Article

Homeopathy for insomnia: a systematic review of research evidence.

School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, Sheffield, UK.
Sleep Medicine Reviews (Impact Factor: 9.14). 03/2010; 14(5):329-37. DOI: 10.1016/j.smrv.2009.11.005
Source: PubMed

ABSTRACT Insomnia is a common problem which impacts on quality of life. Current management includes psychological and behavioural therapies and/or pharmacological treatments.
To systematically review research evidence for effectiveness of homeopathy in the management of insomnia.
Comprehensive searches of biomedical databases (MEDLINE, EMBASE, CINAHL, Cochrane library, Science Citation Index), homeopathy-specific and complementary medicine-specific databases were conducted.
(A) Homeopathic medicines: four randomised controlled trials (RCTs) compared homeopathic medicines to placebo. All involved small patient numbers and were of low methodological quality. None demonstrated a statistically significant difference in outcomes between groups, although two showed a trend favouring homeopathic medicines and three demonstrated significant improvements from baseline in both groups. A cohort study reported significant improvements from baseline. (B) Treatment by a homeopath: No randomised controlled trials of treatment by a homeopath were identified. One cohort study, three case series and over 2600 case studies were identified.
The limited evidence available does not demonstrate a statistically significant effect of homeopathic medicines for insomnia treatment. Existing RCTs were of poor quality and were likely to have been underpowered. Well-conducted studies of homeopathic medicines and treatment by a homeopath are required to examine the clinical and cost effectiveness of homeopathy for insomnia.

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    ABSTRACT: The aim of this review was the critical evaluation of evidence for the effectiveness of homeopathy for insomnia and sleep-related disorders. A search of MEDLINE, AMED, CINAHL, EMBASE and Cochrane Central Register was conducted to find RCTs using any form of homeopathy for the treatment of insomnia or sleep-related disorders. Data were extracted according to predefined criteria; risk of bias was assessed using Cochrane criteria. Six randomised, placebo-controlled trials met the inclusion criteria. Two studies used individualised homeopathy, and four used standardised homeopathic treatment. All studies had significant flaws; small sample size was the most prevalent limitation. The results of one study suggested that homeopathic remedies were superior to placebo; however, five trials found no significant differences between homeopathy and placebo for any of the main outcomes. Evidence from RCTs does not show homeopathy to be an effective treatment for insomnia and sleep-related disorders.
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    ABSTRACT: Background. Cohort studies have reported that patients improve considerably after individualised homeopathic treatment. However, these results may be biased by regression to the mean (RTM). Objective. To evaluate whether the observed changes in previous cohort studies are due to RTM and to estimate RTM adjusted effects. Methods. SF-36 quality-of-life (QoL) data from a German cohort of 2827 chronically diseased adults treated by a homeopath were reanalysed by Mee and Chua's modified t-test. Results. RTM adjusted effects, standardized by the respective standard deviation at baseline, were 0.12 (95% CI: 0.06-0.19, P < 0.001) in the mental and 0.25 (0.22-0.28, P < 0.001) in the physical summary score. Small-to-moderate effects were confirmed for the most individual diagnoses in physical, but not in mental component scores. Under the assumption that the true population mean equals the mean of all actually diseased patients, RTM adjusted effects were confirmed for both scores in most diagnoses. Conclusions. Changes in QoL after treatment by a homeopath are small but cannot be explained by RTM alone. As all analyses made conservative assumptions, true RTM adjusted effects are probably larger than presented.
    Evidence-based Complementary and Alternative Medicine 12/2013; 2013:612890. DOI:10.1155/2013/612890 · 2.18 Impact Factor
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