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Effects of an intervention with drinking chamomile tea on sleep quality and depression in sleep disturbed postnatal women: A randomized controlled trial
Abstract
Aim:
The purpose of this study was to evaluate the effects of chamomile tea on sleep quality, fatigue and depression in postpartum women.
Background:
Sleep quality is a significant issue for postnatal women. Chamomile is widely used as a folk remedy for its presumed sedative-hypnotic effects.
Design:
A pretest-post-test randomized controlled trial was used.
Methods:
A total of 80 Taiwanese postnatal women with poor sleep quality (Postpartum Sleep Quality Scale; PSQS score ≧16) were recruited from November 2012-August 2013. They were systematically assigned, with a random start, to either the experimental group (n = 40) or the control group (n = 40). The participants in the experimental group were instructed to drink chamomile tea for a period of 2 weeks. The participants in the control group received regular postpartum care only. The PSQS, Edinburgh Postnatal Depression Scale, and Postpartum Fatigue Scale were used to assess outcomes. Two-sample t-tests were used to examine the mean differences in outcome variables between the two groups.
Results:
Compared with the control group, the experimental group demonstrated significantly lower scores of physical-symptoms-related sleep inefficiency (t = -2·482, P = 0·015) and the symptoms of depression (t = -2·372, P = 0·020). However, the scores for all three instruments were similar for both groups at 4-week post-test, suggesting that the positive effects of chamomile tea were limited to the immediate term.
Conclusion:
Chamomile tea may be recommended to postpartum women as a supplementary approach to alleviating depression and sleep quality problems.
... A total of 23 articles were included in the final analysis: 16 clinical trials and seven observational studies [6][7][8][9]12,[23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]. The included studies reflect the experiences of a combined 8,343 women (2,065 of whom used chamomile) from nine countries (Canada, Italy, Australia, Norway, Jordan, United Kingdom, Iran, Pakistan, and Taiwan) [6][7][8][9]12,[23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]. ...
... A total of 23 articles were included in the final analysis: 16 clinical trials and seven observational studies [6][7][8][9]12,[23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]. The included studies reflect the experiences of a combined 8,343 women (2,065 of whom used chamomile) from nine countries (Canada, Italy, Australia, Norway, Jordan, United Kingdom, Iran, Pakistan, and Taiwan) [6][7][8][9]12,[23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]. Most of the articles (19/23, 83%) provided findings on the efficacy of chamomile as an alternative therapy during various stages of pregnancy [23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]; the other five studies reported on safety considerations [6][7][8][9]12]. ...
... The included studies reflect the experiences of a combined 8,343 women (2,065 of whom used chamomile) from nine countries (Canada, Italy, Australia, Norway, Jordan, United Kingdom, Iran, Pakistan, and Taiwan) [6][7][8][9]12,[23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]. Most of the articles (19/23, 83%) provided findings on the efficacy of chamomile as an alternative therapy during various stages of pregnancy [23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40]; the other five studies reported on safety considerations [6][7][8][9]12]. ...
... Ten human trials were identified and synthesized in the present review (Table 1). Of these, two focused on oolong tea [38,39], two reported on green tea, including standard and low-caffeine green tea [40,41], two studied regular or black tea [42,43] and the others investigated Chamomile (German) tea [44], lavender tea [45], passionflower tea [46] or a combination of three different herbal teas [47]. ...
... Day-long tea consumption produced similar alerting effects to coffee, despite lower caffeine levels, but was less likely to disrupt sleep [38], validated sleep quality questionnaires or scales [43][44][45]47] and sleep diaries [46]. One study investigated the effects of decaffeinated or regular tea ingestion on participants that were sleep deprived [42]. ...
... Overall, the identified studies concluded that drinking tea and herbal infusions had beneficial or neutral effects on dimensions of sleep [38][39][40][41]43,44,46,47]. Focusing on oolong tea, research with nonobese males demonstrated that oolong tea (two 350 mL/day servings) increased fat oxidation by around 20% without impacting on sleep [39]. ...
Tea is popular global beverage and abundant provider of biologically active plant molecules which have been attributed to its health properties. Relationships between tea drinking and certain aspects of health have been the subject of past reviews. The present systematic review focuses on tea consumption in relation to psychological stress and the challenges of stress and anxiety on sleep health. Publications were searched up to 21st September 2022, in the PubMed database along with references of original articles. Thirty-three publications were included in the main review-17 human trials and 16 mechanistic studies. Human trials were graded to assess quality using the Jadad scale. Overall, a growing body of evidence suggests that tea (including green and oolong) and herbal infusions, at relatively low intakes (around 1 to 2 cups daily), could help to facilitate sleep, alleviate psychological stress and anxiety, primarily by facilitating relaxation. Evidence for black tea, German Chamomile, Lavender, Rose, Jasmine, and Passionflower tea is emerging and looks promising. Ongoing research is needed in the form of randomised controlled trials to build on these provisional findings.
... Eleven studies were classified as lifestyle interventions, including; drinking herbal tea (n = 3) [42,43,71], listening to music (n = 1) [53], massage (n = 2) [44,56] and incorporating exercise/movement (n = 5) [45,52,54,67,72]. Table 6 provides a summary of the interventions. ...
... Characteristics The three herbal tea interventions were largely similar in design; all were RCTs requiring women to drink one cup of tea a day for 2-3 weeks and all were aimed at women experiencing poor sleep health in the early postnatal period [42,43,71]. ...
... All three studies used the PSQS to assess sleep and the EPDS to evaluate mood (both primary measures) with measures completed immediately post intervention and an additional follow-up timepoint 2-3 weeks past the intervention end. Both the chamomile and magnolia tea interventions found the intervention group to have improved physical sleep related symptoms immediately post intervention, though not at follow-up, and fewer depressive symptoms at both post intervention time points compared to controls [42,71]. The lavender tea intervention did not find a between group difference in sleep and although depressive symptoms were better immediately post intervention, this difference was also apparent at baseline and did not extend through to the follow-up timepoint [43]. ...
Background
A woman’s vulnerability to sleep disruption and mood disturbance is heightened during the perinatal period and there is a strong bidirectional relationship between them. Both sleep disruption and mood disturbance can result in significant adverse outcomes for women and their infant. Thus, supporting and improving sleep in the perinatal period is not only an important outcome in and of itself, but also a pathway through which future mental health outcomes may be altered.
Methods
Using scoping review methodology, we investigated the nature, extent and characteristics of intervention studies conducted during the perinatal period (pregnancy to one-year post-birth) that reported on both maternal sleep and maternal mental health. Numerical and descriptive results are presented on the types of studies, settings, sample characteristics, intervention design (including timeframes, facilitation and delivery), sleep and mood measures and findings.
Results
Thirty-seven perinatal interventions were identified and further described according to their primary focus (psychological ( n = 9), educational ( n = 15), lifestyle ( n = 10), chronotherapeutic ( n = 3)). Most studies were conducted in developed Western countries and published in the last 9 years. The majority of study samples were women with existing sleep or mental health problems, and participants were predominantly well-educated, not socio-economically disadvantaged, in stable relationships, primiparous and of White race/ethnicity. Interventions were generally delivered across a relatively short period of time, in either the second trimester of pregnancy or the early postnatal period and used the Pittsburgh Sleep Quality Index (PSQI) to measure sleep and the Edinburgh Postnatal Depression Scale (EPDS) to measure mood. Retention rates were high (mean 89%) and where reported, interventions were well accepted by women. Cognitive Behavioural Therapies (CBT) and educational interventions were largely delivered by trained personnel in person, whereas other interventions were often self-delivered after initial explanation.
Conclusions
Future perinatal interventions should consider spanning the perinatal period and using a stepped-care model. Women may be better supported by providing access to a range of information, services and treatment specific to their needs and maternal stage. The development of these interventions must involve and consider the needs of women experiencing disadvantage who are predominantly affected by poor sleep health and poor mental health.
... Intervention with specific micronutrients has been variously with supplementary vitamin D, 30 vitamin D and calcium, 31 tryptophan and tyrosine 22 and zinc and magnesium 18 targetting depressive symptoms. Interventions lasted from three days (n=1), 22 to two to three weeks (n=2), 41,43 one to two months in most studies (n=4), 18,31-33 six months (n=2) 30,39 and as long as 12 months (n=2). 24,47 The supplement dosage average about 1 capsule per day, 18,22,30,32 or fortnightly. ...
... In nutrition intervention studies, almost all studies involved supplementation of micronutrients and specific foods, 18,22,[30][31][32][33]41,43 were not assisted by a specific counsellor or qualified service provider. On the other hand, most physical activity intervention studies (n=11) involved qualified service providers in informing or enhancing the motivation to undertake physical activity; they were dietitians or nutritionists, health psychologists, midwives, or physical therapists. ...
... 22 Specific food interventions with chamomile tea, magnolia tea, or saffron in postpartum women not only improved mood and reduce depression 33 but also improved sleep quality. 41,43 Dietary modification by Surkan et al, 47 with more fruit and vegetable consumption and limited meat intake, resulted a lower depression score (p=0.046) than in controls. ...
Background and objectives:
Globally, there is a high prevalence of postpartum depression (17.7%) reported in a recent study among mothers during the postpartum period. It contributes to poor health and well-being among newly delivered women. We reviewed the published effect of nutrition and physical activity interventions on improving and treating postpartum depression.
Methods and study design:
The scoping review was performed using Arksey and O'Malley's methodological framework. The systematic search was conducted using Scopus, Pubmed, EBSCOHost and Google Scholar in April 2020, updated in March 2021. Only literature published between January 2010 until February 2021 was searched.
Results:
A total of 25 articles were included, of which 23 were randomised controlled trials , and 2 were quasi-experimental studies. Some of studies found improvements in depression (76% out of all studies). On this basis, nutrition or physical activity intervention probably improves postpartum depression. Moreover, the integration of nutrition and physical activity appears to improve depression in the more thorough follow-up of participants . Active involvement of the participant in the interventions was contributory to effectiveness.
Conclusions:
Nutrition and physical activity interventions with appropriate strategy and delivery are promising options for the management of postpartum maternal mental health. More definitive investigation of non-pharmacological interventions to ameliorate depression among postpartum women is warranted.
... Foram analisados estudos que discorreram sobre terapias alternativas para o tratamento da depressão pós-parto. Tais como ingestão de chá de camomila (Chang;Chen., 2015), ioga (Buttner et al., 2015), técnicas de relaxamento muscular progressivo (Ökşin; Ayaz-alkaya., 2020), acupuntura (Chung et al, 2012), canto (Fancourt;Perkins., 2018), óleo essencial de bergamota (Chen; Chen; Lee., 2022) e uso do açafrão (Kashani et al., 2016). ...
... Identificaram-se benefícios significativas nos sintomas físicos associados à ineficiência do sono e os sintomas de depressão pós-parto tanto associados à ingestão do chá de camomila alemã (Chang;Chen., 2015), quanto ao efeito do relaxamento muscular progressivo (Ökşin; Ayaz-alkaya., 2020). Este último também contribuiu para as habilidades de enfrentamento das puérperas no pósparto, o que culminou em alívio físico e mental das pacientes, comprovadamente melhorando a qualidade de vida dessas puérperas, assim como um estudo, que diz respeito à prática de ioga (Buttner et al., 2015). ...
Objetivo: analisar os benefícios das terapias alternativas no tratamento da depressão pós-parto. Materiais e Métodos: realizou-se uma busca nas bases de dados PubMed, Biblioteca Virtual em Saúde (BVS), Scientific Electronic Library Online (SciELO). Foram utilizados os descritores “alternative therapies” “post partum depression” a partir de uma estratégia de busca avançada com auxílio do operador booleano “AND”. Foram encontrados 202 estudos na PubMed, 47 estudos na BVS e nenhum documento foi encontrado na base de dados do SciELO. Foram incluídos estudos em português, inglês e espanhol, artigos publicados nos últimos 10 anos. Excluíram-se os artigos de revisão de literatura, revisão sistemática e meta-análise, guia de prática clínica, dissertações e teses. Resultados: notou-se melhora dos sintomas depressivos, acompanhado de melhora no sono, progressão da recuperação dos sintomas mais rapidamente, aumento da sociabilidade e qualidade de vida, de acordo com a terapia alternativa aplicada e com o comprometimento com o tratamento. Conclusão: os benefícios consistem na possibilidade de redução dos escores de depressão da puérpera de maneira eficaz e mais rápida, na possibilidade da melhora da estabilidade do humor e da redução dos efeitos físicos e da ineficiência do sono.
... Randomized controlled trials have found enhancement in sleep inefficiencies associated with physical symptoms and reductions in depressive symptoms after drinking German chamomile tea. 36 A longer-term effect on sleep quality was observed with the use of lavender cream and foot baths. 37 Another study using aromatherapy, namely bergamot essential oil, found no improvement in sleep quality between experimental and placebo groups. ...
... Our review took into consideration the efficacy and incorporation of behavioral interventions, including cognitive behavioral therapy, mindfulness meditation, herbal medicine, aromatherapy, gymnastics and physical exercises, psychotherapy and relaxation, as there is growing evidence that they are helpful for sleep issues as well as mood symptoms. 9,10,[35][36][37][38][39][40] The positive effect of a woman's relaxation also affects the behavior of infants. 61 Our understanding of the link between maternal sleep and breastfeeding remains limited. ...
