|Year : 2019 | Volume
| Issue : 2 | Page : 188-191
Efficacy of topical herbal remedies for insomnia in Iranian traditional medicine
Elham Haghjoo1, Asie Shojaii2, Mohammad Mahdi Parvizi3
1 Research Institute for Islamic and Complementary Medicine; Department of Traditional Medicine, School of Persian Medicine, Iran University of Medical Sciences, Tehran, Iran
2 Research Institute for Islamic and Complementary Medicine; Department of Traditional Pharmacy, School of Persian Medicine, Iran University of Medical Sciences, Tehran, Iran
3 Molecular Dermatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
|Date of Web Publication||16-Apr-2019|
Dr. Asie Shojaii
Research Institute for Islamic and Complementary Medicine and School of Persian Medicine, Iran University of Medical Sciences, Tehran
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Background: Insomnia is one of the most prevalent sleep disorders which affect the quality of life. Due to high prevalence of this disease and the side effects of sedative drugs, people tend to use herbal remedies. There are some oral or topical prescriptions in Persian medicine texts for the treatment of insomnia. The aim of this study was to investigate topical treatments for insomnia in Iranian traditional medicine (ITM) and comparing them with current therapies in modern medicine. Methods: In this study, ITM textbooks including the Canon of Medicine, Teb-e-Akbari, Kholasat al-Hekmah, Makhzan al-Advieh, Exir-e-azam, Al-Aghraz al-Tibbia, Val Mabahess al-Alaiia, Sharh-al-Asbab-val-Alamat, Tohfa-al-Momen, and Qarabadeen-e-Kabir were searched to investigate effective topical therapies for treating insomnia. Further, relevant studies on these topical remedies were searched at databases such as PubMed, Google Scholar, Scopus, and ScienceDirect from the beginning till June 2018 and the results were presented as tables. Results: There are some herbs which have been recommended in ITM for the treatment of insomnia in topical dosage form such as ointment, lotion, nasal drop, and oil. The most important herbs used in these topical dosage forms were lettuce, violet, almond, pumpkin, and water lily. Some of these herbal therapies including lettuce and violet have been studied in clinical trial for insomnia. Conclusion: Findings of the present study showed that according to ITM texts, there are some effective topical herbal remedies which can be used in treatment of insomnia with less adverse effects.
Keywords: Efficacy, herbal medicine, insomnia, Iranian traditional medicine, topical
|How to cite this article:|
Haghjoo E, Shojaii A, Parvizi MM. Efficacy of topical herbal remedies for insomnia in Iranian traditional medicine. Phcog Res 2019;11:188-91
|How to cite this URL:|
Haghjoo E, Shojaii A, Parvizi MM. Efficacy of topical herbal remedies for insomnia in Iranian traditional medicine. Phcog Res [serial online] 2019 [cited 2020 Jan 28];11:188-91. Available from: http://www.phcogres.com/text.asp?2019/11/2/188/256297
- There are some topical herbal remedies such as lettuce, violet, almond, and pumpkin in Iranian traditional medicine which their efficacy have been confirmed in experimental or clinical studies.
Abbreviations used: ITM: Iranian traditional medicine; ISI: Insomnia severity index; NREM: Nonrapid eye movement sleep.
