, Department of Psychiatry and Sleep Laboratory, Brussels, Belgium
| | - Philippe Hubain
- Erasme Hospital, Free University of Brussels, Department of Psychiatry and Sleep Laboratory, Brussels, Belgium
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Dietary Patterns and Insomnia Symptoms in Chinese Adults: The China Kadoorie Biobank. Nutrients 2017; 9:nu9030232. [PMID: 28335373 PMCID: PMC5372895 DOI: 10.3390/nu9030232] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 03/01/2017] [Accepted: 03/02/2017] [Indexed: 02/07/2023] Open
Abstract
Limited attention has been paid to the effect of dietary patterns on sleep problems. In the present study, we analyzed the cross-sectional data of 481,242 adults aged 30-79 years from the China Kadoorie Biobank. A laptop-based questionnaire was administered to collect information on food intakes and insomnia symptoms. Logistic regression was used to estimate the odds ratios of each insomnia symptom according to quartiles of each dietary pattern, with adjustment for potential confounders. Two major dietary patterns were derived by factor analysis. The traditional northern dietary pattern was characterized by high intakes of wheat and other staple food, whereas the modern dietary pattern was characterized by high intakes of meat, poultry, fish, eggs, fresh fruit, and dairy products. Both dietary patterns were associated with a decreased prevalence of insomnia symptoms (p for trend < 0.001); after adjustment for potential confounders, individuals who had the highest quartile score of traditional northern dietary pattern were 12%-19% less likely to have insomnia symptoms compared to those in the lowest quartile (odds ratio: 0.81-0.88), and the corresponding values for the modern dietary pattern were 0.89-1.01. Furthermore, interactions of these two dietary patterns on insomnia symptoms were observed. Further prospective studies are needed to elucidate the relationship between diet and insomnia.
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25
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Gammoh OS, Al-Smadi A, Turjman C, Mukattash T, Kdour M. Valerian: An underestimated anxiolytic in the community pharmacy? J Herb Med 2016. [DOI: 10.1016/j.hermed.2016.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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26
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Melatonin-rich milk fortified with alpha s1 casein tryptic hydrolysate improves primary insomnia: a randomized placebo controlled trial. Sleep Biol Rhythms 2016. [DOI: 10.1007/s41105-016-0063-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Shah FK, Na SS, Chong MS, Woo JH, Kwon YO, Lee MK, Oh KW. Poria cocos ethanol extract and its active constituent, pachymic acid, modulate sleep architectures via activation of GABAA-ergic transmission in rats. J Biomed Res 2015. [DOI: 10.12729/jbr.2015.16.3.084] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Dietary patterns and sleep symptoms in Japanese workers: the Furukawa Nutrition and Health Study. Sleep Med 2015; 16:298-304. [DOI: 10.1016/j.sleep.2014.09.017] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Revised: 09/03/2014] [Accepted: 09/10/2014] [Indexed: 01/08/2023]
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30
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Feyzabadi Z, Jafari F, Kamali SH, Ashayeri H, Badiee Aval S, Esfahani MM, Sadeghpour O. Efficacy of Viola odorata in Treatment of Chronic Insomnia. IRANIAN RED CRESCENT MEDICAL JOURNAL 2014; 16:e17511. [PMID: 25763239 PMCID: PMC4341349 DOI: 10.5812/ircmj.17511] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 01/26/2014] [Accepted: 02/08/2014] [Indexed: 12/02/2022]
Abstract
Background: Insomnia is the most common sleep disorder that reduces quality of life. Objectives: Due to side effects of hypnotic drug and the increasing demand for alternative medicine substitutes, violet oil (VO) was used in this study. VO is a known medication in Iranian traditional medicine that induces sleep in insomniac patients. Patients and Methods: This study was conducted as an experimental pretest-posttest evaluation on VO efficacy in 50 patients with chronic insomnia in Iranian Traditional Medicine Clinic of Mashhad University of Medical Sciences, Mashhad, Iran. Treatment consisted of intranasal drop of VO, two drops containing 66 mg of VO in each nostril nightly before sleeping for one month. All patients were asked to complete an Insomnia Severity Index (ISI) questionnaire before the start of the trial and after one month of treatment. Results: Improvements in sleep and ISI scores were significantly greater in patients after a month receiving VO drop in comparison with before starting treatment (P < 0.05). A few patients reported some complications about VO consumption, most of which were mild and no serious adverse event was encountered. Conclusions: VO can be presented as a safe, well-tolerated, and effective herbal preparation in patients with chronic insomnia.