The perinatal and postpartum period is of great significance for women due to physiological changes, shifts in circadian rhythms, social setting, and psychological well-being, all of which affect the quality and quantity of their sleep. A mixed-studies systematic review was undertaken to enhance our understanding of sleep disturbances and mood disorders in women in late pregnancy and the postpartum period, their connection with breastfeeding, and the assessment of interventions for sleep disturbance. Three electronic databases (PUBMED, EMBASE and Google Scholar) were searched for qualitative, observational, and mixed-method studies from the year 2016 to June 2023. Twenty-nine articles were included in the analysis. The results were synthesized into four overarching themes: (і) the sleep quality of women in the perinatal period; (ii) the relationship between sleep and breastfeeding; (iii) the relationship between sleep quality and emotional disturbance in the perinatal period; (iv) sleep interventions in the researched group. The subjective nature of the perception of sleep disturbances, along with the absence of an objective measurement tool is clearly an inconvenience. It is advisable to include the assessment of maternal sleep hygiene and family sleep patterns during postpartum healthcare provider appointments to develop strategies not only for women’s sleep quality but also for their mental well-being.
... Herbal extracts have been a valuable source for new therapeutics intended for the treatment of various diseases or disorders, such as insomnia. Chamomile tea and chamomile essential oils are widely used for their sedative-hypnotic effects [39,40]. In this study, the soporific effect of the M. discoidea dry extracts was assessed by a sleeping-time test induced by thiopental sodium. ...
... Chamomile tea and essential oils have been widely used for calming effects [39,40]. In the present study, we used a thiopental-sodium-induced sleeping time test to investigate the sedativehypnotic effects in rats. ...
Pineapple weed (Matricaria discoidea DC.) is a widely spread plant in Europe and North America. In ethnomedicine, it is well known for its anti-inflammatory and spasmolytic activity. The aim of the research was to develop novel methods of M. discoidea herb complex processing for creating the essential oil and the dry extracts and to investigate their phytochemical composition. Moreo-ver, the molecular docking of main substances and in vivo their soporific and analgesic activity were studied. The essential oil and two dry extracts from M. discoidea were prepared. Total 16 phenolic compounds (7 flavonoids, 7 hydroxycinnamic, 2 phenolic acids) in the dry extracts were identified by means of UPLC-MS/MS. In the essential oil 9 main terpenoids were identified by gas chromatography (GC). We showed that the phenolics extraction from the present herb was successful by using 70% ethanol in a triple extraction and in the range of 1:14-1:16. The in-vivo studies with rodents showed analgesic activity of M. discoidea extracts and the improvements in the sleep of animals. The dry extracts of M. discoidea herb did not show any toxicity. The molecular docking showed the high probability of COX-1,2 inhibition and NMDA receptor antagonism induced by the extracts.
... Due to its availability, low costs, and absence of direct adverse effects, herbal medicine is considered one of the most common and popular CAM methods. According to the World Health Organization (WHO), about 80% of populations uses herbal medicine around the world [10]. ...
... Many medicinal properties can be found in German chamomile, including antibacterial, anti-inflammatory, antispasmodic, analgesic, and antioxidant properties [11][12][13][14][15]. It was found to possess sedative, relaxant, and anxiolytic potential [10,16]. Moreover, anti-tumor, cholestrol-lowering, and wound-healing effects of chamomile have been investigated [11,17,18]. ...
Background and aim
Surgical extraction of the impacted lower third molar is one of the most common surgical procedures in dentistry. Postoperative pain usually reaches its intensity 12 h after the procedure and adversely affects the patient’s quality of life for many days. Chamomile anti-inflammatory and pain-relieving properties have been introduced in the medical literature. The present study aimed to investigate the efficacy of chamomile gel in reducing postoperative pain and symptoms after impacted lower third molar surgeries.
Materials and methods
This study was a triple-blinded placebo-controlled randomised clinical trial with a split-mouth crossover design. The study included 70 impacted lower third molars in 35 patients (13 males and 22 females) with a mean age of 22.29 (±3.00) years. Participants’ extraction sides were randomly allocated into the study groups. Each participant was enrolled twice, i.e., into the study and control groups with a washout period of 3 weeks between the two surgeries. Postoperative pain, need for analgesics, symptoms severity (PoSSe), and wound healing were evaluated.
Results
Gingival healing was significantly better in chamomile group compared to control group (P < 0.001). There were no significant differences in post-extraction alveolar osteitis between chamomile and control group (P = 0.314). VAS results showed significant differences in mean pain scores, with significant decrease in chamomile groups (P < 0.05). Moreover, analgesic consumption was significantly higher in placebo group (P < 0.05). Mean PoSSe scores were 16.8 (±9.4) in the chamomile group, versus 41.1 (±9.9) in the control.
Conclusions
Within the limitations of the present study, it was concluded that intra-socket application of chamomile gel might effectively improve healing, and reduce pain levels, postoperative symptoms severity, and analgesics consumption after surgical extraction of impacted lower third molars.
Highlights
... Sebuah penelitian sebelumnya oleh (Chang & Chen, 2016) yang mengamati bagaimana konsumsi teh chamomile mempengaruhi wanita pasca melahirkan yang mengalami kesulitan tidur dalam hal kualitas tidur mereka. Temuan penelitian menunjukkan bahwa memberi ibu nifas teh chamomile yang mengandung flavonoid merupakan strategi tambahan untuk mengurangi depresi dan masalah kualitas tidur. ...
Penurunan hormon progesteron dan estrogen secara signifikan pada ibu postpartum menyebabkan mood swings, seperti istirahat yang tidak cukup dapat menyebabkan ketidaknyamanan fisik dan kelelahan. Wedang uwuh celup merupakan minuman kaya antioksidan yang mengandung asam askorbat, flavonoid, isoflavon, tanin, eugenol, alkaloid, sapponin, terpenoid, minyak atsiri serta tannin dan memiliki efek sedatif ringan sehingga dapat meningkatkan kualitas tidur. Penelitian ini bertujuan untuk mengetahui pengaruh seduhan wedang uwuh celup terhadap kualitas tidur ibu nifas. Penelitian menggunakan metode true experiment dengan rancangan randomized pretest and posttest with control group design. Variabel independent yaitu seduhan wedang uwuh celup dengan dosis 2 gr/ 220 ml air mendidih dan frekuensi pemberian 1x sehari dalam waktu 14 hari, variable dependent yaitu kualitas tidur ibu nifas yang diukur menggunakan kuesioner PSQI. Variable confounding yaitu asupan nutrisi yang diukur dengan formulir SQ-FFQ dan usia ibu nifas. Jumlah sampel pada penelitian ini yaitu 40 ibu nifas. Hasil Pemberian seduhan wedang uwuh celup dengan dosis 2 gram/ 220 ml diberikan selama 14 hari terbukti berpengaruh terhadap peningkatan kualitas tidur ibu nifas dengan nilai p value < 0.05. Pemberian seduhan wedang uwuh celup berpengaruh terhadap peningkatan dan kualitas tidur ibu nifas.
... Several studies have been carried out on German chamomile and the results have demonstrated its sedative effect (Petitet, 2016). Another study carried out on 80 post-partum women to assess the impact of a chamomile infusion showed a significant improvement in sleep quality and depressive symptoms (Chang & Chen, 2016). It should be noted that not all the plants mentioned have a proven sedative effect, but can improve sleep quality. ...
Highlights ➢ Around 69% of Algerians suffer from insomnia. ➢ Sleep disorders were associated primarily with symptoms of insomnia, poor sleep quality reduced total sleep time, and frequent awakenings during the night. ➢ Insomnia can harm daily life. ➢ Herbal medicine has proven important in regulating sleep disorders by reducing the time it takes to fall asleep, improving sleep quality and reducing tiredness. Graphical Abstract J Nat Prod Res App 2024, 4 (2) : DOI :0.46325/jnpra.v4i02.76 2 Abstract The number of people suffering from sleep disorders is constantly increasing over the years. To preserve their health and avoid the use of conventional drugs (addiction, undesirable effects, toxicity, etc.), phytotherapy remains a good alternative. This study aims to identify the medicinal plants used by the Algerian population to treat sleep disorders. This was an ethnobotanical survey carried out using an electronic questionnaire concerning the population and their knowledge of the medicinal plants used, followed by bibliographical research on the plants mentioned. 197 people from the north of Algeria took part in this study, which revealed the use of 33 medicinal plants and 7 herbal products to regulate sleep or improve its quality. The use of medicinal plants is widespread in Algeria, prompting researchers to carry out various phytochemical and pharmacological studies to ensure their efficacy and detect any interactions (plants/drugs), adverse effects or toxicity.
... Independent t-tests were performed to compare the students reporting use of behaviours as sleep-onset facilitators and students reporting use for other motivations on insomnia (ISI), anxiety and depressive (HADS) symptoms, and coping strategies (BRIEF-COPE). To enhance the power of the analyses, we firstly created the following groups of behaviours based on reported use to facilitate sleep onset: "relaxing behaviours" comprised putatively of de-arousing behaviours based on previous literature (at least one of the following was used to facilitate sleep onset: taking a hot bath or shower, listening to music, reading, drinking herbal tea, doing meditation, doing yoga [44][45][46]; n = 303); "substance use" (at least one of the following: alcohol, cannabis, smoking cigarettes, other substances; n = 84), "medication use" (at least one of the following: prescribed sleep medications, non-prescribed sleep medications, melatonin, antihistamine; n = 114); and "electronic devices use" (at least one of the following: spending time on social media, watching TV shows; n = 356). Table 3 reports the results of the t-test. ...
College students often experience sleep–wake alterations. Different factors can contribute to insomnia symptoms in this population. The present study aims at investigating pre-sleep behaviours and strategies used to aid sleep onset in young college students and their association with insomnia symptoms. A total of 548 Italian college students (mean age = 23.48 years, range = 19–30 years, 80.5% female) completed a web-based survey on pre-sleep behaviours and sleep-onset facilitators, insomnia symptoms and sleep hygiene, anxiety and depression, and coping strategies. The use of electronic devices at bedtime and as a sleep-onset facilitator was predominant. Students using specific behaviours as sleep-onset facilitators were characterised by more psychological difficulties and poorer sleep. In multivariable linear regression analysis, the frequency of using medications and melatonin, regardless of motivations, was associated with higher insomnia symptoms. The use of specific sleep-onset facilitators positively correlated with the severity of insomnia symptoms. Many students engage in behaviours that are considered sleep-interfering and that are often employed in an attempt to facilitate sleep onset without benefits. Overall, the motivational factors behind pre-sleep behaviours need to be addressed in preventive programs targeting young college students.
... Finally, 10 publications with 772 participants were included in the systematic review. [33][34][35][36][37][38][39][40][41][42] The PRISMA flowchart of the selection procedure is illustrated in Fig. 1. ...
... Another randomized, double-blind, placebo-controlled trial examined the effects of chamomile tea on sleep quality and depression in 80 postpartum women. 41 The study reported significant improvements in sleep quality and depression scores in the chamomile group compared with the placebo group after two weeks of treatment. The authors concluded that chamomile tea might be a safe and effective complementary therapy for improving sleep and mood in postpartum women. ...
Objective Herbal and natural supplements have gained popularity as alternative treatments to insomnia and sleep disorders due to their perceived safety and potential effectiveness. This literature review summarizes the current evidence on the efficacy, safety, and mechanisms of action of commonly used supplements for sleep, including valerian, hops, kava, German chamomile, cherry, tryptophan, theanine, melatonin, magnesium, and zinc.Methods We conducted literature review of clinical research on herbal and supplements for sleep reported to date. We summarized key findings and reviewed outcomes related to clinical efficacy and side effects.Results Findings suggest that certain supplements, particularly valerian, hops, and melatonin, could be effective in improving sleep quality and reducing insomnia symptoms through modulation of neurotransmitter systems and regulation of sleep-wake cycles. However, the strength of the evidence varies with unestablished optimal dosages, formulations, and treatment durations. Although generally considered safe, these supplements are not without risks, such as rare but serious adverse effects associated with kava and potential interactions with prescription medications. The quality and purity of supplements also vary widely due to a lack of strict regulations.Conclusion Healthcare providers should remain informed about the latest research and work closely with patients to develop personalized treatment plans. Herbal and natural supplements may offer promising alternatives or adjunct treatments for insomnia and sleep disorders, but their use should be guided by the best available evidence and individual patient requirements. Larger, well-designed clinical trials are needed to establish the efficacy and safety of these supplements for clinical decision-making.
... [ [104][105][106][107][108][109][110][111][112][113][114] Both in vitro and in vivo studies are carried out to assess their pharmacotherapeutic properties, clinical efficacy, and safety concerns related to toxicity and microbiological quality. Table 2 presents a concise overview of the essential bioactive compounds and therapeutic effects found in common edible flowers, often utilized in the preparation of herbal beverages. ...
Herbal beverages with nutraceutical benefits are becoming more widely acknowledged as healthy dietary choices among mindful consumers. There are numerous types of herbal beverages prepared from different morphological plant elements. Edible flowers, with their unique flavors, distinct aromas, vivid colors, and nutraceutical properties, have gained predominance among all the other botanical ingredients utilized in the formulation of herbal beverages. This review elaborates on applications of edible flowers used in the preparation of herbal teas, infusions, and a few other novel developments in herbal beverages. Although several commercialized herbal beverages have been developed with edible flowers, many other edible flowers with medicinal properties remain unexplored. The review further elaborates on the pharmacotherapeutic properties of these flowers, emphasizing their potential to be used in herbal beverage formulations. Additionally, ensuring the food safety aspects of innovative herbal beverages derived from edible flowers by addressing their potential toxicity and microbiological quality is vitally important. Insights presented here pave the way for incorporating edible flowers in herbal beverages, encouraging nutritious and health-promoting beverage development and consumption.
... Medicines restore thyroid hormone level by adding artificial T4 into the body whereas Chamomile helps in a better way; it takes a revolutionary approach by providing the right nutrition to help the thyroid gland naturally produce required levels of T3 and T4. [36] ...