| Introduction|| |
Sleep and wake are among the six principles (Setteye-Zarorie in Iranian traditional medicine [ITM]) of living healthy life, correlating with the life of human and animal and without which system will not survive. Sleep disturbances generally cause daily widespread drowsiness, which can affect human mood, consciousness, memory, safety, and daily function. Interestingly, either in modern medicine, insomnia is not defined by sleeping hours because people's need for sleep is different and some people naturally need a shorter sleep time. From the point of view of ITM, according to the type of temperament, the need for sleep is different in people and people whose brain temperament tends to dry, typically need to sleep less from others. Statistically, the incidence of insomnia is different in studies conducted in different countries; however, in general, 33% of the population report insomnia in a stage of their life. While 13% suffer from persistent and chronic insomnia. Insomnia is one of the most common sleep disorders characterized by difficulty in sleeping, difficulty in falling sleep, or staying sleeper deprivation from reinforcing and refreshing sleep. In modern medicine, there are two main types of sleep disorder based on DSM-IV including “dys-somnia” and “para-somnia.” The most common type of sleep disorder is “insomnia.” According to the DSM-IV criteria, insomnia refers to difficulty in falling or staying asleep or deprivation from reinforcing and refreshing sleep for 1 month or more leading to individual's dysfunction. There are some studies one treatment of insomnia with medicinal herbs, including the research on aromatherapy in Persian medicine to reduce anxiety and sleep disorders  and herbal medicine for insomnia. According to previous studies, herbal medicines such as violets, lilies, pumpkins, and almonds have shown effective role in the treatment of insomnia.
In ITM literature, insomnia is called “Sahar” which means abnormal awaking for a long time. The causes of insomnia are different in traditional medicine ,,, and, accordingly, there are oral and topical treatments or behavioral recommendations for different types of insomnia. The basis of treating insomnia in ITM, particularly insomnia caused by warmth or dryness of the brain, is to moisturize the brain which can be done with foods, medications or massage therapy.,,
Moreover, several articles as well as some clinical trials have been conducted to examine the effect of traditional products on treating insomnia.,,, According to our investigations, efficacy of topical remedies for insomnia in ITM texts according to scientific literature, have not been investigated so far. Hence, in continuous to previous studies on efficacy of herbal remedies in ITM, in the present study, topical herbal remedies for insomnia and also related experimental and clinical articles have been studied.,
| Methods|| |
In this study, a research in ITM reference books (the Canon of medicine, Teb-e-Akbari, Kholasat al-Hekmah, Makhzan al-Advieh, Exir-e-azam, Al-Aghraz al-Tibbia, Val Mabahess al-Alaiia, Sharh-al-Asbab-val Alamat, Tohfa-al-Momen, and Qarabadeen-e-Kabir) was performed to investigate effective topical therapies for treating insomnia. In addition, relevant studies on these topical remedies, was searched at database such as PubMed, Google Scholar, Scopus, and ScienceDirect from the beginning till June 2018 were done and the results were presented as tables.
| Results|| |
The medicinal plants used to treat insomnia as topical dosage forms are presented in [Table 1]. Some of these herbs such as violet, pumpkin, lettuce and almond have been represented in different traditional texts as topical treatments for insomnia.
|Table 1: Medicinal plants used to treat insomnia in topical dosage form in Iranian traditional medicine|
Click here to view
Efficacy of some of the topical herbal remedies for insomnia in ITM has also been investigated in experimental and clinical studies [Table 2].
|Table 2: Experimental and clinical studies of topical herbal remedies for insomnia in Persian medicine|
Click here to view
| Discussion|| |
Insomnia is one of the most common sleep disorders, which is characterized by difficulty in falling or staying asleep or deprivation from reinforcing and refreshing sleep. Sleep disorders generally cause daily widespread drowsiness, which can affect the mood, consciousness, memory, safety, and daily function of the individual.
In current medicine, the treatments used for insomnia besides medication are behavioral therapy, sleep hygiene education, muscles relaxation, biofeedback, stimulus control, sleep restriction, cognitive therapy, cognitive behavioral therapy, and light therapy. Other treatments including herbal products such as valerian, homeopathy, aromatherapy, using certain diets and dietary supplements, including hydroxytryptophan and melatonin, have been also found useful in the treatment of insomnia. Drugs used for insomnia in current medicine include sedative agents (benzodiazepine and non-benzodiazepine), rumletone, antidepressants, antihistamines, and melatonin, which are associated with multiple side effects. Sedative agents have some side effects such as daytime drowsiness, dizziness, cognitive impairment, gait abnormality, dependence, and rebound symptoms if suddenly stopped taking the drug. In addition, benzodiazepines should be used with caution in people such as pregnant women and patients with hepatic diseases, kidney diseases, lung diseases, and sleep apnea. Therefore, there are tendency to alternative and complementary therapies to treat insomnia.
