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      Effect of acupressure with valerian oil 2.5% on the quality and quantity of sleep in patients with acute coronary syndrome in a cardiac intensive care unit

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          Abstract

          The purpose of this three-group double-blind clinical trial study was to investigate the effect of acupressure (指壓 zhǐ yā) with valerian (纈草 xié cǎo) oil 2.5% on the quality and quantity of sleep in patients with acute coronary syndrome (ACS) in a coronary intensive care unit (CCU). This study was conducted on 90 patients with ACS in Mazandaran Heart Center (Sari, Iran) during 2013. The patients were randomly assigned to one of three groups. Patients in the acupressure with valerian oil 2.5% group (i.e., valerian acupressure group) received bilateral acupoint (穴位 xué wèi) massage with two drops of valerian oil for 2 minutes for three nights; including every point this treatment lasted in total 18 minutes. Patients in the acupressure group received massage at the same points with the same technique but without valerian oil. Patients in the control group received massage at points that were 1–1.5 cm from the main points using the same technique and for the same length of time. The quality and quantity of the patients' sleep was measured by the St. Mary's Hospital Sleep Questionnaire (SMHSQ). After the intervention, there was a significant difference between sleep quality and sleep quantity in the patients in the valerian acupressure group and the acupressure group, compared to the control group ( p < 0.05). Patients that received acupressure with valerian oil experienced improved sleep quality; however, this difference was not statistically significant in comparison to the acupressure only group. Acupressure at the ear spirit gate (神門 shén mén), hand Shenmen, glabella (印堂 yìn táng), Wind Pool (風池 fēng chí), and Gushing Spring (湧泉 yǒng quán) acupoints can have therapeutic effects and may improve the quality and quantity of sleep in patients with ACS. Using these techniques in combination with herbal medicines such valerian oil can have a greater impact on improving sleep and reducing waking during the night.

          Graphical abstract

          CCU = coronary intensive care unit.

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          Valerian for sleep: a systematic review and meta-analysis.

          Michael Patterson, Dan Moore, Wolf Mehling … (2006)
          Insomnia affects approximately one-third of the adult population and contributes to increased rates of absenteeism, health care use, and social disability. Extracts of the roots of valerian (Valeriana officinalis) are widely used for inducing sleep and improving sleep quality. A systematic review of randomized, placebo-controlled trials of valerian for improving sleep quality is presented. An extensive literature search identified 16 eligible studies examining a total of 1093 patients. Most studies had significant methodologic problems, and the valerian doses, preparations, and length of treatment varied considerably. A dichotomous outcome of sleep quality (improved or not) was reported by 6 studies and showed a statistically significant benefit (relative risk of improved sleep = 1.8, 95% confidence interval, 1.2-2.9), but there was evidence of publication bias in this summary measure. The available evidence suggests that valerian might improve sleep quality without producing side effects. Future studies should assess a range of doses of standardized preparations of valerian and include standard measures of sleep quality and safety.
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            Acupuncture for treatment of insomnia: a systematic review of randomized controlled trials.

            Huijuan Cao, Xingfang Pan, Hua Li … (2009)
            Acupuncture is commonly used in treating insomnia in China, and clinical studies have shown that acupuncture may have a beneficial effect on insomnia compared with Western medication. We included randomized controlled trials on acupuncture for insomnia. We searched PubMed, the Cochrane Library (2008 Issue 3), China Network Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), and Wan Fang Database. All searches ended in December 2008. Two authors extracted data and assessed the trials' quality independently. RevMan 5.0.17 software was used for data analysis with effect estimate presented as relative risk (RR) and mean difference (MD) with a 95% confidence interval (CI). Forty-six (46) randomized trials involving 3811 patients were included, and the methodological quality of trials was generally fair in terms of randomization, blinding, and intention-to-treat analysis. Meta-analyses showed a beneficial effect of acupuncture compared with no treatment (MD -3.28, 95% CI -6.10 to -0.46, p = 0.02; 4 trials) and real acupressure compared with sham acupressure (MD -2.94, 95% CI -5.77 to -0.11, p = 0.04; 2 trials) on total scores of Pittsburgh Sleep Quality Index. Acupuncture was superior to medications regarding the number of patients with total sleep duration increased for >3 hours (RR 1.53, 95% CI 1.24-1.88, p < 0.0001). However, there was no difference between acupuncture and medications in average sleep duration (MD -0.06, 95% CI -0.30-0.18, p = 0.63). Acupuncture plus medications showed better effect than medications alone on total sleep duration (MD 1.09, 95% CI 0.56-1.61, p < 0.0001). Similarly, acupuncture plus herbs was significantly better than herbs alone on increase of sleep rates (RR 1.67, 95% CI 1.12-2.50, p = 0.01). There were no serious adverse effects with related to acupuncture treatment in the included trials. Acupuncture appears to be effective in treatment of insomnia. However, further large, rigorous designed trials are warranted.
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              Sleep disruption in critically ill patients--pharmacological considerations.