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Affiliation(s)
- Zohre Feyzabadi
- Department of Iranian Traditional Medicine, Shahed University, Tehran, Iran
| | - Farhad Jafari
- Department of Health and Social Medicine, Shahed University, Tehran, Iran
- Corresponding Author: Farhad Jafari, Department of Health and Social Medicine, Shahed University, P. O. Box: 141563111, Tehran, Iran. Tel: +98-2188963849, Fax: +98-21-88946253, E-mail:
| | - Seyed Hamid Kamali
- The School of Iranian Traditional Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Hassan Ashayeri
- Department of Neurosciences, Iran University of Medical Sciences, Tehran, Iran
| | - Shapour Badiee Aval
- Complementary and Traditional Medicine Faculty, Mashhad University of Medical sciences, Mashhad, Iran
| | - Mohammad Mahdi Esfahani
- Quran, Hadith and Medicine Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Omid Sadeghpour
- Department of Herbal and Traditional Medicine, Research Institute of Islamic and Complementary Medicine, Iran University of Medical Sciences, Tehran, Iran
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Cho S, Yoon M, Pae AN, Jin YH, Cho NC, Takata Y, Urade Y, Kim S, Kim JS, Yang H, Kim J, Kim J, Han JK, Shimizu M, Huang ZL. Marine polyphenol phlorotannins promote non-rapid eye movement sleep in mice via the benzodiazepine site of the GABAA receptor. Psychopharmacology (Berl) 2014; 231:2825-37. [PMID: 24488362 DOI: 10.1007/s00213-014-3445-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 01/08/2014] [Indexed: 10/25/2022]
Abstract
RATIONALE In psychopharmacology, researchers have been interested in the hypnotic effects of terrestrial plant polyphenols and their synthetic derivatives. Phlorotannins, a marine plant polyphenol, could have potential as a source of novel hypnotic drugs. OBJECTIVES The effects of phlorotannins and major phlorotannin constituent eckstolonol on sleep-wake profiles in mice were evaluated in comparison with diazepam, and their hypnotic mechanism was also investigated. METHODS The effects of phlorotannin preparation (PRT) and eckstolonol orally given on sleep-wake profiles were measured by recording electroencephalograms (EEG) and electromyograms in C57BL/6N mice. Flumazenil, a GABAA-benzodiazepine (BZD) receptor antagonist, was injected 15 min before PRT and eckstolonol to reveal its hypnotic mechanism. RESULTS PRT administration (>250 mg/kg) produced a significant decrease in sleep latency and an increase in the amount of non-rapid eye movement sleep (NREMS). Eckstolonol significantly decreased sleep latency (>12.5 mg/kg) and increased the amount of NREMS (50 mg/kg). PRT and eckstolonol had no effect on EEG power density of NREMS. The hypnotic effects of PRT or eckstolonol were completely abolished by pretreatment with flumazenil. CONCLUSIONS We demonstrated that phlorotannins promote NREMS by modulating the BZD site of the GABAA receptor. These results suggest that phlorotannins can be potentially used as an herbal medicine for insomnia and as a promising structure for developing novel sedative-hypnotics.
