Insomnia is a disorder which can underlie other long-term health conditions such as diabetes, coronary heart disease, lowered immune function, depression, and anxiety.1,2 Furthermore, its prevalence is wide, effecting an estimated 10-40% of the population. Since insomnia, left unmitigated, has such far-reaching consequences on health and homeostasis, it is paramount that said condition is addressed in a safe and effective manner. As such, this author would like to present research exploring a natural composite of botanicals used to help insomniacs reach deep and restorative sleep.
Insomnia can be defined as difficulty falling asleep, and staying asleep.3 Symptoms of insomnia can include tiredness upon waking, tiredness throughout the day, irritability, difficulty paying attention, focusing, and remembering.3 The causes of insomnia are also numerous and include mental health disorders (i.e., PTSD), medications (i.e., anti-depressants, blood pressure medications, medications for asthma), sleep-related disorders (i.e., sleep apnea), chronic pain (i.e., arthritis) and dietary habits (i.e., caffeine, alcohol, and nicotine).3 Risk factors for insomnia include gender (i.e., higher in women), advanced age (i.e., over 60), mental/physical disorder, stress, inconsistent schedules (i.e., shift work).3Thus, it is critical that insomnia is addressed and managed, which can include the use of botanicals to improve sleep. Ranjbar et al1(329) stated that many individuals use singular botanicals, and combinations of two or more, to treat mood disorders and insomnia. As such, the following will consider a randomized placebo-controlled trial which explored the same.
As mentioned in the aforementioned section, individuals often use botanicals to help improve sleep hygiene which frequently includes plants such as lemon balm (Melissa officinalis); plants known to help lower mild to moderate anxiety and sleep disturbances.1(329) Another popular botanical would include Persian lavender (Nepeta menthoides), which can help ameliorate anxiety and help improve mood in individuals with major depressive disorder.1(329) As such, Ranjbar et al1(329) selected two said botanicals because traditional texts claimed a synergistic effect when Persian lavender and lemon balm were fused together into a singular therapy1(329) As such, the researchers evaluated the effects of Persian lavender/lemon balm on insomnia severity, anxiety, and depression amongst diagnosed insomniacs. As a means of understanding the effects of said botanicals on markers of insomnia, the following will explore the study of Ranjbar et al1(329) in greater detail.
Inclusion criteria of participants included age ranges between 18-60, with an insomnia score higher than 7.3(329) Furthermore, participants were excluded if they were working night shifts, had a psychological or physical problem, had other sleep disorders, consumed drugs that affected sleep, alcohol abuse, history of suicidal thoughts, who were candidates for electroconvulsive therapy, or who were pregnant.3(329) Participants were randomly divided into two groups; one group received 500 mg of Persian lavender/lemon balm (400 mg/1000 mg, respectively) or a placebo (which was designed to have the same smell as Persian lavender/lemon balm) each night for four weeks.1(329) The primary outcomes included measuring anxiety, depression, and insomnia while the secondary outcomes included side effects from the botanical combination. Finally, participants were assessed at baseline and after the four-week intervention using the insomnia severity score (ISI), Beck anxiety inventory (BAI), and depression inventory-second edition (BDI). Finally, 45 participants (23 within the treatment group, and 22 in the placebo group) completed the study our of 54 eligible cases.1(329)
Results suggested that the ISI score dropped significantly compared to baseline for the treatment group and when compared to the placebo group.1(331) Furthermore, the average difference in BAI also decreased significantly in the treatment group compared to baseline and compared to the placebo group.1(329) Side effects from the intervention included itching (one person), agitation (three people), and higher anxiety which dissipated after approximately three days.1(331) Although the results are encouraging, the researchers did caution the reader about generalizing said findings; the study was of short duration, and lacked follow-up after the study, and lacked an explanation of mechanism of action.1(331) The researchers did, however, conclude that Persian lavender/lemon balm in the amounts of 400 mg/1000 mg, respectively, had the potential of being an alternative intervention for treating insomnia as well as depression and anxiety. Finally, said botanical combination therapy could be appealing for individuals suffering from poor sleep as it has little to no side effects, especially when compared to pharmaceutical medications for the same.
In conclusion, insomnia is a disorder which can underlie other long-term health conditions such as diabetes, coronary heart disease, lowered immune function, depression, and anxiety. Furthermore, its prevalence is wide, effecting an estimated 10-40% of the population. Since insomnia, left unmitigated, has such far-reaching consequences on health and homeostasis, it is paramount that said condition is addressed in a safe and effective manner. Preliminary research suggests that Persian lavender/lemon balm could serve as potential alternatives to their pharmaceutical counterparts, with little to no side-effects. If successful, such a botanical-based approach might help support deeper, longer, and more consistent sleep patterns which, in turn, may help lower the risk of other sleep-associated health conditions.
References
1. Ranjbar M, Firoozabadi A, Salehi A, et al. Effects of herbal combination (Melissa officinalis L. and Nepeta menthoides Boiss. & Buhse) on insomnia severity, anxiety and depression in insomniacs: Randomized placebo-controlled trial. Integr Med Res. 2018;7(4):328-332. doi: https://doi.org/10.1016/j.imr.2018.08.001.
2. Gallicchio L, Kalesan B. Sleep duration and mortality: A systematic review and meta-analysis. J Sleep Res. 2009;18:148-158. doi:10.1111/j.1365-2869.2008.00732.x.
3. Insomnia: Symptoms and Causes. Mayo Clinic website. https://www.mayoclinic.org/diseases-conditions/insomnia/symptoms-causes/syc-20355167. Accessed June 18, 2020.
-Michael McIsaac