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Perspective
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Phytotherapy Against Insomnia: Extravagant Claims or an Alternative Medicine? |
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Abhijit Dey
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Amrita Dey
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ABSTRACT
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Insomnia or sleeplessness is a disorder characterized by a personal incapability to falling or staying asleep for a desirable period of time. Apart from Valeriana officinalis and Ziziphus jujuba most of the ethnobotanicals used for sleep disorders have not been evaluated for pharmacological or clinical efficacy against insomnia. Chinese herbal medicines involving polyherbal formulations are yet to be characterized and long term side effects are yet to be evaluated. Anti insomniac phytotherapy opens up an exciting aspect of research which might benefit a large number of patients suffering from different degrees of insomnia.
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Received: December 07, 2012;
Accepted: February 13, 2013;
Published: March 16, 2013
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INTRODUCTION
Insomnia or sleeplessness is a disorder characterized by a persons incapability
to falling or staying asleep for a desirable period of time (Roth,
2007). Insomnia is associated with psychiatric and medical illnesses and
depression (Benca, 2001). Approximately 30% of the
general population is affected by chronic insomnia and almost 40% of adults
with insomnia suffer from psychiatric disorder such as depression (Roth,
2007).
Ethnobotany serves as a starting point in many drug discovery programs. Traditional
remedy using medicinal plants has been reported against a number of human and
livestock ailments (Dey and De, 2010) such as gastrointestinal
disorders (Dey and De, 2012a), snakebite (Dey
and De, 2012b), fever (Dey and De, 2012c), skin
diseases and wound healing (Dey et al., 2012)
etc. Various and separate preparations of leaves of Araucaria bidwillii
Hook. (a gymnosperm), fronds of Dicranopteris linearis Underw. (a pteridophyte)
and roots of Laporteai interrupta (L.) Chew. along with Cratoxylum
leaves were prescribed in insomniac children by the hill tribes of Northern
Thailand (Anderson, 1986). Dried flowers of Lavandula
angustifolia Miller and seeds of Ocimum basilicum L. are among the
two ethnomedicinal remedy against insomnia practiced by the people residing
around Izmir province, Turkey (Ugulu et al., 2009).
Rauvolfia serpentina (L). has also been reported as a phytotherapy against
sleeplessness (Dey and De, 2011). Hibiscus rosasinensis
L. flowers are used against nervousness and insomnia in Santa Rita Estado
Aragua, Venezuela (Martinez et al., 2012). In
another observation, leaves of Lactuca sativa L. was suggested for the
same purpose in the Natural Park of Serra de São Mamede (Portugal)
(Camejo-Rodrigues et al., 2003). Even in urban
areas of Samogitia region, Lithuania, Humulus lupulus L. fruits and
Valeriana officinalis L. roots are reported as anti-insomniacs (Petkeviciute
et al., 2010). Roots of Centaurea ornata Willd. and dried
petals of Papaver rhoeas L. have been reported from Arribes del Duero,
western Spain for the same reason (Gonzalez et al.,
2010). Flowers of Papaver rhoeas L. and Tilia cordata Mill.
are reported from Gollak region, Kosovo to promote sleep (Mustafa
et al., 2012).
Herbal remedy is considered as an alternative and complementary treatment of
insomnia which has been reflected in many ethnobotanical investigations. Despite
the scarcity of data regarding effectiveness and safety of these sleep inducing
natural products, the common perception of using such remedies have been popularized
widely (Sanchez-Ortuno et al., 2009). Two dietary
or herbal supplements valerian and melatonin have been used extensively to treat
sleep disorder and increase sleep quality (Shimazaki and
Martin, 2007). Valerian medication was found to safe with moderate beneficial
effects in insomnia when compared to placebo (Oxman et
al., 2007). Xylaria nigripes (Kl.) Sacc mycelia is used in the
form of Wuling Capsule to treat insomnia and it was found to improve sleep disorder
in patients in multicenter, randomized, double-blind trials (Lin
et al., 2013). Chinese herbal medicine is considered as one of the
most common Chinese Medicine (CM) therapies to treat primary insomnia (Yan
et al., 2013). Traditional Chinese Medicine (TCM) treatments involve
the use of herbal medicine to treat sleep disorders but high quality further
research was suggested to draw a conclusion (Yeung et
al., 2012a). Ziziphus jujuba is reported as a single herb based
preparation used against insomnia in Chinese herbal medicine (Yeung
et al., 2012b). Polyherbal preparations with complex formulae used
in Chinese herbal medicines have gained popularity in Taiwan. A survey to monitor
the drug utilization patterns of these medicines indicated the need for further
studies (Chen et al., 2005; 2009).
Although herbal medication was found to be modestly effective to improve sleep
quality, long term study with a large sample size is needed to evaluate possible
drug interactions in the long run (Shimazaki and Martin,
2007). Apart from Valeriana officinalis and Ziziphus jujuba
most of the ethnobotanicals used for sleep disorders have not been evaluated
for pharmacological or clinical efficacy. Chinese herbal medicines involving
polyherbal formulations are yet to be characterized and long term side effects
are yet to be evaluated. Anti-insomniac phytotherapy opens up an exciting aspect
of research which might benefit a large number of patients suffering from different
degrees of insomnia.
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