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Affiliation(s)
- Suengmok Cho
- Korea Food Research Institute, Sungnam, 463-746, Republic of Korea
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Roussin A, Bouyssi A, Pouché L, Pourcel L, Lapeyre-Mestre M. Misuse and dependence on non-prescription codeine analgesics or sedative H1 antihistamines by adults: a cross-sectional investigation in France. PLoS One 2013; 8:e76499. [PMID: 24098516 PMCID: PMC3789666 DOI: 10.1371/journal.pone.0076499] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Accepted: 08/28/2013] [Indexed: 11/22/2022] Open
Abstract
Background Given the growing worldwide market of non-prescription drugs, monitoring their misuse in the context of self-medication represents a particular challenge in Public Health. The aim of this study was to investigate the prevalence of misuse, abuse, and dependence on non-prescription psychoactive drugs. Method During one month, in randomly solicited community pharmacies, an anonymous questionnaire was offered to adults requesting paracetamol (control group), codeine combined with paracetamol in analgesics, or sedative H1 antihistamines. Responses about misuse (drug use not in agreement with the Patient Information Leaflet) abuse (excessive drug use having detrimental consequences), and dependence (established according to questions adapted from the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition criteria) on psychoactive drugs were compared to those of the paracetamol control group. Results 295 patients (mean age 48.5 years, 68.5% of women) having used one of the studied drugs during the previous month were included. Misuse and dependence to codeine analgesics concerned 6.8% and 17.8% of the patients exposed to these drugs, respectively, (n = 118), which was significantly higher than for paracetamol. 19.5% had used codeine analgesics daily for more than six months. Headache was the most frequent reason for persistent daily use. A high prevalence of persistent daily users of sedative H1 antihistamines was also observed. Whereas these drugs are recommended only for short treatment courses of occasional insomnia, 72.2% of the participants having taken doxylamine (n = 36) were daily users, predominantly for more than six months. Conclusions Results on misuse and dependence on non-prescription codeine analgesics suggest that chronic pain, in particular chronic cephalalgia, requires better medical care. In addition, as for hypnotics on prescription, persistent use of doxylamine for self-medication is not justified until an acceptable benefit-risk ratio for chronic sleep disturbance is shown by clinical data.
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Affiliation(s)
- Anne Roussin
- Equipe de Pharmacoépidémiologie, UMR1027 INSERM- Université de Toulouse III, Toulouse, France ; Centre d'Evaluation et d'Information sur la Pharmacodépendance (Addictovigilance Centre), Service de Pharmacologie Clinique, Hôpitaux de Toulouse, Toulouse, France
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Proctor A, Bianchi MT. Clinical pharmacology in sleep medicine. ISRN PHARMACOLOGY 2012; 2012:914168. [PMID: 23213564 PMCID: PMC3504423 DOI: 10.5402/2012/914168] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Accepted: 06/07/2012] [Indexed: 11/23/2022]
Abstract
The basic treatment goals of pharmacological therapies in sleep medicine are to improve waking function by either improving sleep or by increasing energy during wakefulness. Stimulants to improve waking function include amphetamine derivatives, modafinil, and caffeine. Sleep aids encompass several classes, from benzodiazepine hypnotics to over-the-counter antihistamines. Other medications used in sleep medicine include those initially used in other disorders, such as epilepsy, Parkinson's disease, and psychiatric disorders. As these medications are prescribed or encountered by providers in diverse fields of medicine, it is important to recognize the distribution of adverse effects, drug interaction profiles, metabolism, and cytochrome substrate activity. In this paper, we review the pharmacological armamentarium in the field of sleep medicine to provide a framework for risk-benefit considerations in clinical practice.
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Affiliation(s)
- Ashley Proctor
- Sleep Division, Neurology Department, Massachusetts General Hospital, Wang 720, Boston, MA 02114, USA
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McCarthy CG, Alleman RJ, Bell ZW, Bloomer RJ. A dietary supplement containing chlorophytum borivilianum and velvet bean improves sleep quality in men and women. INTEGRATIVE MEDICINE INSIGHTS 2012; 7:7-14. [PMID: 22778558 PMCID: PMC3388003 DOI: 10.4137/imi.s9720] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Impaired sleep quality is commonplace within industrialized societies, as evidenced by the increasing number of prescription sleep aids available. Certain herbal preparations have been suggested to provide a natural benefit to sleep; however, limited controlled data are available documenting this benefit. In the present study we tested the effect of an experimental dietary supplement, containing the active ingredients Chlorophytum borivilianum and Velvet bean, on sleep quality using the Pittsburgh Sleep Quality Index (PSQI). METHODS Eighteen healthy and active men and women, with evidence of impaired sleep quality, consumed the supplement daily for 28 days. The PSQI was administered before and after the intervention period. As indicators of safety, resting heart rate and blood pressure were measured, and a complete blood count, comprehensive metabolic panel, and lipid panel were determined. RESULTS Sleep quality was influenced by the supplement, as evidenced by an improvement in every category of the PSQI questionnaire (P < 0.05), with most category scores improving approximately 50% from pre to post intervention. No adverse outcomes were noted with use of the supplement, as indicated by no change in resting heart rate, blood pressure, or any bloodborne parameter. CONCLUSIONS An investigational dietary supplement containing the active ingredients Chlorophytum borivilianum and Velvet bean improves sleep quality in men and women. Additional placebo controlled trials are needed to corroborate these findings in individuals with self-reported sleeping difficulty.
