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The effects of Lavender and Chamomile essential oil inhalation aromatherapy on depression, anxiety and stress in older community-dwelling people: A randomized controlled trial

Authors:
Hossein Ebrahimi at Shahroud University of Medical Sciences
Hossein Ebrahimi
Abbas Mardani at Qazvin University of Medical Sciences
Abbas Mardani
Mohammad Hasan Basirinezhad at Tehran University of Medical Sciences
Mohammad Hasan Basirinezhad
Azam Hamidzadeh at Shahroud University of Medical Sciences
Azam Hamidzadeh
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Abstract

Background Considering the prevalence of mental health problems in older adults, this study aims to investigate the effect of inhalation aromatherapy using lavender and chamomile essential oils on depression, anxiety, and stress of community-dwelling older people. Methods A three-armed, parallel, randomized, and controlled trial design was used in this study. 183 participants were enrolled and randomly assigned to three groups (n = 61): the lavender, chamomile, and control groups. The participants in the experimental groups inhaled three drops of 1.5% lavender and chamomile essential oils for 30 nights. The participants in the control group inhaled only distilled water in a similar fashion. Data were collected using the Depression, Anxiety, and Stress-Scale (DASS) at baseline, immediately after the intervention, and one month after the intervention. Chi-square, Fisher's exact, one-way ANOVA, and repeated measures ANOVA were used for data analysis. Results Statistically significant improvement occurred in depression, anxiety, and stress levels immediately and one month after the intervention in lavender and chamomile groups compared to the control group (p < 0.01). Conclusion Inhalation aromatherapy with both lavender and chamomile essential oils helped decrease depression, anxiety, and stress levels in community-dwelling older adults.
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The effects of Lavender and Chamomile essential oil inhalation
aromatherapy on depression, anxiety and stress in older community-
dwelling people: A randomized controlled trial
Hossein Ebrahimi
a
, Abbas Mardani
b
, Mohammad Hasan Basirinezhad
c
, Azam Hamidzadeh
d,
*,
Fatemeh Eskandari
e
a
Center for Health-Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
b
Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
c
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
d
Department of Midwifery, School of Nursing & Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
e
Making Life Better, Mental health community support worker, Sydney, Australia
ARTICLE INFO
Article History:
Received 24 October 2020
Revised 23 December 2020
Accepted 27 December 2020
Available online xxx
ABSTRACT
Background: Considering the prevalence of mental health problems in older adults, this study aims to investi-
gate the effect of inhalation aromatherapy using lavender and chamomile essential oils on depression, anxi-
ety, and stress of community-dwelling older people.
Methods: A three-armed, parallel, randomized, and controlled trial design was used in this study. 183 partici-
pants were enrolled and randomly assigned to three groups (n= 61): the lavender, chamomile, and control
groups. The participants in the experimental groups inhaled three drops of 1.5% lavender and chamomile
essential oils for 30 nights. The participants in the control group inhaled only distilled water in a similar fash-
ion. Data were collected using the Depression, Anxiety, and Stress-Scale (DASS) at baseline, immediately after
the intervention, and one month after the intervention. Chi-square, Fisher’s exact, one-way ANOVA, and
repeated measures ANOVA were used for data analysis.
Results: Statistically significant improvement occurred in depression, anxiety, and stress levels immediately and
one month after the intervention in lavender and chamomile groups compared to the control group (p<0.01).
Conclusion: Inhalation aromatherapy with both lavender and chamomile essential oils helped decrease
depression, anxiety, and stress levels in community-dwelling older adults.
© 2021 Elsevier Inc. All rights reserved.
Keywords:
Aromatherapy
Chamomile
Lavender
Mental health
Older adult
1. Introduction
Population aging is considered a global matter that is becoming
increasingly acute.
1
It is estimated that the aging portion of the world’s
population will nearly double from about 12% to 22% between 2015 and
2050.
2
The increase in aging populations brings many challenges to
public health.
1
For instance, mental or neurological disorders impact
more than 20% of adults aged 60 years old and over.
2
There is numerous
evidence of increasing morbidity, hospitalization, mortality, and func-
tional disability related to mental disorders in these populations.
3
Late-life depression is a crucial public health problem because of
its devastating consequences. It is related to an increased risk of mor-
bidity, suicide, and self-neglect, as well as reduced physical, cognitive
and social functioning.
4
Anxiety is another prevalent mental health
problem that impacts older adults and can have serious consequen-
ces on their quality of life and functional levels.
5
Perceived stress
symptoms, daily stressors, or other lifetime traumatic events also
negatively impact the mental health and well-being of older adults
and often lead to other physical and mental illnesses.