Medicinal herbs are mainly used as restorative vehicles in many forms of conventional therapy and are sensational beverages worldwide. Chamomile is a member among several other members of the medicinal herbs family. Chamomile extract is mainly used to heal PCOS, hypo and hyperglycemia, cardiovascular disease and weight reduction,; it contains some functional phytochemicals like different phenolic compounds (flavonoids and non-flavonoids), terpenoids, carotenoids, lignins, lignans etc. In this review, we are going to talk about chamomile, how medicinal herbs can be beneficial for health, and what further research is required to understand whether regular consumption can contribute to healthy living or not.
... Ghamchini et al. [22] effects on anxiety in cancer patients. The differences between their results and the findings of another study that investigated cancer patients [51], showed that any cancer patient has a different response to chamomile tea treatment. On the other hand, studies including female participants had more promising results; Bazrafshan et al. [49], reported that chamomile tea might help postmenopausal women feel less anxious. ...
Anxiety disorder is a prevalent psychiatric issue that affects 4.05% of the global population. As complementary and alternative medicine gains popularity, many individuals with anxiety symptoms seek herbal remedies. This systematic review aims to explore the sedative efficacy of chamomile as an herbal medicine for anxiety treatment. Our search was conducted in PubMed, Google Scholar, and Scopus databases until August 2023. Among 389 papers found, after removing duplicates and irrelevant papers, 10 clinical trials investigating the effect of oral consumption of chamomile on anxiety were included. Two researchers independently completed all steps, including the screening process and data extraction. Out of the 10 articles selected, 9 studies have concluded that chamomile is effective in reducing anxiety. Even though, the exact mechanism of chamomile's anxiolytic action is not well understood, evidence suggests that its active compounds, including apigenin, may modulate the function of the hypothalamic-pituitary-adrenocortical axis by affecting neurotransmitter pathways. This systematic review showed that chamomile potentially has an anxiolytic effect. In addition, due to the side effects of drugs used to treat anxiety disorders, the use of chamomile seems to be effective and less dangerous.
... Herbal extracts have been a valuable source of new therapeutics for the treatment of various diseases or disorders; for example, insomnia. Chamomile tea and chamomile essential oils are widely used for their sedative-hypnotic effects [35,36]. In this study, the soporific effect of the M. discoidea dry extracts was assessed by measuring their effects on sodium thiopental-induced sleep. ...
Pineapple weed (Matricaria discoidea DC.) is a widespread plant in Europe and North America. In ethnomedicine, it is well-known for its anti-inflammatory and spasmolytic activities. The aim of this research was to develop novel methods of M. discoidea processing to obtain essential oil and dry extracts and to investigate their phytochemical compositions. Moreover, the molecular docking of the main substances and the in vivo studies on their soporific and analgesic activities were conducted. The essential oil and two dry extracts from M. discoidea were prepared. A total of 16 phenolic compounds (seven flavonoids, seven hydroxycinnamic acids, and two phenolic acids) in the dry extracts were identified by means of UPLC-MS/MS. In the essential oil, nine main terpenoids were identified by gas chromatography (GC). It was shown that phenolic extraction from the herb was successful when using 70% ethanol in a triple extraction method and at a ratio of 1:14–1:16. The in vivo studies with rodents demonstrated the analgesic activity of the M. discoidea extracts and improvements in the sleep of animals. The dry extracts of M. discoidea did not show any toxicity. The molecular docking analysis showed a high probability of COX-1,2 inhibition and NMDA receptor antagonism by the extracts.
... Drinking chamomile tea after birth for two weeks also caused significant improvements in sleep efficiency and postnatal depression (64). These benefits largely disappeared four weeks posttest, though this could be due to broader changes in physiological activity weeks after birth, rather than a loss in efficacy of chamomile itself (65). ...
NAD⁺, a pivotal coenzyme central to metabolism, exhibits a characteristic decline with age. In mice, NAD⁺ levels can be elevated via treatment with apigenin, a natural flavonoid that inhibits the NAD⁺-consuming glycoprotein CD38. In animal models, apigenin positively impacts both sleep and longevity. For example, apigenin improves learning and memory in older mice, reduces tumor proliferation in a mouse xenograft model of triple-negative breast cancer, and induces sedative effects in mice and rats. Moreover, apigenin elongates survival in fly models of neurodegenerative disease and apigenin glycosides increase lifespan in worms. Apigenin’s therapeutic potential is underscored by human clinical studies using chamomile extract, which contains apigenin as an active ingredient. Collectively, chamomile extract has been reported to alleviate anxiety, improve mood, and relieve pain. Furthermore, dietary apigenin intake positively correlates with sleep quality in a large cohort of adults. Apigenin’s electron-rich flavonoid structure gives it strong bonding capacity to diverse molecular structures across receptors and enzymes. The effects of apigenin extend beyond CD38 inhibition, encompassing agonistic and antagonistic modulation of various targets, including GABA and inflammatory pathways. Cumulatively, a large body of evidence positions apigenin as a unique molecule capable of influencing both aging and sleep. Further studies are warranted to better understand apigenin’s nuanced mechanisms and clinical potential.
... Several studies have shown the effect of chamomile against muscle spasms, rheumatism, and gastrointestinal disorders [5,6]. Furthermore, extensive literature promotes the effect of chamomile tea, such as the German chamomile Matricaria chamomilla L., against obesity, depression, stress, inflammation, and cancer [7][8][9][10][11][12]. Moreover, different clinical trials demonstrated not only the anti-inflammatory effect against eczema as well as chemo-and radiotherapy-induced mucositis by a chamomile tea extract and its bioactive secondary metabolites, apigenin and α-bisabolol [13,14]. ...
Chamomile tea is a popular beverage and herbal remedy with various health benefits, including antioxidant and antimicrobial activities and beneficial effects on metabolism. In this study, we investigated the inhibitory activities of secondary metabolites from Matricaria chamomile L. against COX2, an enzyme involved in inflammation and linked to cancer development. The cytotoxicity of the compounds was also evaluated on a panel of 60 cancer cell lines. Myricetin, one of the COX2-inhibiting and cytotoxic compounds in chamomile tea, was further studied to determine a proteomic expression profile that predicts the sensitivity or resistance of tumor cell lines to this compound. The expression of classical mechanisms of anticancer drug resistance did not affect the responsiveness of cancer cells to myricetin, e.g., ATP-binding cassette (ABC) transporters (ABCB, ABCB5, ABCC1, ABCG2), tumor suppressors (p53, WT1), and oncogenes (EGFR, RAS), whereas significant correlations between myricetin responsiveness and GSTP expression and cellular proliferation rates were observed. Additionally, Kaplan–Meier survival time analyses revealed that high COX2 expression is associated with a worse survival prognosis in renal clear cell carcinoma patients, suggesting a potential utility for COX2 inhibition by myricetin in this tumor type. Overall, this study provides insight into the molecular modes of action of chamomile secondary metabolites and their potential as cancer-preventive or therapeutic agents.
... The intervention was the use of 30 mg dried stigmas of the saffron plant (Mostafavi company, Iran. This company is one of the largest producers of saffron in Iran and the world), which was boiled once (in the morning) (in 300 ml of boiling water for 10-15 min); one cup of saffron tea was consumed daily with white rock candy [27][28][29]. The study participants were instructed to use herbal tea completely and avoid using other medicinal plants at the same time, according to the previous agreement and the individual's consent. ...
Background:
Evidence suggests that menopause can be associated with a variety of negative psychological changes such as depression and anxiety, and improving the mental health status of women during menopause is one of the important priorities and challenges of the health system. The aim of this study was to determine the effect of saffron (Crocus sativus L., Iridaceae) herbal tea on happiness in postmenopausal women.
Methods:
In this randomized clinical trial which was conducted in 2021, 72 postmenopausal women were enrolled and divided into intervention and control groups. The randomization blocks method was used for random allocation, and the Oxford Happiness Questionnaire was utilized to measure the scores. The intervention included the use of 30 mg of dried stigmas of the saffron plant, which was boiled once (in the morning, in 300 ml of boiling water for 10-15 min) and consumed with white rock candy as one cup of saffron tea daily. To compare the trend of changes and after removing the effect of other variables, generalized estimating equation (GEE) was used.
Results:
There was no significant difference between the intervention and control groups in any of the quantitative and qualitative characteristics (p > 0.05). The results of paired samples t-test showed that the happiness mean score in the intervention group increased significantly (p < 0.001) from 42.93 ± 8.54 to 61.58 ± 8.24, while in the control group, there was no significant difference between the happiness mean score at the beginning and end of the study (p = 0.861). Also, after applying the treatment program in the intervention group, there was a significant difference between the two groups in terms of the happiness mean scores (p < 0.001).
Conclusion:
Saffron herbal tea had a positive effect on reducing depression and increasing the happiness score; thus, it is recommended that it should be used as a complementary treatment in consultation with the treating physician.
Trial registration:
The present study was registered with the code of IRCT20210403050818N1 (Registration date: 09/04/2021) in the Iranian Registry of Clinical Trials. It was also approved by the Ethics Committee of Larestan University of Medical Sciences (Approval ID: IR.LARUMS.REC.1399.017).
... 27 Results of another RCT illustrated that those women who drank chamomile tea realized improvements in their symptoms-related postpartum depression. 60 A cross-sectional study demonstrated that chamomile was one of the most widely used complementary alternative medicine therapies that 62.8% of depressed patients used due to its anti-depressant effects. 61 The effect of chamomile on anxiety and depression can be attributed to the stimulation of the limbic system, releasing several neurotransmitters and neurobiological changes. ...
Background and objectives:
Despite significant advances in the diagnosis and treatment of cancer, many people across the world still suffer from this chronic disease and its complications. Chamomile as an herbal medicine has gained an increasing attention for relieving cancer complications. This study aimed to integrate and synthesize current international evidence regarding the effect of chamomile on cancer complications.
Methods:
A systematic review was undertaken. Five online databases including Web of Science, PubMed [including MEDLINE], Cochrane Library, Scopus, and Embase were searched and articles published from inception to January 2023 were retrieved. All clinical trials and similar interventional studies on human subjects examining the effects of chamomile on cancer complications were included in the review and research synthesis. Relevant data were extracted from eligible studies after quality appraisals using proper methodological tools. The review results were presented narratively given that meta-analysis was impossible.
Results:
A total of 2240 studies were retrieved during the search process, but 18 articles were selected. The total sample size was 1099 patients with cancer of which 622 participants were female. Fifteen studies used an RCT design. Various forms of chamomile were used such as mouthwash, topical material, tea, capsule, syrup and aromatherapy massage. Chamomile effectively reduced oral mucositis, skin complications, depression, and vomiting and also improved appetite and quality of life among cancer patients.
Conclusion:
The use of chamomile as a non-pharmacologic and safe method can be helpful for mitigating cancer complications in patients with cancer. Therefore, it can be incorporated into routine care along with other therapeutic measures to reduce patients' suffering related to cancer.
Systematic review registration number (prospero):
CRD42022307887.
... 27 Results of another RCT illustrated that those women who drank chamomile tea realized improvements in their symptoms-related postpartum depression. 60 A cross-sectional study demonstrated that chamomile was one of the most widely used complementary alternative medicine therapies that 62.8% of depressed patients used due to its anti-depressant effects. 61 The effect of chamomile on anxiety and depression can be attributed to the stimulation of the limbic system, releasing several neurotransmitters and neurobiological changes. ...
Background and objectives:
Despite significant advances in the diagnosis and treatment of cancer, many people across the world still suffer from this chronic disease and its complications. Chamomile as an herbal medicine has gained an increasing attention for relieving cancer complications. This study aimed to integrate and synthesize current international evidence regarding the effect of chamomile on cancer complications.
Methods:
A systematic review was undertaken. Five online databases including Web of Science, PubMed [including MEDLINE], Cochrane Library, Scopus, and Embase were searched and articles published from inception to January 2023 were retrieved. All clinical trials and similar interventional studies on human subjects examining the effects of chamomile on cancer complications were included in the review and research synthesis. Relevant data were extracted from eligible studies after quality appraisals using proper methodological tools. The review results were presented narratively given that meta-analysis was impossible.
Results:
A total of 2240 studies were retrieved during the search process, but 18 articles were selected. The total sample size was 1099 patients with cancer of which 622 participants were female. Fifteen studies used an RCT design. Various forms of chamomile were used such as mouthwash, topical material, tea, capsule, syrup and aromatherapy massage. Chamomile effectively reduced oral mucositis, skin complications, depression, and vomiting and also improved appetite and quality of life among cancer patients.
Conclusion:
The use of chamomile as a non-pharmacologic and safe method can be helpful for mitigating cancer complications in patients with cancer. Therefore, it can be incorporated into routine care along with other therapeutic measures to reduce patients’ suffering related to cancer.
... These results were similar to Maulidawati study (Maulidawati et al., 2022) that prove improvement in sleep quality in the third trimester pregnant women after consuming chamomile tea and using lavender aromatherapy during sleeping. A research by Chang and Chen also found chamomile tea was beneficial to improve sleep quality and reduce stress, as PSQS score decreasing, in postpartum mother (Chang & Chen, 2016). Other studies found chamomile aromatherapy could reduce prevalence of insomnia in student and elderly (Khasanah, 2020) (Fitriana et al., 2019). ...
One of the commonest issues found in pregnant women, mainly in the third trimester, was sleep disruption. Decreasing sleeping time could be a cause of increasing anxiety and/or physical discomfort as higher gestational age. This affected physical and emotional condition such as decreasing concentration, tiredness, and emotional imbalance. The Purpose of this study was to examine lavender and chamomile aromatherapy effectivity on sleep quality of the third semester pregnant women in Semper Barat I Primary Health Care. This study was a quasi-experimental study. Participants were 30 pregnant women which would be divided into two groups interventions, randomly. the participants asked to fill Pittsburgh sleep quality index (PSQI) questionnaire before and after intervention. Three drops of essential oil mixed with water was used to fill diffuser. It will be put in the bedroom for two weeks. Lavender and chamomile aromatherapy were effective to improve sleep quality in our participants. Average score of PQSI after intervention using lavender aromatherapy was dropped significantly (11,3 vs 5,73; p=0,0001) as well as chamomile aromatherapy (10,53 vs 6,53; p=0,0001). These facts could be used to help pregnant women to improve sleep quality. It is suggested to healthcare worker to use nonpharmacological therapy as well as this technique.