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Affiliation(s)
- Cameron G McCarthy
- Cardiorespiratory/Metabolic Laboratory, Department of Health and Sport Sciences, University of Memphis, Memphis, TN, USA
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Antoniades J, Jones K, Hassed C, Piterman L. Sleep…Naturally: A Review of the Efficacy of Herbal Remedies for Managing Insomnia. ACTA ACUST UNITED AC 2012. [DOI: 10.1089/act.2012.18310] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
| | | | - Craig Hassed
- A senior lecturer in the department of general practice at Monash University, in Notting Hill, Victoria Australia
| | - Leon Piterman
- The pro vice-chancellor, at Monash University, in Berwick and Peninsula, Victoria Australia
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Sleep America: managing the crisis of adult chronic insomnia and associated conditions. J Affect Disord 2012; 138:192-212. [PMID: 21652083 DOI: 10.1016/j.jad.2011.05.014] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2011] [Revised: 04/22/2011] [Accepted: 05/09/2011] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Chronic insomnia, a public health crisis affecting 10-15% of the U.S. population and costing billions of dollars annually, typically presents with one or more comorbid psychiatric or organic conditions. Historical classification of chronic insomnia as "secondary" to a presenting comorbid condition has resulted in under-recognition and under-treatment of both the insomnia and comorbid condition(s). Though critical in any model of comorbid disease management, chronic insomnia receives little, if any, public policy attention. METHOD We conducted a systematic review of recent empirical studies, review papers, books, government documents, press releases, advertisements, and articles pertaining to the classification, epidemiology, treatment, and physiology of sleep, insomnia, and comorbid conditions. Data were located primarily through MEDLINE, PsycINFO, SCOPUS, and PUBMED databases. OBJECTIVE AND RESULTS Our goal was to provide an overview of the systems for classifying insomnia and available epidemiological data, and to review theoretical models regarding the etiology and maintaining factors of chronic insomnia along with research on the complex, bidirectional associations between chronic insomnia and various affective (and other) conditions. CONCLUSIONS After thorough review of the literature, we propose several public policy measures as an initial step in managing chronic insomnia in the United States. These include introducing a nation-wide multi-modal educational and awareness campaign titled "Sleep America;" increasing the availability and demand for behavioral sleep medicine - the initially preferred treatment approach; and increasing the use of monitoring and enforcement activities by regulatory authorities to curtail false and misleading claims by sponsors of supplements or treatments for insomnia. Through the adoption of such measures, we hope to galvanize a national interest in healthy sleep and the evidence-based treatment of chronic insomnia.
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Peuhkuri K, Sihvola N, Korpela R. Diet promotes sleep duration and quality. Nutr Res 2012; 32:309-19. [PMID: 22652369 DOI: 10.1016/j.nutres.2012.03.009] [Citation(s) in RCA: 268] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Revised: 03/13/2012] [Accepted: 03/20/2012] [Indexed: 12/12/2022]
Abstract
Sleep, much like eating, is an essential part of life. The mechanisms of sleep are only partially clear and are the subject of intense research. There is increasing evidence showing that sleep has an influence on dietary choices. Both cross-sectional and epidemiologic studies have demonstrated that those who sleep less are more likely to consume energy-rich foods (such as fats or refined carbohydrates), to consume fewer portions of vegetables, and to have more irregular meal patterns. In this narrative review, we pose the opposite question: can ingested food affect sleep? The purpose of this review is to discuss the evidence linking diet and sleep and to determine whether what we eat and what kind of nutrients we obtain from the food consumed before bedtime matter. In addition, scientific evidence behind traditional sleep-promoting foods such as milk and some herbal products is briefly described. These are reviewed using data from clinical trials, mostly in healthy subjects. In addition, we discuss the possible mechanisms behind these observations. Lastly, we summarize our findings that emerging evidence confirms a link between diet and sleep. Overall, foods impacting the availability of tryptophan, as well as the synthesis of serotonin and melatonin, may be the most helpful in promoting sleep. Although there are clear physiological connections behind these effects, the clinical relevance needs to be studied further.