6
Generally, psy-
chotropic medicines are prescribed widely to manage depression,
anxiety, and stress symptoms in elderly populations; however, these
medicines have limited effects, significant side effects, and can be
costly, so they are not considered viable options by some health pro-
fessions.
7,8
Therefore, nonpharmacological modalities have been sug-
gested to manage these problems.
Aromatherapy is one of the most prevalent complementary and
alternative medicine (CAM) practices that has grown substantially in
recent years to relieve mental health symptoms.
9
For thousands of
years, aromatherapy has been used as a form of herbal medicine in
countries such as Iran, Egypt, and India, in which essential oils influ-
ence the connection between body and mind by interacting with the
olfactory system.
10
Aromatherapy can be practiced in different ways,
* Corresponding author.
E-mail addresses: ebrahimi@shmu.ac.ir (H. Ebrahimi), mardani.a@iums.ac.ir
(A. Mardani), hasan.basirinzhad@yahoo.com (M.H. Basirinezhad),
azhamidzadeh@shmu.ac.ir (A. Hamidzadeh), eskandari_re@yahoo.com (F. Eskandari).
https://doi.org/10.1016/j.explore.2020.12.012
1550-8307/© 2021 Elsevier Inc. All rights reserved.
ARTICLE IN PRESS
Explore 000 (2021) 17
Contents lists available at ScienceDirect
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journal homepage: www.elsevier.com/locate/jsch
... This EO has also been used to relieve symptoms of depression, improve sleep quality, and reduce contractions in early labor. Its sedative and anxiolytic effects have been related to the presence of apigenin, a flavone that binds to GABA receptors to exert both biological activities [15]. Aromatherapy also is used successfully in surgeries or dental treatment, as well as for the masking of unpleasant odors from some components used in these procedures such as occurs with eugenol, an EO derived from clove (Syzygium aromaticum, Myrtaceae) that is part of the components of dental cement and is used as an endodontic sealer [60]. ...
... Ylang-ylang, lavender, chamomile, rosemary (Salvia rosmarinus, Lamiaceae), and cinnamon (Cinnamomum verum, Lauraceae) oils have been reported to help reduce this disorder and improve mood [13,40]. In older adults, lavender and chamomile are the most recommended essences due to their effectiveness in treating anxiety, depression, and stress scores [15]. Peppermint (Mentha piperita, Lamiaceae) is a herb used for both culinary and medicinal purposes. ...
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Complementary and alternative medicine (CAM) encompasses a variety of ancient therapies with origins in cultures such as those of China, Egypt, Greece, Iran, India, and Rome. The National Institutes of Health (NIH) classifies these integrative therapies into five categories: (1) mind–body therapies, (2) biological practices, (3) manipulative and body practices, (4) energy medicine, and (5) whole medical systems, including traditional Chinese medicine and Ayurvedic medicine. This review explores the role of biological practices utilizing aromatic plants, particularly through inhalation aromatherapy and massage with essential oils, as effective complementary strategies within health systems. The review compiles information on the most commonly used plants and essential oils for holistic health maintenance from a complementary and alternative perspective. Given their accessibility and relative safety compared to conventional treatments, these therapies have gained popularity worldwide. Furthermore, the integration of essential oils has been shown to alleviate various psychological and physiological symptoms, including anxiety, depression, fatigue, sleep disorders, neuropathic pain, nausea, and menopausal symptoms. Among the studied plants, lavender has emerged as being particularly notable due to its broad spectrum of therapeutic effects and its designation by the US Food and Drug Administration (FDA) as “Generally Recognized as Safe”. Other essential oils under investigation include eucalyptus, damask rose, sandalwood, vetiver, calamus, frankincense, chamomile, lemon, grapefruit, tangerine, orange, sage, rosemary, garlic, and black pepper. This study emphasizes the potential benefits of these aromatic plants in enhancing patient well-being. Additionally, it underscores the importance of conducting further research to ensure the safety and efficacy of these therapies.
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... In contrast, linalyl acetate exhibited both anxiolytic and antidepressant effects in patients with higher levels of depression. These findings were consistent with results in hemodialysis patients (25) and elderly community-dwelling individuals (26), who The present study also found that clary sage oil was effective in reducing anxiety and stress in patients with lower levels of depression, whereas linalyl acetate was effective in alleviating anxiety and depression in patients with higher levels of depression. This result provides an evidence-based foundation for the use of clary sage oil and its main component, linalyl acetate, as non-pharmacological psychological interventions for patients with DFU. ...