... Aromatherapy has been used for pain and anxiety relief, relaxation, and creating a pleasant feeling in mothers [47][48][49], which could help to relieve fatigue and depressive emotions. Women in the intervention group reported the bene ts of drinking chamomile tea to be facilitating emotional stability and relaxation and having an aromatic fragrance, which could calm restlessness, facilitate the postnatal paternity relationship, and alleviate postpartum fatigue [50]. However, the positive effects did not last long after the intervention. ...
Background: Postpartum fatigue is the most common issue among postnatal women and it could not only seriously affect the health of mothers but also bring about adverse impacts on their offspring. However, postpartum fatigue is an ongoing research issue but is seldom treated. This systematic review and meta-analysis aims to synthesize nonpharmacological evidence and evaluate the effectiveness of interventions for reducing postpartum fatigue among puerperae.
Methods: The Cochrane Library, PubMed, Embase, Web of Science, PsycINFO, CINAHL and ProQuest databases were searched for papers published from inception until February 2021. Grey literature was searched using OpenGrey. Randomized controlled trials (RCTs) or controlled clinical trials (CCTs) evaluating nonpharmacological interventions for postpartum fatigue reduction were eligible for inclusion. The methodological quality of the included studies was independently assessed by two reviewers using the Cochrane risk-of-bias tool and the risk of bias in nonrandomized studies of interventions. The meta-analysis was conducted using Review Manager 5.3.
Results: Seventeen published clinical trials matched the eligibility criteria for the systematic review, and thirteen studies involving 1686 participants were included in this meta-analysis. The results of the meta-analysis revealed that exercise (SMD= -1.74, 95% CI=-2.61 to -0.88), physical therapy (SMD= -0.50, 95% CI=-0.96 to -0.03) and drinking tea (MD= -3.12, 95% CI=-5.44 to -0.80) resulted in significant improvements in women’s postpartum fatigue at postintervention. Drinking tea may have beneficial effects on depression (MD= -2.89, 95% CI=-4.30 to -1.49). Positive effects of psychoeducational interventions on postpartum fatigue or depression were not observed.
Conclusions: This review provides evidence that exercise, physical therapy and drinking tea are effective nonpharmacological interventions for relieving postpartum fatigue. Detailed instructions for postpartum exercise should be offered to puerperae. Physical therapy could be used in combination to enhance the intervention efficacy. Multiple daily cups of tea may be recommended. Psychoeducational interventions were ineffective for postpartum fatigue, but they could be integrated with the internet or smartphones to improve their effectiveness in the future. Fatigue-related nonpharmacological interventions of psychological outcomes still need to be studied.
... Among the reasons that increase sleep problems experienced in the postpartum period, socioeconomic problems, living in rural areas, physiological and psychological changes experienced after birth were determined (Fischer et al., 2021;Stremler et al., 2017). In some studies conducted on postpartum women, it has been found that practices such as exercise, back massage, reflexology application, inhaled lavender oil, aromatherapy, foot bath with lavender cream, chamomile tea, and breastfeeding increase sleep quality (Afshar et al., 2015;Chang & Chen, 2016;Chen, 2014;Effati-Daryani et al., 2018;Ko & Lee, 2014;Li et al., 2011;Varghese et al., 2014;Yang & Chen, 2018). ...
Postpartum dönem, doğumdan sonra annede değişikliklere yol açan, annenin hemşirelik bakımına ihtiyaç duyduğu 6 haftalık bir geçiş dönemidir. Postpartum dönemde en sık yaşanan sağlık sorunları uyku kalitesi ile ilişkilidir. Bu dönemde yaşanan uyku sorunlarının ilerleyen zamanlarda da devam ettiği bildirilmiştir. Uyku kalitesi, bireyin uykuya dalma hızı, uyku süresi, uyanma sayısı, uykunun derinliği ve dinlendiriciliğini ifade etmektedir. Postpartum dönemde yaşanan uyku problemlerinin nedenleri; doğumda yaşanan sorunlar, uterus kasılmaları, kesi ağrısı, stres, bebek bakımı ve beslenmesidir. Annenin uyku sorunu ile baş edebilmesi için partnerinden, ailesinden ya da bakım verenlerden destek alması gerekmektedir. Postpartum 6 haftalık sürede anne ve bebek izleminin sağlanması ve annelerin yaşadıkları sorunların hemşire tarafından belirlenmesi ve değerlendirilmesi gerekmektedir. Hemşire hastaneden taburcu olduktan sonra anneyi kendi yaşadığı ortamda gözlemlemelidir. Annenin bulunduğu ortamda sorun ve endişesini rahat anlatabilmesi, yaşanacak sağlık sorunlarının erken dönemde önlenmesine olanak sağlamaktadır. Bu nedenle anne ile iletişime geçilerek sağlık sorunlarının belirlenmesi ve buna yönelik girişim planlanması önemli görülmektedir.
... Chamomile is an excellent reliever when patients with depression have physical and psychological discomfort [8]. Chamomile tea made from chamomile flower heads can effectively relieve depressive symptoms and the sleep status of postpartum women, which provides a new idea for treatment of depression [87]. Some pharmacological experiments have suggested the antidepressant activity of Chamomile [88]. ...
Matricaria chamomilla L. (MC) and Chamaemelum nobile (L.) All. (CN) are two varieties of Chamomile. These herbs have been used for thousands of years in Greece, Rome and ancient Egypt. Chamomile has been used for the treatment of stomach problems, cramps, dermatitis, and minor infections. The purpose of this study was to introduce the botanical characteristics and geographical distribution, traditional uses, chemical constituents, pharmacological activities, toxicity studies and quality control studies, and lay a theoretical foundation for the rational development and utilization of chamomile. This review powered that chemical constituents include flavonoids, coumarins, volatile oils, terpenes, organic acids, polysaccharides, and others. These compounds possess anticancer, anti-infective, anti-inflammatory, antithrombotic, antioxidant, hypolipidaemic, hypoglycaemic, antihypertensive, antidepressant, neuroprotective activities, among others. Chamomile is a widely used herb in traditional medicine. It brings great economic value due to its numerous pharmacological effects and traditional uses. However, more toxicity tests should be carried out to confirm its safety. There is need for further research to provide concrete scientific evidence and validate its medicinal properties.
... Cohen et al., 1985). The Chinese versions of the PSQI, EDS, PSS, and ISEL have been shown adequate internal consistency and construct validity in prior research (Chang & Chen, 2016;C. H. Chen et al., 1994;Ko et al., 2010) and were found to have adequate internal consistency in this study (Cronbach's α = 0.75,0.86,0.84,and ...
We aimed to investigate the effect of a mental health website intervention on perceived stress, depression, sleep quality, and social support in women with recurrent miscarriage (RM). Performing a randomized controlled trial, the participants in the experimental group (n = 31) received a 12-week mental health website intervention; the participants in the control group (n = 31) received RM standard medical care only. The paired t-tests results for the mean posttest scores for depression (p = .023) and perceived stress (p = .041) in the experimental group showed a significant decrease, but did not in the control group.
... However, some studies have pointed out that drinking an appropriate tea may help to relieve depression, overcome sleep problems, and improve digestion. [6,37] As shown above, insights into TCMC can provide useful information for the adjustment of lifestyle behaviors such as the use of appropriate tea products, to alleviate body constitution. ...
The World Health Organization states prevention of chronic diseases should be based on good lifestyle behaviors and healthy diets as they can reduce the risk of chronic diseases by 80%. The theory of traditional Chinese medicine constitution (TCMC) emphasizes the congenital differences of TCMC stem from the genes of parents, while acquired differences in TCMC are caused by factors as living environments, lifestyle behaviors, and dietary habits. From the perspective of preventive medicine, this study explores the correlation between dietary habits and lifestyle behaviors as potential risk factors for different types of TCMC—balanced constitution, Yang deficiency, Yin deficiency, and Phlegm stasis. Research data were collected from 2760 subjects aged 30 to 70 years participating in a survey conducted by Taiwan Biobank in 2012 to 2017. The survey included basic demographic characteristics, lifestyle behaviors, and dietary habits along with a Body Constitution Questionnaire. Compared to men, women were 3 to 4 times more likely to develop Yang-deficiency, Yin-deficiency, and Phlegm stasis. Variables that affected TCMC were smoking, midnight snack consumption, consumption of gravy-soaked or lard-soaked rice/noodles, deep-fried soybean products, bread spread, pickled vegetables as side dishes for the main course of a meal, and the dietary habit of vegetables or fruits instead of high-fat desserts. Poor dietary habits and lifestyle behaviors are the cause of unbalanced TCMCs. Understanding the specific TCMC of individual can provide useful information and predictions to maintain physical health and achieve early disease prevention to meet the goal of preventive medicine.
... This finding may be due to a limitation of the study questionnaire, which did not ascertain the specific types of tea (black, green, herbal, etc.) consumed by participants. Non-caffeinated varieties such as chamomile have been linked to relaxation and improved sleep among adults (Chang and Chen, 2016), whereas caffeinated teas have a dose-dependent disruptive effect on sleep (Hindmarch et al., 2000). Certain types of tea consumption may bear some benefit in our sample and further interventional research could consider this beverage in modifying sleep among PLWH. ...
Sleep disturbance is common among persons living with HIV (PLWH) causing significant health impacts. Nigeria recently switched from efavirenz to dolutegravir (DTG) for first-line antiretroviral therapy (ART). This study aimed to assess the prevalence of sleep disturbance and to determine factors associated with sleep disturbance among treatment-experienced PLWH. Using a cross-sectional study design and systematic random sampling, 300 participants were recruited from the Infectious Diseases Institute, Ibadan, Nigeria (IDI). Interviewer administered questionnaire was used to collect data regarding sociodemographic, sleep disturbance (Pittsburgh Sleep Quality Index; PSQI), depression (Patient Health Questionnaire; PHQ-9), anxiety (Generalized Anxiety Disorder-7; GAD-7), and psychoactive substance use. HIV-specific data were retrieved from IDI's medical records. The relationship between the PSQI score and the scores on the PHQ-9 and GAD-7 were explored with the Pearson correlation coefficient. Chi-square global tests of independence were used to assess factors associated with sleep disturbance and a multivariable binary logistic model was used to determine independent predictors of sleep disturbance. The mean age of the sample was 44.5 ± 11.4 (years), the average duration of HIV diagnosis was 8.13 ± 5.33 (years) and the majority were on DTG-based regimens (95%). Depression and anxiety were present in 14 and 17.3%, respectively. Prevalence of sleep disturbance (PSQI score of 6 or more) was 21.7%. Higher PSQI scores were associated with higher PHQ-9 scores (r = 0.526; p < 0.001) and higher GAD-7 scores (r = 0.529; p < 0.001). Sleep disturbance was associated with age (χ2 = 4.483, p = 0.038), marital status (χ2 = 7.187, p < 0.01), depression (χ2 = 46.589, p < 0.001), and anxiety (χ2 = 38.379, p < 0.001). There was no significant association between sleep disturbance and HIV clinical stage at diagnosis, virological suppression status, and ART regimen type (p > 0.05), whereas tea intake was associated with an absence of sleep disturbance (χ2 = 6.334, p < 0.014). Age (>45 years), depression and anxiety were associated with higher odds of sleep disturbance among PLWH. Sleep disturbance remains common among PLWH in the DTG era. Depression and anxiety are significant factors associated with sleep disturbance. Assessing these factors in future studies may improve the sleep health of PLWH.
... Chamomile Oil from Matricaria chamomilla L. plays a beneficial role in anxiety and improves sleep patterns. It has benzodiazepine-like activity contributed by apigenin [53,54]. The main active constituents are apigenin (flavone), quercetin (flavonoids), Patuletin (O-methylated flavonol), and luteolin (tetrahydroxy flavone), responsible for the nootropic effects of chamomile. ...
Ageing comes with degeneration in many biological activities like impairment of cognition, intelligence, attention, and memory. The decline in all those mental capabilities would be due to the abnormal changes in neuronal architecture with increasing age, chronic oxidative stress and inflammatory state of the tissue, nutritional deficiency. Nootropics or smart drugs enhance memory, attention, creativity, and cognitive performance by affecting the synthesis and receptor binding of neurotransmitters in the brain, especially dopamine, serotonin, gamma-aminobutyric acid, glutamate, and acetylcholine. Nootropics have shown their positive effects in parkinson's, autism, alzheimer's, huntington's disorders, where impaired memory is the primary concern. Synthetic class of nootropics has limitations and reported exacerbation of other brain disorders (off label effects) or therapeutic failure in some instances. Nutraceuticals are dietary derived vitamins, minerals, herbal products, proteins, marine products, and probiotics. The health benefits derived from Nutraceuticals are increasing brain blood flow, reducing inflammation in nervous tissues, detoxifying toxins from the brain, balancing neurotransmitter turnover rate, correcting neuronal and receptor damages and facilitating synaptic transmission, good antioxidant properties and power of improving neuroplasticity of the brain that combat neurodegeneration. The demands for effective nootropics will remain high as the number of cases are increased tremendously.