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Affiliation(s)
- Katri Peuhkuri
- Institute of Biomedicine, Pharmacology, Medical Nutrition Physiology, University of Helsinki, Helsinki, Finland.
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Kudesia RS, Bianchi MT. Decreased nocturnal awakenings in young adults performing bikram yoga: a low-constraint home sleep monitoring study. ISRN NEUROLOGY 2012; 2012:153745. [PMID: 22577578 PMCID: PMC3345216 DOI: 10.5402/2012/153745] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Accepted: 01/24/2012] [Indexed: 11/23/2022]
Abstract
This pilot study evaluated the impact of Bikram Yoga on subjective and objective sleep parameters. We compared subjective (diary) and objective (headband sleep monitor) sleep measures on yoga versus nonyoga days during a 14-day period. Subjects (n = 13) were not constrained regarding yoga-practice days, other exercise, caffeine, alcohol, or naps. These activities did not segregate by choice of yoga days. Standard sleep metrics were unaffected by yoga, including sleep latency, total sleep time, and percentage of time spent in rapid eye movement (REM), light non-REM, deep non-REM, or wake after sleep onset (WASO). Consistent with prior work, transition probability analysis was a more sensitive index of sleep architecture changes than standard metrics. Specifically, Bikram Yoga was associated with significantly faster return to sleep after nocturnal awakenings. We conclude that objective home sleep monitoring is feasible in a low-constraint, real-world study design. Further studies on patients with insomnia will determine whether the results generalize or not.
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Affiliation(s)
- Ravi S Kudesia
- Sleep Division, Neurology Department, Massachusetts General Hospital, Wang 720, Boston, MA 02114, USA
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Arnold RM, Miller M, Mehta RS. Insomnia: Drug Therapies #105. J Palliat Med 2012; 15:243-4. [DOI: 10.1089/jpm.2011.9611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ravula SB, Yu J, Tran JA, Arellano M, Tucci FC, Moree WJ, Li BF, Petroski RE, Wen J, Malany S, Hoare SR, Madan A, Crowe PD, Beaton G. Lead optimization of 2-(piperidin-3-yl)-1H-benzimidazoles: Identification of 2-morpholin- and 2-thiomorpholin-2-yl-1H-benzimidazoles as selective and CNS penetrating H1-antihistamines for insomnia. Bioorg Med Chem Lett 2012; 22:421-6. [DOI: 10.1016/j.bmcl.2011.10.115] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2011] [Revised: 10/26/2011] [Accepted: 10/31/2011] [Indexed: 10/15/2022]
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Abstract
OBJECTIVES A new class of beverages called relaxation drinks advertises calming effects and an easy way to wind down when life gets stressful. This article examines these drinks in the context of their use in adolescents. METHODS A review of the literature relevant to relaxation drinks and their functional ingredients was conducted. RESULTS The beverages contain ingredients such as melatonin, valerian, kava, tryptophan, and other products traditionally thought to play a role in sleep, sedation, or neurocognitive function. Studies of the efficacy and safety of these supplements are limited and many have significant methodological limitations. Despite appropriate warnings placed on the labels of relaxation drinks, marketing is cleverly designed to appeal to young consumers and often evokes the experiences produced by alcohol and drug use. CONCLUSION Although moderate consumption of these beverages by healthy individuals is likely safe, an objective reduction in stress is improbable and associated adverse effects are possible.
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Affiliation(s)
- Sylvie Stacy
- University of Massachusetts Medical School, Uxbridge, Massachusetts 01569, USA.