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... A aromaterapia utiliza óleos essenciais derivados de plantas para promover o relaxamento e melhorar o humor. Certos aromas, como lavanda, camomila ou bergamota, são conhecidos por seus efeitos calmantes e redutores do estresse (Agatonovic-Kustrin et al., 2020).Além disso, certas ervas e suplementos, como a erva de São João, a lavanda e a camomila, têm sido utilizados tradicionalmente para apoiar a saúde mental (Benitez et al., 2022;Ebrahimi et al., 2022), mas é essencial consultar um profissional de saúde antes de utilizá-los, pois podem interagir com medicamentos e apresentar possíveis efeitos colaterais. ...
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... 1. Trial Name: The effects of Lavender and Chamomile essential oil inhalation aromatherapy on depression, anxiety, and stress in older community-dwelling people: A randomized controlled trial (Ebrahimi et al. 2022) Abstract summary Inhalation of lavender and chamomile essential oils reduced depression, anxiety, and stress in older adults. ...
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... [12] Aromatherapy using fragrances like cedar, cinnamon, chocolate, lavender, and various essential oils has been used for older adults to improve sleep quality [13], relieve pain [14], reduce their depression and anxiety levels [14,15], improve cognitive functions and memory recall, potentially easing the burden of nursing care [16]. There are different ways that aromatherapy has been adopted for older adults, for example, through inhalation [17] and massage [15]. Although aromatherapy has been shown to be promising with a potential positive impact on older adults, a review by Ball et al. [18] and a report from the National Institute for Health and Care Excellence [19] highlighted uncertainties in how and to what extent aromatherapy could benefit people living with dementia, such as improving depressive symptoms or having an impact on behaviours. ...
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The Effect of Lavender (Lavandula stoechas L.) on Reducing Labor Pain: A Systematic Review and Meta-Analysis
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Background: Labor pain is one of the most severe pains, which most of women experience. By using novel supportive methods, the labor pain can be reduced, which makes this event pleasant and delightful. Several original studies have been conducted in regard to the effect of lavender on reducing labor pain, whose results are controversial. One of the applications of meta-analysis studies is to respond to these hypotheses and remove controversies; therefore, this study aimed to determine the effect of lavender on labor pain in Iran by using meta-analysis. Methods: In this study, to find published articles electronically from 2006 to 2019, the published articles in national and international databases of SID, MagIran, IranMedex, IranDoc, Google Scholar, Cochrane Library, Embase, ScienceDirect, Scopus, PubMed, and Web of Science (ISI) were used. Heterogenic index between studies was determined by Cochrane test (Q)c and I2. Due to heterogeneity, the random effects model was used to estimate standardize difference of the mean score of lavender test in order to assess the labor pain between intervention and control group. Results: In this meta-analysis and systematic review, finally 13 eligible articles met the inclusion criteria of the study. The sample size from original studies enrolled in the meta-analysis entered in the intervention group was 794 individuals and in the control group was 795 individuals. Mean score for pain in the control group was 7.2 ± 0.42 and in the intervention group was 5.4 ± 0.58 and this difference was statistically significant (p ≤ 0.001). Conclusion: The results of this study showed that lavender can reduce labor pain, which can be considered by health policy makers and gynecologists.
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Effect of Lavender on Sleep, Sexual Desire, Vasomotor, Psychological and Physical Symptom among Menopausal and Elderly Women: A Systematic Review
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Objectives: The present systematic review was conducted to compare the effect of lavender on the quality of sleep, sexual desire, and vasomotor, psychological and physical symptoms among menopausal and elderly women. Methods: There were five electronic databases which selected to search respective articles which included were Scopus, PubMed, Web of Science, Google Scholar, and the Cochrane Library without any language restriction since the study inception to March 10, 2018. The quality of studies was assessed in accordance with a jaded scale. Results: According to three trials, the lavender as utilized in a capsule form or aromatherapy could significantly improve the measured Pittsburgh Sleep Quality Index score (P < 0.05) in the menopausal and elderly women. The aromatherapy with lavender improved sexual function (P < 0.001), depression (P < 0.001), anxiety (P < 0.001), and physical (P < 0.001) symptoms. Based on a trial, 66.7%, 70.0%, and 53.3% of subjects reported feelings of relaxation, happiness, and cleanness effects of having used lavender respectively. Conclusions: The results suggested the effectiveness of the use of lavender either in capsule form or aromatherapy on the improved quality of sleep, depression, anxiety, sexual desire, and psychological and physical symptoms. These results, however, should be interpreted with caution considering the limitations of the study.