Floriculture and horticulture are now intertwined within the food industry, with flowers emerging as a promising avenue for fulfilling the escalating demand for innovative food options that offer both sensory appeal and health benefits. Flowers, rich in pigmentation, contain numerous phytochemicals that positively impact human health, including antioxidants that combat cellular aging. Edible flowers are widely used to enhance the appearance and flavor of various foods. Flowers like Rose, Hibiscus, Pansy, Nasturtium, and Rhododendron are popular choices for salads, cakes, garnishes, and flavorings. They are not only visually appealing but also offer nutritional benefits. They contain carbohydrates, proteins, fats, vitamins, minerals, and phenolics, which contribute to their functional properties such as antioxidant, anti-inflammatory, antimicrobial, anticancerous, neuroprotective, antidiabetic, uricosuric, and antihaemolytic effects. The demand for functional foods and new tastes is increasing, creating significant opportunities for the commercial use of edible flowers in the food industry. However in India, challenges for edible flowers include limited awareness, lack of standardized cultivation practices, insufficient research on nutritional benefits, seasonal availability, and regulatory hurdles for commercialization, impacting their adoption in culinary and medicinal applications.
Background: Postpartum depression (PPD) is a disorder that can negatively affect both maternal and neonatal health. Objectives: This study aimed to evaluate the effect of chamomile on PPD. Methods: This randomized controlled trial was conducted on 144 women with PPD. The women were randomly assigned to an intervention group (n = 72) that received chamomile capsules (500 mg twice a day) and a placebo group that received a placebo for eight weeks. A demographic questionnaire and Beck's Depression Inventory were used to collect the data. The chi-square test, independent t-test, Mann-Whitney U test, and Wilcoxon test were used to analyze the data. Results: A total of 128 women completed the study. The mean depression score in the intervention group decreased from 21.66 ± 4.01 at baseline to 18 ± 3.66 after the intervention. In the control group, the depression scores reduced from 22.36 ± 3.83 to 20.09 ± 3.77. The reduction in depression scores was statistically significant in the intervention group compared to the control group (P = 0.002). Before the intervention, 41 (65.1%) women in the intervention group and 50 (76.9%) in the control group had moderate depression. After the intervention, however, 7 (11.1%) women in the intervention group were without depression, and 60.3% had mild depression, while the reduction in the control group was negligible (P = 0.002). Conclusions: Chamomile capsules (500 mg) taken twice a day for eight weeks significantly reduced the score and frequency of mild and moderate PPD. However, due to the lack of laboratory evaluation, the results of this study should be interpreted with caution. Further studies are needed to confirm these findings.
Depression is a multifactorial disease with unknown etiology affecting globally. It’s the second most significant reason for infirmity in 2020, affecting about 50 million people worldwide, with 80% living in developing nations. Recently, a surge in depression research has been witnessed, resulting in a multitude of emerging techniques developed for prediction, evaluation, detection, classification, localization, and treatment. The main purpose of this study is to determine the volume of depression research conducted on different aspects such as genetics, proteins, hormones, oxidative stress, inflammation, mitochondrial dysfunction, and associations with other mental disorders like anxiety and stress using traditional and medical intelligence (medical with AI). In addition, it also designs a comprehensive survey on detection, treatment planning, and genetic predisposition, along with future recommendations. This work is designed through different methods, including a systematic mapping process, literature review, and network visualization. In addition, we also used VOSviewer software and some authentic databases such as Google Scholar, Scopus, PubMed, and Web of Science for data collection, analysis, and designing comprehensive picture of the study. We analyzed 60 articles related to medical intelligence, including 47 from machine learning with 513,767 subjects (mean ± SD = 10,931.212 ± 35,624.372) and 13 from deep learning with 37,917 subjects (mean ± SD = 3159.75 ± 6285.57). Additionally, we also found that stressors impact the brain's cognitive and autonomic functioning, resulting in increased production of catecholamine, decreased cholinergic and glucocorticoid activity, with increased cortisol. These factors lead to chronic inflammation and hinder the brain's normal functioning, leading to depression, anxiety, and cardiovascular disorders. In the brain, reactive oxygen species (ROS) production is increased by IL-6 stimulation and mitochondrial cytochrome c oxidase is inhibited by nitric oxide, a potent inhibitor. Proteins, lipids, oxidative phosphorylation enzymes, and mtDNA are further disposed to oxidative impairment in the mitochondria. Consequently, mitochondrial dysfunction exacerbates oxidative stress, impairs mitochondrial DNA (mtDNA) or deletions of mtDNA, increases intracellular Ca2+ levels, changes in fission/fusion and mitochondrial morphology, and lastly leads to neuronal death. This study highlights the multidisciplinary approaches to depression with different aspects using traditional and medical intelligence. It will open a new way for depression research through new emerging technologies.
The aim of the study is to determine the midwifery approach in these stages by evaluating the effect and results of the concept of sleep in different stages of women’s life. The stages of women’s life; a national and international literature review was conducted for studies conducted between 2010 and 2020 using the keywords menstruation, pregnancy, birth, postpartum, menopause and sleep. As a result of the literature review, it has been revealed that sleep is an important factor in all phases of women’s life. During pregnancy, sleep problems are experienced more than other times and women feel extremely tired especially in the first and third trimesters, women who have been mothers sleep more at night than first-time mothers, increased pain and discomfort during childbirth in women who experience sleep deprivation during pregnancy. It has been concluded that there is a relationship with higher cesarean section rates, preterm birth and higher proinflammatory serum cytokine levels, sleep disturbance in the postpartum period affects anxiety symptoms and postpartum depression, mood disorder and breastfeeding self-efficacy, and sleep problems are encountered more frequently in the early periods during menopause.
The perinatal period is a time of vulnerability for psychological distress with increased risk of depressive and anxiety symptoms. However, the most common subjective complaint, particularly during the post-partum period, is that of fatigue. While some fatigue may be normative for all new parents, a minority of women experience sustained fatigue, which interferes with their ability to function, yet this is currently not well addressed within health systems. This chapter provides a brief overview of psychological changes during and after pregnancy and a more detailed focus on post-partum fatigue as it is the most prevalent psychological change during and after pregnancy. We review the development of models of post-partum fatigue over the last decades and document their more recent developments. We also review the scales currently validated to measure post-partum fatigue and the evidence base for available treatment options. We also propose recommendations for improving the understanding and treatment of fatigue during and after pregnancy in the future.
Low mental energy can contribute to decreased productivity, altered life balance, decreased physical performance, and ultimately affect quality of life. As such, there is a great demand for food and beverage products that positively impact mental energy. Numerous products claim to alter mental energy making continued review of the scientific evidence critical. The objective of this study was to conduct a scoping review of randomized controlled trials to evaluate the effect of 18 dietary ingredients on mental energy outcomes in adults without severe disease. Methods: A literature search, completed using PubMed, resulted in the identification of 2261 articles, 190 of which met eligibility from initial abstract review. Full-text review was completed on the 190 studies which resulted in 101 articles that fully met eligibility for inclusion in this study. The search strategy for two ingredients did not yield any eligible studies, leaving studies for 16 ingredients that were extracted and summarized by reported significantly improved outcomes for cognition, mood and perceived feelings, and sleep assessments. The preliminary results for several dietary ingredients directionally suggested a mental energy benefit (≥20% of outcomes), including ashwagandha, chamomile, dark chocolate, ginseng, green tea, lavender, lion's mane mushroom, maca, tart cherries, turmeric, and valerian root. The results of this scoping review suggest that of the 16 dietary ingredients reviewed, 11 may be promising for further exploration on their potential benefits in supporting mental energy. Given consumer demand and market growth for food and beverage products that positively impact mental energy; continued efforts in assessment method alignment and additional evaluation in well-designed trials is warranted. KEY TEACHING POINTSOf the 16 dietary ingredients reviewed, 11 (ashwagandha, chamomile, dark chocolate, ginseng, green tea, lavender, lion's mane mushroom, maca, melatonin foods, turmeric, and valerian root) may be promising for further exploration on their potential mental energy benefits.Dark chocolate, ginseng, ashwagandha, and lion's mane mushroom were the most promising ingredients for further evaluation in the cognition domain of the ingredients evaluated.Turmeric, maca, lavendar, and ashwagandha were the most promising ingredients for further evaluation in the mood and perceived feelings domain of the ingredients evaluated.Ashwagandha, chamomile, green tea, melatonin foods, valerian root were the most promising ingredients for further evaluation in the sleep domain of the ingredients evaluated.Additional, well-designed, consistent, clinical trials and systematic reviews are warranted as the challenge of heterogeneity in mental energy study design remains.
Amaç: Bu çalışma, papatyanın anksiyete bozukluğu olan bireylerin psikolojik iyi oluşluluk, depresyon ve anksiyete düzeyi üzerindeki etki büyüklüğünü incelemek amacı ile yapılmıştır. Materyal-metod: Meta analiz türündeki bu çalışmadaki veriler Mart-Mayıs 2022’de PubMed, Web of Scıence, EBSCOhost ve Google Akademik, YÖK tez veri tabanlarında yıl sınırlamasına gidilmeden tarama yapılarak elde edilmiştir. Araştırmaya incelemeler yapıldıktan sonra 7 araştırma dâhil edilmiştir. Araştırmalarda toplam örneklem sayısı 784’tür.. Bulgular: Araştırma sonucunda papatyanın anksiyete üzerinde etkili bir değişken olduğu (SMD: 3,747, %95 CI: 1,621- 0.2,628; Z= 2,311, p = 0.021, I2= %99,448); papatyanın depresyon üzerinde etki büyüklüğünün mükemmel düzeyde olduğu (SMD: 5,762, %95 CI: 6,926- 10,921; Z= 2,190, p = 0.029, I2= %98,753) bulunmuştur. Öte yandan papatyanın anksiyete üzerinde etkili bir değişken olmadığı (SMD: -1,313, %95 CI: 0,294- 0.087; Z= -4,462, p = 0.010, I2= %94,653) belirlenmiştir. Sonuçlar: Çalışmamız sonucunda anksiyete bozukluğu olan bireylerde papatya kullanımının depresyon ve psikolojik iyi oluşluluk üzerinde etkili olduğu bulunmuştur. Çalışmamız sonuçları papatyanın anksiyete bozukluğu olan bireylerde klinik olarak anlamlı bir antidepresan etki üretebileceğini ve bireylerde psikolojik iyi oluşluluk sağlayabileceğini düşündürmektedir.
Sleep problems, particularly sleep deprivation and fragmentations, are common hazards in modern lifestyles and maybe an unavoidable occupational drawback. Different metabolic or hereditary causes may induce sleep problems. Cognitive functions and the closely related metacognition, which depends significantly on decision making, are essential for learning and problem-solving. When impaired for any reason, the quality of life deteriorates, and the person may become dependent on others in severe cases of dysfunction. Sleep and cognition/metacognition are related, and an insult to one function may lead to the other domain's collapse. The present review highlights the significant causes and conditions of sleep problems, cognitive and metacognitive dysfunctions, the possible mechanisms, interactions, and the potential tools or agents that may improve them.
When experiencing mental health challenges, we all deserve treatments that actually work. Whether you are a healthcare consumer, student, or mental health professional, this book will help you recognize implausible, ineffective, and even harmful therapy practices while also considering recent controversies. Research-supported interventions are identified in this book and expanded upon in a companion volume. Chapters cover every major mental disorder and are written by experts in their respective fields. Pseudoscience in Therapy is of interest to students taking courses in psychotherapy, counseling, clinical psychology, and behavior therapy, as well as practitioners looking for a guide to proven therapeutic techniques.
Background
New research supports an integrated approach to treating depression, and lifestyle modifications should be a regular component of both preventative and treatment programs. Therefore, in order to investigate the relationship between various antioxidant supplements and depressive status, we carried out a meta-analysis of randomized controlled trials (RCT).
Methods
We thoroughly searched PubMed, Medline, Scopus, and Web of Science databases to screen publications focusing on the effects of antioxidant supplements on depression status. The meta-analysis mainly compared depression scores between groups that received antioxidant supplements and controls. We also pooled studies reporting changes in anxiety status as a secondary outcome.
Results
52 studies with 4049 participants were eventually identified. The meta-analysis found that the positive effect of antioxidant supplementation, such as magnesium (SMD = 0.16, p = 0.03), zinc (SMD = 0.59, p = 0.01), selenium (SMD = 0.33, p = 0.009), CoQ10 (SMD = 0.97, p = 0.05), tea and coffee (SMD = 1.15, p = 0.001) and crocin (MD = 6.04, p < 0.00001), on depressive status were all significant. And antioxidant supplementation also showed significant improvement in anxiety (SMD = 0.40, p < 0.00001). Subgroup analysis by scale types and countries were performed, and antioxidant supplementation's positive effects on depressive and anxiety states remained significant.
Limitations
This study did not limit the characteristics of the included population, and the diversity of scales also contributed to the heterogeneity.
Conclusion
Intake of antioxidant supplements is associated with improved depression and anxiety states, further affirms the therapeutic potential of antioxidant supplements as adjunctive therapy to conventional antidepressants.
Sleep can be influenced and impaired in countless ways. Sleep disorders often severely impair quality of life and lead to high morbidity, as well as increased mortality. The indication for pharmacological treatment is based on the diagnosis of a sleep disorder, which often varies in symptoms, intensity, and duration. This chapter discusses medications for the treatment of sleep disorders and related symptoms. For more detailed information about sleep medicine diagnostics, as well as for nonpharmacological therapy modalities, please refer to the relevant sleep medical literature. We herein propose a new classification and terminology for medicines for the treatment of sleep disorders: Somnologics (lat. somnologica). With a focus on insomnia disorders, trouble falling and staying asleep, we review substances that promote sleep (anti-insomnics), either by increasing sleep pressure (somnics) or by reducing wake pressure (antivigilantics). With regards to circadian rhythm disorders, we discuss substances for the realignment of the sleep phase (chronotherapeutics). After that, medications for the treatment of hypersomnia disorders, associated with an increased need for sleep, are reviewed (antihypersomnics). Herein, we include medications for the reduction of the sleep drive (vigilantics), as well as for the treatment of cataplexy (anticataplectics).