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Eichhorn T, Greten HJ, Efferth T. Self-medication with nutritional supplements and herbal over-thecounter products. NATURAL PRODUCTS AND BIOPROSPECTING 2011; 1:62-70. [PMCID: PMC4131654 DOI: 10.1007/s13659-011-0029-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2011] [Accepted: 11/07/2011] [Indexed: 06/08/2023]
Abstract
In recent years, the popularity increased for nutritional supplements and herbal products. Prescription drugs, but not herbal therapies are paid by health insurances. They are sold over-the-counter (OTC) on the patients’ own expense. However, there are potential risks of self-medication, e.g. incorrect self-diagnosis, severe adverse reactions, dangerous drug interactions, risk of addiction etc. They are often used by patients at their own discretion without knowledge of and control by their physicians. Certain users are at risk of intoxication. Multiple medications taken by older patients increase the risk for adverse drug reactions, drug-drug interactions, and compliance problems for this age group (polypharmacy). Herbals should be discontinued prior to operations to avoid interactions with anesthetics or anticoagulants. Herbal preparations may also be carcinogenic or interfere with cancer treatments. Pregnant women use various OTC preparations. However, in many cases, it is unclear whether their use is safe for mother or baby. Self-medication with herbals is also largely distributed among anxious and depressive patients, and patients with other conditions and symptoms. The popularity of herbal products has also brought concerns on quality, efficacy and safety. Cases of botanical misidentification, contaminations with heavy metals, pesticides, radioactivity, organic solvents, microbials as well as adulteration with chemical drugs necessitate the establishment of international quality control standards. Hepatotoxic effects have been reported for more than 300 plant species, and some commonly used herbs have been demonstrated to interact with Western medication. Health care professionals have a critical responsibility assessing the self-care ability of their patients. Databases are available for pharmacists with information on action, side effects and toxicities as well as herb-drug interactions. There is a need for established guidelines regarding the correct use of nutritional supplements and herbal OTC preparations (phytovigilance). Physicians, pharmacists, and other health care professionals have to counsel patients and the general public on the benefits and risks associated with herbal drugs. Information centers for consumers and general practitioners are needed, and convincing evidence on safety and efficacy of herbal products has to be demonstrated in placebo-controlled, double blind and randomized clinical trials.
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Affiliation(s)
- Tolga Eichhorn
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
| | - Henry Johannes Greten
- Heidelberg School of Chinese Medicine, Karlsruher Straße 12, 69126 Heidelberg, Germany
- Biomedical Sciences Institute Abel Salazar, University of Porto, Porto, Portugal
| | - Thomas Efferth
- Department of Pharmaceutical Biology, Institute of Pharmacy and Biochemistry, Johannes Gutenberg University, Staudinger Weg 5, 55128 Mainz, Germany
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OMORI K, KAGAMI Y, YOKOYAMA C, MORIYAMA T, MATSUMOTO N, MASAKI M, NAKAMURA H, KAMASAKA H, SHIRAISHI K, KOMETANI T, KURIKI T, HUANG ZL, URADE Y. Promotion of non-rapid eye movement sleep in mice after oral administration of ornithine. Sleep Biol Rhythms 2011. [DOI: 10.1111/j.1479-8425.2011.00515.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Zadeh SS, Begum K. Comparison of nutrient intake by sleep status in selected adults in Mysore, India. Nutr Res Pract 2011; 5:230-5. [PMID: 21779527 PMCID: PMC3133756 DOI: 10.4162/nrp.2011.5.3.230] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2010] [Revised: 12/09/2010] [Accepted: 12/10/2010] [Indexed: 11/12/2022] Open
Abstract
Insomnia has become a major public health issue in recent times. Although quality of sleep is affected by environmental, psychophysiological, and pharmacological factors, diet and nutrient intake also contribute to sleep problems. This study investigated the association between nutrient intake and co-morbid symptoms associated with sleep status among selected adults. Subjects in this study included 87 men and women aged 21-45 years. Presence of insomnia was assessed using the Insomnia Screening Questionnaire, and dietary intake was measured over three consecutive days by dietary survey. Descriptive analysis, ANOVA, and Chi-Square tests were performed to compute and interpret the data. Approximately 60% of the participants were insomniacs. People with insomnia consumed significantly lesser quantities of nutrients as compared to normal sleepers. Differences in intakes of energy, carbohydrates, folic acid, and B12 were highly significant (P < 0.002). Further, intakes of protein, fat, and thiamine were significantly different (P < 0.021) between insomniacs and normal sleepers. The nutrient intake pattern of the insomniacs with co-morbid symptoms was quite different from that of the normal sleepers. Based on these results, it is probable that there is an association between nutrition deficiency, co-morbid symptoms, and sleep status. More studies are required to confirm these results.