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Background Parents’ mental health can be impacted by sleep problems experienced by children diagnosed with ADHD. This study aimed to investigate the effect of group-based behavioral parent training (BPT) related to sleep problems of children with ADHD on parents’ mental health. Methods A parallel randomized controlled trial design was used in this study. Participants included 58 parents of school-age children with ADHD who had at least one sleep problem and who were known to medical services in a psychiatric clinic in Rasht city, Iran. Participants were randomly allocated to the intervention or control groups equally. Participants in the intervention group received a 5-week BPT intervention program related to sleep problems of ADHD children including 3 sessions group-based training and 2 telephone follow-up. Data were collected before and two months after the intervention. Data were analyzed using descriptive and inferential statistics via the SPSS software. Results The findings revealed two months after the intervention, participants in the intervention group had a significant improvement in the anxiety (p = 0.01) and stress (p = 0.02) levels compared to the control group. Conclusion The results suggest that group-based BPT related to sleep problems of children with ADHD could be an effective strategy in improving parents' mental health.
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Introduction: Regarding the importance of anxiety management and improvement of the quality of sleep in patients with burn injuries, this study aimed to determine the effect of aromatherapy massage (using aromatic oils of lavender and chamomile) on the anxiety and sleep quality of the patients with burn injuries. Method: In a quasi-experimental study, 105 patients with burns were recruited by convenience sampling method and then assigned into three groups (control, placebo massage, and combined aromatic oil massage). The study intervention was performed 20min before bedtime in three sessions, within a week. The control group was only under daily routine care. The study data were collected using the Persian version of Spielberg's anxiety scale and the Pittsburgh Sleep Quality Inventory. Descriptive and inferential statistical tests were used to analyze the data in SPSS version 20. Results: The results showed a significant difference among the three groups in terms of anxiety score (P<0.001) and in terms of sleep quality after the intervention (P=0.027). Conclusion: Since the aromatherapy massage as a non-pharmacological and simple method can improve the anxiety and quality of sleep in patients with burns, it is suggested that nurses and burn medical care team apply it to reduce burn patients' anxiety and promote their sleep quality. Applying massage alone also reduces anxiety in burn survivors.
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Essential Oil Compositions and Antibacterial and Antioxidant Activities of Five Lavandula stoechas Cultivars Grown in Thailand
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The essential oils of five Lavandula stoechas cultivars grown in Thailand were characterized for their volatile compounds using GC‐FID and GC‐MS methods as well as screened for antibacterial and antioxidant activities. Dried aerial parts, including flowers and stems from each cultivar, were subjected to hydrodistillation for 4 h. The essential oil yields were 0.18%‐0.82% w/w. Of the 95 compounds detected and identified, 1,8‐cineole, fenchone, and camphor were considered the major compounds. Essential oil from each cultivar demonstrated different patterns of antibacterial activity and a variety of antioxidant properties. The highest antibacterial activity, MIC = 0.39 mg mL ‐1 , was observed from the essential oil of L. stoechas ‘major’ (against Klebsiella pneumoniae and Salmonella typhimurium) and the essential oil of L. stoechas ‘white lavender’ (against S. typhimurium ) . The essential oil of L. stoechas x viridis ‘St. Brelade’ possessed the highest antioxidant capacity, as determined by the DPPH and ABTS assays (IC 50 of 67.65 and 89.26 mg mL ‐1 , respectively). The results indicated that some of these essential oils could be used as key ingredients in lavender oil products in Thailand to increase their therapeutic efficacy, depending on their intended application.
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Article
  • Mar 2019
Introduction: Academic stress is prevalent among pharmacy students. Several factors such as hectic schedules, courses and exam load as well as lack of recreational time during semester have been reported as determinants of academic stress. Studies revealed; the use of aroma oils especially with relaxant properties may help ease stress. Methods: This study aimed to investigate the effect of lavender oil on academic stress during exams in pharmacy students. A randomized-single-blind placebo-controlled trial providing aromatherapy with lavender oil as an intervention was conducted in male pharmacy students. The outcomes assessed included stress, stool pattern, headache and vital signs that comprised of systolic, diastolic blood pressure (SBP and DBP) and heart rate (HR). The study was approved from concerned authority and registered in ClinicalTrials.gov (NCT#03460626). Results: The placebo and experimental group showed a significant (p < 0.01) difference in stress score (F = 244.865, p < 0.0001), headache VAS score (F = 8.187, p < 0.0001), SBP (F = 11.141, p < 0.0001), DBP (F = 3.873, p < 0.001) and HR (F = 8.537, p < 0.0001); at during-exam time-point as compared to control group. No significance was achieved; among three treatment groups in stool pattern (F = 2.143, p > 0.05) and, at post-exam time-point (p > 0.05). Conclusion: Aromatherapy with lavender oil did not have any effect on academic stress. Trial registration: The study was registered prospectively on ClinicalTrials.gov (NCT#03460626) on 19th February 2018.
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