Chronic sleep deficiency, a public health epidemic, triggers an elevated risk for physical and mental disorders and may cause unpleasant sensations or experiences in daily life. Importantly, sleep-associated skin diseases attract public attention because most people have anxiety about their facial appearance in modern society. Amounts of health food, especially derived from edible and efficient plant extracts, have been developed for skincare via improvement of sleep quality. Mechanisms of good sleep and healthy skin have been studied, however, the relationship between sleep-promoting herbs and skincare is less elucidated. In this review, we summarize the main signaling pathways of neurotransmitter-mediated skin beauty and list dozens of functional plant extracts for sleep assistance. We conclude several plant candidates for oral cosmetics application through sleep-related neurotransmitters regulation. This review provides pieces of evidence for the application of oral cosmetic food derived from plant extracts in sleep-related beauty.
Throughout history, Matricaria chamomilla L. (M. chamomilla) has had countless applications in traditional medicine. Its extracts, oils and teas have been used for treating diverse ailments, including wounds, rheumatic pain, menstrual cramps, eye and ear infections, gastrointestinal disorders, and respiratory illnesses. These traditional applications guided modern research into its medicinal effects through increasingly detailed in vitro and in vivo studies and clinical trials. A plethora of preclinical studies have assessed the antimicrobial, antioxidant, anti-inflammatory, antiulcer, hypoglycemic, hypolipidemic, cardioprotective, hepatoprotective, neuroprotective, nephroprotective, anti-diarrheal, antispasmodic, wound healing, and anticancer properties of M. chamomilla. These pharmacological properties of M. chamomilla are attributed to its rich reservoir of phytochemical constituents, primarily its flavonoids, such as luteolin, apigenin, and quercetin, as well as its sesquiterpenes, mainly chamazulene and (−)-α-bisabolol. Remarkably, preclinical studies have paved the way for progress towards controlled human clinical trials. M. chamomilla has been clinically evaluated for its effects against anxiety, sleep-deficiency, depression, as well as oral, women-related, inflammatory, metabolic, dermatological, gastrointestinal disorders, and children-related conditions. In this sense, this review elucidates and discusses the recent findings for M. chamomilla development as a therapeutic agent that possesses health-promoting, disease-preventing and even treatment properties. The traditional medicinal uses and evidence-based research studies, which were performed in cell culture, animal models and human subjects to assess the pharmacological activities of M. chamomilla, are extensively highlighted. Particular emphasis is given to some phytochemical constituents of M. chamomilla, which demonstrate great potential in treating various conditions.
Mental illness affects millions of people around the world. Anxiety disorders are one of the most common mental disorders, occurring in 16.6% of the population around the world. Anxiety (anxietas-worry, fear, uneasiness) is a specific psychic state, characterized by an excessive manifestation of emotionality. It occurs under the influence of stress, which in interaction with the genetically innate level of emotional activity and reactivity, causes excessive manifestation of emotionality, which is manifested by excessive changes in the behavior and activation of the autonomic nervous system (dilation of pupils, tachycardia, sweating of the palms, respiratory disorder, GIT disorders, etc.). In mild and reversible forms of anxiety disorders, anxiety can be stimulating and productive. However, in strong forms, anxiety can hinder normal human activity for a long time, which requires therapy. In addition to pharmacological therapy, many herbal medicines have shown efficacy in the treatment of anxiety disorders, as therapeutic agents or in addition to therapy, which is confirmed by numerous scientific studies. Herbal preparations of Passiflora incarnata, Kava-Kava, St. John’s wort, valerian, chamomile, lemon balm, lavender are used for centuries in traditional medicine due to sedative effect and positive mood impact. Studies proving the usefulness of these herbal remedies and their extracts in the treatment of anxiety disorders have been gaining importance over the past several decades.
Chamomile has long been used in traditional medicine for the treatment of inflammation-related disorders. In this study we investigated the inhibitory effects of chamomile on nitric oxide (NO) production and inducible nitric oxide synthase (iNOS) expression, and explored its potential anti-inflammatory mechanisms using RAW 264.7 macrophages. Chamomile treatment inhibited LPS-induced NO production and significantly blocked IL-1β, IL-6 and TNFα-induced NO levels in RAW 264.7 macrophages. Chamomile caused reduction in LPS-induced iNOS mRNA and protein expression. In RAW 264.7 macrophages, LPS-induced DNA binding activity of RelA/p65 was significantly inhibited by chamomile, an effect that was mediated through the inhibition of IKKβ, the upstream kinase regulating NF-κB/Rel activity, and degradation of inhibitory factor-κB. These results demonstrate that chamomile inhibits NO production and iNOS gene expression by inhibiting RelA/p65 activation and supports the utilization of chamomile as an effective anti-inflammatory agent.
This study investigated whether there was a relationship between disrupted sleep and postpartum mood disturbances in women during the week after delivery.
Sleep and mood were measured during the third trimester (Time-1) and one week postpartum (Time-2) in a 2-stage longitudinal design.
Participants were recruited from an antenatal clinic in a regional Melbourne hospital.
Forty-four healthy women at low risk for postpartum depression.
N/A.
Objective sleep was measured by actigraphy and subjective sleep by the Pittsburgh Sleep Quality Index; mood was assessed by the Depression Anxiety Stress Scale, the Hospital Anxiety Depression Scale, and the Positive and Negative Affect Schedule. Sleep and mood questionnaires were administered at Time-1 and Time-2. Wrist actigraphy was collected for one week at both times. After delivery, both objective and subjective nighttime sleep significantly worsened with decreased total sleep time and sleep efficiency, while daytime napping behavior significantly increased. On average, mood improved across all scales after delivery, although 45.95% of the sample experienced deterioration of mood. Regression analyses showed little relationship between Time-1 and Time-2 objective nighttime sleep, and postpartum mood. Variables that related to both Time-1 and Time-2 subjective perception of sleep, including subjective nighttime sleep, sleep-related daytime dysfunction, and daytime napping behavior, were significant predictors of postpartum mood.
The perception of poor sleep, and the conscious awareness of its impact during wake-time, might share a stronger relationship with the occurrence of immediate postpartum mood disturbances than actual sleep quality and quantity.
(1) To describe the prevalence of and risk factors for postpartum maternal sleep problems and depressive symptoms simultaneously, (2) identify factors independently associated with either condition, and (3) explore associations between specific postpartum sleep components and depression.
Cross-sectional.
Population-based.
All women (n = 4191) who had delivered at Stavanger University Hospital from October 2005 to September 2006 were mailed a questionnaire seven weeks postpartum. The response rate was 68% (n = 2830).
None.
Sleep was measured using the Pittsburgh Sleep Quality Index (PSQI), and depressive symptoms using the Edinburgh Postnatal Depression Scale (EPDS). The prevalence of sleep problems, defined as PSQI > 5, was 57.7%, and the prevalence of depression, defined as EPDS > or = 10, was 16.5%. The mean self-reported nightly sleep duration was 6.5 hours and sleep efficiency 73%. Depression, previous sleep problems, being primiparous, not exclusively breastfeeding, or having a younger or male infant were factors associated with poor postpartum sleep quality. Poor sleep was also associated with depression when adjusted for other significant risk factors for depression, such as poor partner relationship, previous depression, depression during pregnancy and stressful life events. Sleep disturbances and subjective sleep quality were the aspects of sleep most strongly associated with depression.
Poor sleep was associated with depression independently of other risk factors. Poor sleep may increase the risk of depression in some women, but as previously known risk factors were also associated, mothers diagnosed with postpartum depression are not merely reporting symptoms of chronic sleep deprivation.
To compare the sleep patterns, mood states, and cognitive functioning of primiparous mothers during the first 3 weeks postpartum with those of a control group of nonpostpartum women and to assess the relationships among these variables.
For the first 3 weeks postpartum, 30 primiparous women and 28 nonpostpartum mothers completed daily assessments of mood and recorded multiple aspects of sleep including time of retiring, occurrence and duration of sleep interruption, time of awakening, and morning alertness. Objective measures of memory, attention/concentration, and psychomotor performance were obtained on three occasions.
Postpartum women reported more evening awakenings, more time awake after retiring, and more naps than controls, but overall sleep time was similar. New mothers experienced a higher level of dysphoric mood during the first week than nonpostpartum controls; however, controlling for the effect for "time awake" at night eliminated the significant effect for dysphoric mood. Few differences were observed on the multiple assessments of cognitive function; however, performances of new mothers on memory and psychomotor tasks were likely to be influenced by sleep loss.
Women must make important adjustments in their sleep patterns during the postpartum period. In the study group, these adjustments were largely successful, particularly after the first week postpartum, in avoiding the negative consequences of sleep disturbances such as dysphoric mood and impaired cognitive function. Nevertheless, the significant associations between sleep indices and mood and objective measures of cognitive function point to the importance of encouraging appropriate amounts of sleep for recently delivered women.
The purpose of this study was to describe the sleep patterns and fatigue of both mothers and fathers before and after childbirth. The authors used wrist actigraphy and questionnaires to estimate sleep and fatigue in 72 couples during their last month of pregnancy and 1st month postpartum. Both parents experienced more sleep disruption at night during the postpartum period as compared to the last month of pregnancy. Compared to fathers, with their stable 24-h sleep patterns over time, mothers had less sleep at night and more sleep during the day after the baby was born. Sleep patterns were also related to parents' work status and type of infant feeding. Both parents self-reported more sleep disturbance and fatigue during the 1st month postpartum than during pregnancy. Mothers reported more sleep disturbance than fathers, but there was no gender difference in ratings of fatigue. At both time points, fathers obtained less total sleep than mothers when sleep was objectively measured throughout the entire 24-h day. Further research is needed to determine the duration of sleep loss for both mothers and fathers, to evaluate the effect of disrupted sleep and sleep loss on psychosocial functioning and job performance, and to develop interventions for improving sleep patterns of new parents.
The aim of this study was to examine the risk of depression in the postpartum period (first four months after delivery) as compared to the remaining postnatal year and the pregnancy period. All postpartum women from two municipalities in Norway were included in a questionnaire study of mental health (n = 416). Over 50% of the women (n = 259) answered an identical questionnaire at an additional time either before or after the postpartum period. The level of depression was measured by the Edinburgh Postnatal Depression Scale (EPDS) and the Hopkins Symptom Check List-25 items (SCL-25). The point prevalence of depression (EPDS> or =10) in the first four months postpartum did not differ significantly as compared to other time periods during pregnancy and the postnatal year. This finding remained also after controlling for other risk factors of depression; high score on the life event scale, prior depression and poor partner relationship. There was a non-significant trend of lower prevalence of depression during early pregnancy and after the first eight postnatal months. In conclusion, our findings suggest that the first four months postpartum were not distinguished by higher depression prevalence as compared to other time periods during pregnancy and the first postnatal year.
Studies on postpartum mental disorders among mothers have primarily focused on either depression or psychoses and have generally not included the broader spectrum of mental disorders. A few studies have found that some men have symptoms of depression after becoming fathers, but these studies have not documented whether this exceeds the morbidity among men in general.
To estimate the risk of postpartum mental disorders necessitating hospital admission or outpatient contact for mothers as well as fathers during a 1-year postnatal follow-up period after birth of first live-born child and to investigate whether parents in general differ from nonparents in the risk of admission with a mental disorder and how this difference varies with age.
Register-based cohort formed by linking information from Danish health and civil service registers. A total of 2,357,942 Danish-born persons were followed up from their 15th birthday or January 1, 1973, whichever came later, until date of onset of the disorder in question, date of death, date of emigration from Denmark, or July 1, 2005, whichever came first. From 1973 to 2005, a total of 630,373 women and 547,431 men became parents for the first time, and during the first year after childbirth, these parents contributed 1,115,639 person-years at risk.
First-time psychiatric hospital admission or outpatient contact 0 to 12 months after becoming a parent.
A total of 1171 mothers and 658 fathers were admitted with a mental disorder to a psychiatric hospital during the first 12 months after parenthood, and the corresponding prevalence of severe mental disorders through the first 3 months after childbirth was 1.03 per 1000 births for mothers and 0.37 per 1000 births for fathers. Compared with women who had given birth 11 to 12 months prior, primiparous women had an increased risk of incident hospital admission with any mental disorder through the first 3 months after childbirth, with the highest risk 10 to 19 days postpartum (relative risk [RR], 7.31; 95% confidence interval [CI], 5.44-9.81). Among mothers, risk was also increased for psychiatric outpatient contacts through the first 3 months after childbirth, also with the highest risk occurring 10 to 19 days postpartum (RR, 2.67; 95% CI, 1.99-3.59). Unlike motherhood, fatherhood was not associated with any increased risk of hospital admission or outpatient contact.
In Denmark, the risk of postpartum mental disorders among primiparous mothers is increased for several months after childbirth, but among fathers there is no excess of severe mental disorders necessitating admission or outpatient contacts.
Chamomile has long been used in traditional medicine for the treatment of inflammation-related disorders. In this study we aimed to investigate the inhibitory effects of chamomile on nitric oxide (NO) production and inducible nitric oxide synthase (iNOS) expression, and to explore its potential anti-inflammatory mechanisms using RAW 264.7 macrophages. Chamomile treatment inhibited LPS-induced NO production and significantly blocked IL-1β , IL-6 and TNFα-induced NO levels in RAW 264.7 macrophages. Chamomile caused reduction in LPS-induced iNOS mRNA and protein expression. In RAW 264.7 macrophages, LPS-induced DNA binding activity of RelA/p65 was significantly inhibited by chamomile, an effect that was mediated through the inhibition of IKKβ , the upstream kinase regulating NF-κ B/Rel activity, and degradation of inhibitory factor-κ B. These results demonstrate that chamomile inhibits NO production and iNOS gene expression by inhibiting RelA/p65 activation and supports the utilization of chamomile as an effective anti-inflammatory agent.
The purpose of this study was to explore postpartum women's sleep quality and its predictors in Taiwan.
Cross-sectional design.