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Affiliation(s)
- Sara Sarrafi Zadeh
- Department of Studies in Food Science and Nutrition, Manasagangothri, University of Mysore, Mysore-06, India
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Ngan A, Conduit R. A double-blind, placebo-controlled investigation of the effects of Passiflora incarnata (passionflower) herbal tea on subjective sleep quality. Phytother Res 2011; 25:1153-9. [PMID: 21294203 DOI: 10.1002/ptr.3400] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2010] [Revised: 11/27/2010] [Accepted: 12/01/2010] [Indexed: 11/08/2022]
Abstract
Passiflora incarnata is a traditional herbal sedative, anxiolytic and a popular sleep aid used for the treatment of sleep disturbance. Several controlled experiments have demonstrated enhanced sleep in laboratory animals, but clinical trials in humans are lacking. The aim of the present study was to investigate the efficacy of Passiflora incarnata herbal tea on human sleep, as measured using sleep diaries validated by polysomnography (PSG). This study featured a double-blind, placebo-controlled, repeated-measures design with a counterbalanced order of treatments (passionflower vs placebo tea), separated by a 1 week 'washout' period. Forty-one participants (18-35 years) were exposed to each treatment for a week, whereby they consumed a cup of the tea and filled out a sleep diary for 7 days, and completed Spielberger's state-trait anxiety inventory on the seventh morning. Ten participants also underwent overnight PSG on the last night of each treatment period. Of six sleep-diary measures analysed, sleep quality showed a significantly better rating for passionflower compared with placebo (t(40) = 2.70, p < 0.01). These initial findings suggest that the consumption of a low dose of Passiflora incarnata, in the form of tea, yields short-term subjective sleep benefits for healthy adults with mild fluctuations in sleep quality.
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Affiliation(s)
- A Ngan
- School of Psychology and Psychiatry, Monash University, Clayton, Victoria, Australia
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Chhangani B, Greydanus DE, Patel DR, Feucht C. Pharmacology of sleep disorders in children and adolescents. Pediatr Clin North Am 2011; 58:273-91, xiii. [PMID: 21281861 DOI: 10.1016/j.pcl.2010.11.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
There is a high prevalence of sleep disorders in children and an apparent increasing need for pharmacologic management. However, because of the paucity of data available with regards to dosing, efficacy, tolerability, and safety profiles of medications as well as a lack of adequate well-designed clinical trials, medications are currently not approved for the pediatric population by the US Food and Drug Administration. There are no pharmacologic guidelines for the specific sleep disorders or the different pediatric age ranges. Additional research is needed for evidence-based pediatric sleep pharmacotherapy. This article reviews pediatric sleep disorders and the pharmacologic therapeutic options.
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Affiliation(s)
- Bantu Chhangani
- Sleep Medicine, Saint Mary's Neuroscience Program, Saint Mary's Neuroscience Institute, Kalamazoo, MI 49503, USA.
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Abstract
An increasing number of studies have evaluated the role of herbal supplements in pediatric disorders, but they have numerous limitations. This review provides an overview of herbal components, regulation of supplements, and importance of product quality assurance. Use of herbal supplements is discussed with reference to factors that influence use in the pediatric population. The remainder of the article discusses the use of St John's wort, melatonin, kava, valerian, eicosapentaenoic acid, and docosahexaenoic acid, focusing on indications, adverse effects, and drug interactions, and providing a limited efficacy review. Herbal supplements used for weight loss are also briefly discussed.
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