              Kingston Mills, Christina R. Bourne (2004)
              Sleep disturbances are common in critically ill patients and contribute to morbidity. Environmental factors, patient care activities and acute illness are all potential causes of disrupted sleep. Additionally, it is important to consider drug therapy as a contributing factor to this adverse experience, which patients perceive as particularly stressful. Sedative and analgesic combinations used to facilitate mechanical ventilation are among the most sleep disruptive drugs. Cardiovascular, gastric protection, anti-asthma, anti-infective, antidepressant and anticonvulsant drugs have also been reported to cause a variety of sleep disorders. Withdrawal reactions to prescribed and occasionally recreational drugs should also be considered as possible triggers for sleep disruption. Tricyclic antidepressants and benzodiazepines are commonly prescribed in the treatment of sleep disorders, but have problems with decreasing slow wave and rapid eye movement sleep phases. Newer non-benzodiazepine hypnotics offer little practical advantage. Melatonin and atypical antipsychotics require further investigation before their routine use can be recommended.
              Article 0 comments Cited 38 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Somayeh Rezaie
                Journal
                Journal ID (nlm-ta): J Tradit Complement Med
                Journal ID (iso-abbrev): J Tradit Complement Med
                Title: Journal of Traditional and Complementary Medicine
                Publisher: Elsevier
                ISSN (Electronic): 2225-4110
                Publication date PMC-release: 31 January 2015
                Publication date Collection: October 2015
                Publication date (Electronic): 31 January 2015
                Volume: 5
                Issue: 4
                Pages: 241-247
                Affiliations
                [a ]Antimicrobial Resistant Nosocomial Infection Research Center, Mazandaran University of Medical Sciences, Sari, Iran
                [b ]Traditional and Complementary Medicine Research Centre, Mazandaran University of Medical Sciences, Sari, Iran
                [c ]Student Research Committee, School of Nasibeh Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
                [d ]TCM Specialist, Shahid Beheshti University of Medical Sciences, Tehran, Iran
                [e ]Department of Biostatistics, Health Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran
                Author notes
                [∗ ]Corresponding author. Nursing Department, School of Nasibeh Nursing and Midwifery, Khazar St, Mazandaran University of Medical Sciences, Sari, Iran. aram_ir2007@ 123456yahoo.com
                Article
                Publisher ID: S2225-4110(14)00015-7
                DOI: 10.1016/j.jtcme.2014.11.005
                PMC ID: 4624350
                PubMed ID: 26587395
                SO-VID: 94ce6ad9-d707-4bdd-bcbf-70ed3275ad16
                Copyright © Copyright © 2014, Center for Food and Biomolecules, National Taiwan University. Production and hosting by Elsevier Taiwan LLC. All rights reserved.
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).

                History
                Date received : 6 June 2014
                Date revision received : 23 June 2014
                Date accepted : 30 June 2014
                Categories
                Subject: Original Article

                Keywords: acupressure,acute coronary syndrome,cardiac intensive care unit,sleep quality,sleep quantity,valerian oil
                Data availability:
                Keywords: acupressure, acute coronary syndrome, cardiac intensive care unit, sleep quality, sleep quantity, valerian oil

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