Postpartum women (N = 327) were recruited during their postnatal check-ups in Taiwan. Data were collected from October 2008 to July 2009 using a demographic form, the Pittsburgh Sleep Quality Index (PSQI), Physical Symptoms Checklist, Perceived Stress Scale, and Postpartum Social Support Scale. Descriptive statistics, Pearson's correlation, and stepwise multiple regression analysis were used to analyze data.
Most participants (87.5%) reported poor sleep quality (PSQI > 5). Postpartum sleep quality was predicted by postpartum physical symptoms, frequency of nighttime awakening, co-sleeper disturbance, marital satisfaction, perceived stress, and baby sleep status, which explained 29.9% of the total variance.
Most postpartum women did not sleep well due to physical discomfort, perceived stress, co-sleeper disturbance, and marital dissatisfaction.
Evaluation of sleep quality should be a routine part of postnatal check-ups. Information on women's sleep problems, marital satisfaction, stress, co-sleepers, and baby sleep status can be used to individualize intervention protocols for sleep-disturbed women.
New parents should be aware that infants' sleep is unlike that of adults and that meeting their infant's needs is likely to disrupt their own sleep. They will need to adjust their routine to manage their own sleep needs. Parental sleep patterns in the postpartum period are tied to the infant's development of a circadian sleep-wake rhythm, and the infant's feeds. Close contact with the mother and exposure to light/dark cues appear to assist in the development of the infant's circadian rhythm. The composition of breastmilk varies over the course of 24 hours and some components produced at night are likely to contribute to the infant's day/night entrainment. There is no clear evidence that using artificial feeds improves maternal sleep. Most infants need night feeds but requirements for nighttime feeds vary with the individual.
The World Health Organization estimates that 80% of the world’s population relies on herbal medicine, with the use of herbs in the United States expanding significantly in the past decade. Alternative and herbal medicines—such as St. John’s wort, kava, ginkgo biloba, and valerian, among others—have become increasingly popular treatments for nervous and sleep disorders including stress, anxiety, dementia, and forgetfulness. This article reviews the use of ginkgo, kava, passionflower, and valerian in psychiatric practice, summarizing existing research on these major botanicals. Herbal remedies are compared with pharmaceuticals, and dosages, benefits, adverse effects, and drug–herb interactions are discussed for each herb.
: Postpartum sleep disorders are a significant problem for postnatal women. Although factors predisposing postnatal women to sleep disorders have been identified, few sleep quality assessment instruments adequately address these factors.
: This study aimed to develop a Postpartum Sleep Quality Scale (PSQS) and test its psychometric properties.
: Sixteen PSQS items were generated from clinical practice, a literature review, and expert recommendations. Two hundred two postpartum women were recruited from a medical center and an obstetric clinic in southern Taiwan in 2010-2011 to assess the internal consistency, test-retest reliability, construct validity, and convergent validity of the developed PSQS.
: Item analysis removed two of the initial PSQS items. The resultant 14-item PSQS showed good internal consistency (α = .81) and acceptable 5-day test-retest reliability (r = .81). Construct validity was confirmed using exploratory factor analysis, which extracted and defined "Infant night care-related daytime dysfunction" and "Physical symptoms-related sleep inefficiency" as the two main categories of postpartum sleep quality. These two factors explained 44.49% of total variance, with factor loadings between .43 and .76. Significant correlation (r = .67) with the Pittsburgh Sleep Quality Index showed convergent validity.
: The 14-item PSQS is a reliable, valid, and useful scale for measuring postpartum sleep quality and examining intervention protocols in Taiwanese postpartum women with sleep disturbance.
Insomnia is a frequent problem among the elderly, for which patients often self-medicate. The use of alternative medicine by individuals worldwide, including the elderly, is increasing and insomnia is a common reason for its use. Conventional treatments do not benefit all, and there is uncertainty about the effects of their long-term use. Many alternative therapies have been considered for the treatment of sleep disorders in published medical reports. These consist of pharmacological therapies, including melatonin, valerian, lavender, hops, kava, Chinese and Japanese herbal compounds, pyridoxine, St John's wort and German chamomile, and non-pharmacological therapies, including massage, acupuncture, music therapy, tai chi, magnetism and white noise. Comparison of these treatments, either with each other or with conventional therapies, is difficult because many studies inadequately define insomnia, have few subjects or lack randomization or controls. Many have not been tested specifically on elderly subjects. As a result of the problems in the trials of these treatments, drawing a definitive conclusion about the effectiveness of these therapies is difficult. Melatonin appears to be the most promising. It has been shown to produce some limited benefit by studies to date, although it has not been investigated in enough appropriate subjects to definitively conclude that there is a benefit at a sufficiently low risk. A promising role for melatonin might be in the treatment of elderly people with sleep-phase disorders. Other pharmacological treatments with potential await well-designed studies on the elderly. There are many non-pharmacological therapies that offer the potential advantages of a low side-effect profile, but the investigations of these have been even less rigorous.
Purpose:
This study explored (a) differences in sleep quality, depression, and stress among second- and third-trimester pregnant and nonpregnant women, and (b) relationships among depression, stress, and sleep quality of pregnant women in Taiwan.
Design:
Cross-sectional.
Methods:
A convenience sample of 150 second-trimester and 150 third-trimester pregnant women was recruited from two medical centers in Taiwan. A comparison group of 300 nonpregnant women was recruited by the acquaintance technique. Data were collected from October 2006 to September 2007 using a demographic form, Pittsburgh Sleep Quality Index (PSQI), Edinburgh Postnatal Depression Scale, and Perceived Stress Scale.
Findings:
The prevalence of poor sleepers (PSQI score>5) was 60.0% for second- and third-trimester pregnant women and 48.0% for nonpregnant women. After controlling for significant covariates, pregnant women reported worse global sleep quality, habitual sleep efficiency, and sleep disturbances than nonpregnant women, and poorer sleep quality and sleep latency were most prevalent during their third trimester. A high prevalence of antenatal depression (27.3% to 36.0%) was found in pregnant women, depressed women had worse sleep quality than nondepressed women in all groups, and stress affected sleep quality in pregnant women but not in nonpregnant women.
Conclusions:
This cross-sectional study provides preliminary evidence that pregnant women suffer significantly more poor sleep quality than nonpregnant women, and that sleep quality of pregnant women was related to stress and depression.
Clinical relevance:
Evaluation for sleep quality and depression should be part of routine prenatal check-ups. Information on women's sleep quality, stress, and depressive status can be used to individualize interventions for pregnancy-associated sleep disorder.
Chamomile (German Chamomile, Matricaria recutita L., Asteraceae) is one of the most popular medicinal plants in use as an herbal tea for food purposes and in folk medicine. Qualitative and semi-quantitative analyses of the volatile fraction of chamomile herbal tea were performed. Volatile constituents of the infusion were isolated by two different methods, namely hydrodistillation and solid phase extraction (SPE), and analysed by GC-MS. The relative proportions of particular chemical classes, present in the essential oil and volatile fractions of the infusion showed remarkable differences. The proportion of mono- and sesquiterpene hydrocarbons in the infusion, as compared to the essential oil, was significantly lower. Strikingly, the dichloromethane extract of the infusion contained a lower amount of bisabolol oxides and chamazulene, but higher amounts of spiroethers, sesquiterpene lactones and coumarins, as compared to the hydrodistillates of the herbal drug and the infusion. In addition to the previously known guaianolides matricarin and achillin, acetoxyachillin and leucodin (= desacetoxymatricarin), corresponding C-11 stereoisomers with various biological activities typically occurring in Achillea species, were identified in the dichloromethane extract of chamomile tea for the first time.
Sleep and wake have a homeostatic relation that influences most aspects of physiology and waking behavior. Sleep disturbance has a detrimental effect on sleepiness and psychomotor vigilance. The purpose of this study was to identify which actual or perceived sleep characteristics accounted for the most variance in daytime functioning among postpartum mothers. Seventy first-time postpartum mothers' actual sleep (actigraphically estimated: total sleep time, number of wake bouts, length of nocturnal wake, and sleep efficiency) and perceived sleep (self-reported: number of awakenings, wake time, and sleep quality) were measured along with their daytime functioning (Stanford Sleepiness Scale [SSS], Epworth Sleepiness Scale [ESS], Visual Analogue of Fatigue Scale [VAFS], and morning Psychomotor Vigilance Test [PVT]). Data were repeatedly collected from the same sample during postpartum weeks 2, 7, and 13. Four stepwise linear regressions were calculated for each postpartum week to examine which objective and/or subjective variable(s) accounted for the most variance in daytime functioning. The SSS and VAFS were both most consistently associated with perceived sleep quality. The ESS was most consistently associated with actual total sleep time. PVT performance was most consistently associated with estimates of actual and perceived sleep efficiency. Actual and perceived sleep profiles were differentially associated with specific daytime functions. These results from postpartum mothers may indicate that populations who experience specific forms of sleep disturbance (e.g. fragmentation and/or deprivation) may also experience specific daytime conditions.
Inducible cyclooxygenase (COX-2) has been implicated in the process of inflammation and carcinogenesis. Chamomile has long been used in traditional medicine for the treatment of inflammatory diseases. In this study we aimed to investigate whether chamomile interferes with the COX-2 pathway.
We used lipopolysaccharide (LPS)-activated RAW 264.7 macrophages as an in vitro model for our studies.
Chamomile treatment inhibited the release of LPS-induced prostaglandin E(2) in RAW 264.7 macrophages. This effect was found to be due to inhibition of COX-2 enzyme activity by chamomile. In addition, chamomile caused reduction in LPS-induced COX-2 mRNA and protein expression, without affecting COX-1 expression. The non-steroidal anti-inflammatory drug, sulindac and a specific COX-2 inhibitor, NS398, were shown to act similarly in LPS-activated RAW 264.7 cells. Our data suggest that chamomile works by a mechanism of action similar to that attributed to non-steroidal anti-inflammatory drugs.
These findings add a novel aspect to the biological profile of chamomile which might be important for understanding the usefulness of aqueous chamomile extract in the form of tea in preventing inflammation and cancer.
We conducted a randomized, double-blind, placebo-controlled efficacy and tolerability trial of Matricaria recutita (chamomile) extract therapy in patients with mild to moderate generalized anxiety disorder (GAD). We hypothesized that chamomile would be superior to placebo in reducing GAD symptoms with a comparable tolerability profile.
Sixty-one outpatients with mild to moderate GAD were enrolled, and 57 were randomized to either double-blind chamomile extract (n = 28) or placebo therapy (n = 29) for 8 weeks. The study was powered to detect a statistically significant and clinically meaningful group difference in change over time in total Hamilton Anxiety Rating (HAM-A) scores. Secondary outcomes included change in the Beck Anxiety Inventory, Psychological Well Being, and Clinical Global Impression Severity scores and the proportion of patients with 50% reduction or more in baseline HAM-A score.
We observed a significantly greater reduction in mean total HAM-A score during chamomile versus placebo therapy (P = 0.047). Although the study was not powered to identify small to moderate differences in secondary outcomes, we observed a positive change in all secondary outcomes in the same direction as the primary outcome measure. One patient in each treatment group discontinued therapy for adverse events. The proportion of patients experiencing 0, 1, 2, or 3 adverse events or more was not significantly different between groups (P = 0.417).
This is the first controlled clinical trial of chamomile extract for GAD. The results suggest that chamomile may have modest anxiolytic activity in patients with mild to moderate GAD. Future studies are needed to replicate these observations.
Despite the prevalence of sleep complaints among psychiatric patients, few questionnaires have been specifically designed to measure sleep quality in clinical populations. The Pittsburgh Sleep Quality Index (PSQI) is a self-rated questionnaire which assesses sleep quality and disturbances over a 1-month time interval. Nineteen individual items generate seven "component" scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. The sum of scores for these seven components yields one global score. Clinical and clinimetric properties of the PSQI were assessed over an 18-month period with "good" sleepers (healthy subjects, n = 52) and "poor" sleepers (depressed patients, n = 54; sleep-disorder patients, n = 62). Acceptable measures of internal homogeneity, consistency (test-retest reliability), and validity were obtained. A global PSQI score greater than 5 yielded a diagnostic sensitivity of 89.6% and specificity of 86.5% (kappa = 0.75, p less than 0.001) in distinguishing good and poor sleepers. The clinimetric and clinical properties of the PSQI suggest its utility both in psychiatric clinical practice and research activities.
This study of mother-baby sleep patterns used an exploratory descriptive approach. The subjects were a sample of convenience of nine first time mothers and their baby. Data were collected by means of unstructured non-directive interviews and the Nursing Child Assessment Sleep Activity Record (NCASAR) during the second to fourth postpartum weeks. The findings showed that most of the mothers obtained as many hours of sleep in the postpartum period as they did prior to pregnancy. However, this sleep was subject to many interruptions. All of the subjects felt less rested and complained of tiredness which they ascribed to meeting the needs of their baby rather than with actual reduction in the number of sleep hours. The mothers described tiredness in two ways, physical and emotional. Support from partner and others was critical to the mothers in assisting them to adapt to and cope with the responsibilities of motherhood. The findings of this study confirmed the unpredictable nature of baby sleep-wake cycles during the early postpartum period.
The development of a 10-item self-report scale (EPDS) to screen for Postnatal Depression in the community is described. After extensive pilot interviews a validation study was carried out on 84 mothers using the Research Diagnostic Criteria for depressive illness obtained from Goldberg's Standardised Psychiatric Interview. The EPDS was found to have satisfactory sensitivity and specificity, and was also sensitive to change in the severity of depression over time. The scale can be completed in about 5 minutes and has a simple method of scoring. The use of the EPDS in the secondary prevention of Postnatal Depression is discussed.
