رویکردهای طب مکمل در درمان اختلالات خواب
Complementary and Alternative Medicine (CAM) Approaches in the Treatment of Sleep Disordersr
Background: Despite scientific and medical approaches for the treatment of sleep disorders, many patients because of lack of awareness of the need to go and get medical treatment, availability of facilities or personal interest, prefer to use complementary and alternative medicine (CAM). In this article the most popular complementary and alternative methods in the treatment of sleep disorders, current scientific evidence on the efficacy and effectiveness of these mechanisms have been studied.
Methods: In this review, by search various websites and databases such as Pubmed and Medlineplus, reliable research related to complementary and alternative therapies have been studied.
Results: Relaxation techniques can be helpful for insomnia and nighttime anxiety. They are generally safe. Cognitive relaxation techniques (like meditation) have better results than somatic methods (such as progressive muscle relaxation). Yoga can be effective in improving sleep quality. Hypnotherapy enhanced the effectiveness of cognitive-behavioral therapy and relaxation techniques. Further investigation is needed in this area. Music therapy can be useful in the elderly and children. A systematic review concluded that current evidence does not demonstrate significant effects on homeopathic medicines for insomnia. Melatonin supplements are helpful for sleep problems that are caused by the shift work (Changes to the circadian rhythm) and jet lag. It may also be helpful for people and especially elderlies with insomnia to fall asleep faster, sleep longer and sleep better, but the effect is small. Melatonin is relatively safe for short term use, but long-term safety has not been established. Nutritional supplements containing melatonin precursors such as L -Tryptophan and 5-Hydroxytryptophan (5-HTP) for the treatment of insomnia have reported conflicting results. Use of medical foods is a new area that requires further investigation. Aromatherapy with essential oils such as lavender or chamomile is a common method, preliminary studies indicate their sleep-inducing effects, but there are not enough studies. Chamomile is usually used as chamomile tea before bedtime, but enough scientific evidence for its effectiveness against insomnia is lacked. Kava-Kava is used for insomnia, but there is no credible evidence to prove its effectiveness. Supplement valerian is one of the most popular therapies for insomnia treatment. Several studies show that taking valerian (for 4 to 6 weeks) can help improve sleep quality and slightly reduce the time it takes to fall asleep. However, all indications are not positive. The recommended dose of valerian is safe for short-term use. Some combination products of valerian with herbs such as hops, lavender, lemon balm, and skullcap (Skullcap) are available. Although many of these herbs have sedative properties, reliable evidence regarding the impact on improvement of insomnia and synergistic effects are not exist. There are serious concerns about the safety of kava-kava (due to severe liver damage) and supplement L- tryptophan (due to a serious disorder associated with eosinophilia-myalgia syndrome (EMS)).
Conclusion: In general, it seems that some CAM approaches in the treatment of sleep disorders have shown promising results. However, scientific evidence to support the efficacy and safety of these methods are limited and do more systematic studies are needed in this area.
Keywords: sleep disorders, alternative medicine, complementary medicine