Pregnant and postpartum women were presented with auditory stimuli, of from 10 to 70 decibels, of baby's cries, a woman's voice saying “baby is crying” and a speech noise during stage 2, stage REM and slow-wave stages of sleep. The subjects were awakened with increasing difficulty in the above-given order of stages, and with increasing facility going from speech noise to human voice to baby's cry, in that order. There was an overall lowering of awakening threshold after delivery. All the differences found were statistically significant, except that the difference between the voice saying “baby is crying” and the tape-recorded baby's cry was not significant.
The theoretical implications of these findings are discussed.
To determine the length of time mothers prefer their infants with them, 1,000 mothers at North Shore University Hospital (NSUH) and 435 mothers at Kings County Hospital (KCH) were asked postpartum whether they would prefer their infants with them every four hours for 1/2 hour for feeding or rooming-in with their infants during the daytime only or 24 hours a day. Approximately one third of the mothers at NSUH preferred rooming-in whereas approximately three quarters of the mothers at KCH preferred rooming-in. Significantly more mothers at KCH preferred 24-hour rooming-in than at NSUH. Factors such as primiparity, attendance at Lamaze classes, and breast-feeding were significantly associated with the mother's preference to room-in at NSUH, but there was no such association at KCH. This study suggests that: (1) the desire to room-in is not universal; (2) each institution must individualize rooming-in facilities according to the needs of the population; (3) although the demand for rooming-in varies, more mothers prefer rooming-in than there are accommodations presently available; and (4) factors that may be associated with rooming-in are not the same in all populations. It appears that it is as inappropriate to impose rooming-in as it is to deprive mothers of rooming-in.
The dried flower heads of Matricaria recutita L. (Asteraceae) are used in folk medicine to prepare a spasmolytic and sedative tea. Our fractionation of the aqueous extract of this plant led to the detection of several fractions with significant affinity for the central benzodiazepine receptor and to the isolation and identification of 5,7,4'-trihydroxyflavone (apigenin) in one of them. Apigenin competitively inhibited the binding of flunitrazepam with a Ki of 4 microM and had no effect on muscarinic receptors, alpha 1-adrenoceptors, and on the binding of muscimol to GABAA receptors. Apigenin had a clear anxiolytic activity in mice in the elevated plusmaze without evidencing sedation or muscle relaxant effects at doses similar to those used for classical benzodiazepines and no anticonvulsant action was detected. However, a 10-fold increase in dosage produced a mild sedative effect since a 26% reduction in ambulatory locomotor activity and a 35% decrement in hole-board parameters were evident. The results reported in this paper demonstrate that apigenin is a ligand for the central benzodiazepine receptors exerting anxiolytic and slight sedative effects but not being anticonvulsant or myorelaxant.
Using modified Barnard and Eyres (1979) Sleep/Activity Records, 44 mothers recorded diurnal sleep and awake times for themselves and their infants during the 4th week postpartum. Independent two-way analyses of variance, using a two-factor design (3a x 2b), compared data from each mother and each infant. Independent variables were (a) parity groups (mothers feeding their first, second, or third infant) and (b) feeding method (breast vs. bottle). A statistically significant difference (alpha = .05) was apparent between breast-fed and bottle-fed babies regarding the number of awakenings and the hours of night sleep, with breast-fed babies awakening more and sleeping less at night. But there was no statistically significant difference in the hours of total sleep diurnally. Mothers exhibited corresponding differences in sleep patterns, with a statistically significant increase in night waking for breast-feeding mothers. Infants in this study averaged 14.6 hr of sleep in 24 hr, which is in contrast to the 15.5 to 17.3 hr of sleep commonly reported in nursing texts based on studies from the 1960s.
The purpose of this study was to understand the sleep-wake cycle during the period from late pregnancy to about 3 months of postpartum by evaluating the number of actigraphic activities in four women (one multipara and three primi gravidae), and to compare the results with the findings from sleep logs. An irregularity of the sleep-wake cycle with increased number of wakings at night was notable during about 1 month after delivery, compared to the late pregnancy period, and subsequently this number tended to decrease. These results were indicative of the association between the lactation cycle to neonates and the sleep-wake cycle.
To describe changes in women's sleep patterns from prepregnancy to postpartum.
Polysomnography was done in women's homes for 2 consecutive nights. Forty-five women were studied during the follicular and luteal phases of their menstrual cycles, and 33 conceived and were studied during each trimester of pregnancy. Twenty-nine were studied at 1 and 3 months postpartum.
Compared with prepregnant sleep characteristics, significant changes in sleep patterns were evident by 11-12 weeks' gestation, with a significant increase in total sleep time but less deep sleep and more awakening during sleep. By the third month postpartum, there was improvement in sleep characteristics; however, sleep efficiency remained significantly lower than baseline prepregnancy values.
Sleep disturbance was greatest during the first postpartum month, particularly for first-time mothers.
This review examines herbs commonly used for psychiatric symptoms-St. John's wort, kava, ginkgo biloba, and valerian.
MEDLINE was searched for articles related to the use of herbs in psychiatry published after 1990. A secondary search examined sources cited in articles obtained from the MEDLINE search.
Of nine controlled and standardized trials of St. John's wort, five showed the herb's superiority to placebo, and four found no differences in effectiveness when compared with antidepressant drugs. The pharmacologically active components are not known. Several double-blind, placebo-controlled trials have demonstrated the anxiolytic efficacy of kava, but these studies had ill-defined patient populations, small sample sizes, and short treatment duration. All but one of 40 controlled trials of ginkgo extracts in the treatment of dementia found clinically significant improvement in memory loss, concentration, fatigue, anxiety, and depressed mood. Most studies of gingko had poorly defined patient populations and small sample sizes and used nonstandard measures. A recent well-designed multicenter study showed significantly less decline in cognitive function among patients with dementia receiving gingko. Valerian has been shown to decrease sleep latency and nocturnal awakenings and improve subjective sleep quality, but placebo effects were marked in some studies, and in some cases the beneficial effects were not seen until two to four weeks of therapy.
Although evidence of the efficacy of herbal preparations in treating psychiatric conditions is growing, translating the results of efficacy studies into effective treatments for patients is hampered by the chemical complexity of the products, the lack of standardization of commonly available preparations, and the paucity of well-controlled studies.
The Chinese version of the Edinburgh Postnatal Depression Scale (EPDS) was revalidated among Chinese women in Taiwan during the fourth week postpartum. One hundred and twenty primiparas completed the EPDS and the Beck Depression Inventory (BDI) four weeks after giving birth. The concurrent validity of the EPDS evaluated against the BDI scores was r = 0.79. The internal consistency (Cronbach's alpha) of the EPDS was 0.87. Results showed that the Chinese version of the EPDS has appropriate reliability and validity and a cut-off score of 9/10 is recommended for screening postnatal depression among Taiwanese women.
In order to know when and how infants obtain their circadian sleep-wake rhythm, infants' developing circadian rest-activity rhythm and mothers' circadian rhythm in the postpartum period were examined using actigraph monitoring. The subjects were 11 primipara and their infants. Actigraphic recordings for the infants and their mothers were made over 3-5 continuous days during the 3rd, 6th, 9th and 12th weeks after birth. A 24-h peak on a mean autocorrelogram of the infants' movements was detected at the 3rd week. The infants' circadian rest-activity rhythm already existed in the 3rd week. The amplitude of this 24-h peak gradually increased from the 6th to 12th week. This may be useful as an index of the development of infants' circadian rest-activity rhythm. An 11-h peak was also observed at the 3rd week. This 11-h peak was thought to be a semi-circadian rhythm. Regarding the mothers, the amplitude of the 24-h peak on the mean autocorrelogram at the 3rd week was the smallest of all other weeks, and it became larger from the 3rd to 12th week. This meant that the mothers' circadian rhythm at the 3rd week was influenced by their interrupted sleep at night to take care of their infants. The mother-infant synchronization is probably the 1st factor in the entrainment of infants' circadian sleep-wake rhythm. In this study, we also propose a novel method for compensating for missing data in autocorrelogram analysis.
World-wide use of herbal medicines is increasing, following regulatory and manufacturing developments. Herbs are attractive alternative medications to many patients with sleep disorders, who may be averse to using conventional drugs. We review here the most common herbal stimulants and sedatives. Caffeine, in herbal teas, black tea, coffee, soft drinks and pharmaceuticals, is used widely to control sleepiness, but more research is needed on its use in sleep disorders. Ephedra, and its constituent ephedrine, are used in both stimulant and weight loss preparations, sometimes with caffeine; safety concerns have arisen with this practice. Yohimbe is another herb used in stimulant and body-building preparations which has safety concerns. Asian and Siberian ginseng have been traditionally used for fatigue, and have some supportive experimental evidence for this use. Herbal sedatives also have some evidence for efficacy; the observations that certain plant flavonoid compounds bind to benzodiazepine receptors adds interest to their use. Valerian and kava have received the most research attention; both have decreased sleep onset time and promoted deeper sleep in small studies, and kava also shows anxiolytic effects. German chamomile, lavender, hops, lemon balm and passionflower are reputed to be mild sedatives but need much more experimental examination.
To survey the effects of pregnancy on mothers' sleep.
Mothers were interviewed during and after pregnancy with a series of five questionnaires to assess alterations in their sleep. The first questionnaire covered the 3 months before becoming pregnant, the next three the trimesters of pregnancy and the last the 3 months after delivery. The study was carried out in a central hospital and the maternity care units in the nearby rural community. Altogether, 325 pregnant women completed all five questionnaires.
The total amounts of reported sleep and of nocturnal sleep increased significantly during the first trimester of pregnancy, began to decrease thereafter and were shortest during the 3 months after pregnancy. During late pregnancy expectant mothers over 30 years of age reported less sleep than those under 30. During the whole pregnancy, but increasingly toward the end of pregnancy, sleep became more restless and fragmentary and its subjective quality worsened, due at least partly to increased restless legs and nightly awakenings increasing with advancing pregnancy.
The subjective quality of sleep is disturbed as early as the first trimester of pregnancy, although total sleeping time increases. The amount of reported sleep begins to decrease in the second trimester. The frequency of reported sleep disturbances, such as restless legs syndrome and nocturnal awakenings, is maximum in the third trimester but is about normal within 3 months after delivery.
Taiwanese mothers have identified insufficient sleep as a major manifestation of postpartum depression. Few studies have thoroughly examined the relationship between sleep and depression during the early postpartum period, however. The objectives of this study were to compare the characteristics of both the postpartum sleep and daytime sleepiness of depressed first-time mothers and of their non-depressed counterparts, and to determine the factors that significantly increased mothers' risks of being depressed. A non-probability sample of 163 first-time mothers completed a questionnaire between the 13th and 20th days of the postpartum period. The Center of Epidemiological Studies- Depression and Pittsburgh Sleep Quality Index were used to measure mothers' experiences of depression symptoms and sleep. Daytime sleepiness was estimated in four ways, derived from the Roy Adaptation Model. The results indicated that the depressed mothers had poorer sleep quality than the non-depressed mothers, slept less efficiently, reported more sleep disturbances, and exhibited more daytime dysfunctions. Mothers who frequently perceived their daytime sleepiness to be affected by infant-care performance were more likely to be depressed. The study' s findings support the view that there is a connection between depression and poor sleep among postpartum mothers in Taiwan, and indicate that depressed mothers' experiences of poor sleep are multi-faceted, and not simply a matter of insufficient sleep.
A metabonomic strategy, utilizing high-resolution 1H NMR spectroscopy in conjunction with chemometric methods (discriminant analysis with orthogonal signal correction), has been applied to the study of human biological responses to chamomile tea ingestion. Daily urine samples were collected from volunteers during a 6-week period incorporating a 2-week baseline period, 2 weeks of daily chamomile tea ingestion, and a 2-week post-treatment phase. Although strong intersubject variation in metabolite profiles was observed, clear differentiation between the samples obtained before and after chamomile ingestion was achieved on the basis of increased urinary excretion of hippurate and glycine with depleted creatinine concentration. Samples obtained up to 2 weeks after daily chamomile intake formed an isolated cluster in the discriminant analysis map, from which it was inferred that the metabolic effects of chamomile ingestion were prolonged during the 2-week postdosing period. This study highlights the potential for metabonomic technology in the assessment of nutritional interventions, despite the high degree of variation from genetic and environmental sources.
To examine how sleep-wake cycles and social rhythms of Japanese parents are related to their sleeping arrangements before and after the birth of their first child.
Prospective longitudinal, time-series methods.
Participants' homes in four geographical areas of Japan.
Convenience sample of 101 Japanese first-time parent couples who completed antepartum and postpartum questionnaires.
24-hr sleep-wake rhythm from 7-day logs at 32 to 36 weeks gestation and 4 to 5 weeks postpartum and daily social rhythm from Monk's Social Rhythm Metric.
Mothers' total sleep time and activity level decreased after birth. Social rhythms became less regular for mothers and more consistent and regular for fathers. Although sleeping arrangement had no effect on parents' daily social rhythms, it had a significant effect on the 24-hr sleep-wake rhythm. Regularity of sleep-wake rhythms was more prominent for fathers sleeping with mother and baby than for fathers sleeping alone.
Couples having their first child face great changes in their sleep-wake cycles and social rhythms. Nurses can counsel expectant parents to think about their sleeping habits and social activities and assist them in making informed decisions about the best sleeping arrangement during transition to parenthood.
Psychophysiologic and situational correlates of postpartum fatigue
- Ko Y.L.
Nursing Research: Generating and Assessing Evidence for Nursing Practice
- Polit D.F.
- Beck C.T.
Psychiatry and Society
- Lin T.
The quality of sleep and its associated factors in the puerperium women
- Teng F.L.
- See L.C.
- Cheng P.J.
- Lee J.T.
Healthful Herbal Tea
- Ying G.J.
The correlation of postpartum fatigue, social support, and maternal confidence
- Yang Y.O.
The quality of sleep and its associated factors in the puerperium women
- Teng F.L.