In ITM literature, insomnia is called “Sahar.” The basis of treating insomnia in traditional medicine, especially insomnia due to the dryness of brain, is to moisturize the brain, which can be done by nutrition, using spice or massage therapy.,
According to the results of the current study, oral and topical therapies have been used to treat insomnia in traditional medicine. Topical treatments of insomnia include various dosage forms such as ointment, lotion, nasal drops, topical oils, and inhalants. Medicinal herbs are prescribed as single drug or combination of herbs in these topical treatments. The most common herbs used topically to treat insomnia, which has been mentioned in different traditional literatures, include pumpkin, violet, lettuce, water lily, and almond. Among these plants, lettuce and violet have been examined and turned out to be effective to treat insomnia in clinical trial. These results are in agreeing to previous studies on effective herbal drugs for insomnia.
The findings showed that plants such as aromatic violets, pumpkin, almond, lettuce, poppy, coriander, lavendula, chamomile, and saffron, which have been recommended for insomnia in ITM, also have shown good effects in animal or human models for the treatment of insomnia. Some common herbs recommended in ITM for insomnia such as water lily have not been examined in animal or human studies yet.
Further clinical studies on topical herbal remedies for insomnia may due to produce new topical treatment origin from medicinal herbs for insomnia.
| Conclusion|| |
According to ITM literature, topical forms of herbs or herbal preparations are effective treatments for improving sleep disorders. Some topical drug from medicinal herbs such as violet, pumpkin, or almond can be potential alternative medicine for insomnia. These medications are generally applied in forms of poultices, lotions, ointments, inhalation, olfaction, and nasal drop on the temporal area, frontal area, or other places.
This study was supported by School of Persian Medicine and Research institute for Islamic and Complementary medicine, Iran University of Medical Sciences, Tehran, Iran.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Feyzabadi Z, Jafari F, Feizabadi PS, Ashayeri H, Esfahani MM, Badiee Aval S, et al.
Insomnia in Iranian traditional medicine. Iran Red Crescent Med J 2014;16:e15981.
Mousavi SA, Mirzaei E, Khosravi A. Sleep pattern and daytime sleepiness in over-15-year-old people in Shahroud. Knowledge and Health 2010;4:45-9.
Sadock B, Kaplan SV, Sadock VK. Sadocks Synopsis of Psychiatry. Philadelphia: Williams and Wilkins; 2003.
Kermani N. Sharh-ol-Asbab val Alamat. Tehran: Research Institute for Islamic and Complementary Medicine Publication; 2008.
Benca RM. Diagnosis and treatment of chronic insomnia: A review. Psychiatr Serv 2005;56:332-43.
Fayazi S, Babashahi M, Rezaei M. The effect of inhalation aromatherapy on anxiety level of the patients in preoperative period. Iran J Nurs Midwifery Res 2011;16:278-83.
Yarnell E. Herbal medicine for insomnia. Altern Complement Ther 2015;21:173-9.
Khorasani MA. Makhzan al Advieh. Tehran, Iran: Bavardaran Press, Research institute for Islamic and Complementary Medicine, Iran University of Medical Sciences; 2001.
Jorjani S. Al-Aghraz al-Tibbia Val Mabahess al-Alaiia. Tehran: Tehran University Press; 2006.
Azam Khan M. Exir Azam (Persian). Tehran: Institute of Meical History, Islamic Medicine and Complementary Medicine, Iran Medical University; 2008.
Arzani M. Teb Akbari, Research: Institute of Revival Natural Medicine, Institute of Historical Studies, Islamic Medicine Supplements Iran University of Medical Sciences. Qom: Jalaluddin Publications; 2008.
Avicenna H. Ghanoon Dar Teb, The Canon of Medicine. Bulaq Edition. Translated by Sharafkandi A. Tehran: University of Tehran Press; 1978.
Feyzabadi Z, Javan R, Mokaberinejad R, Aliasl J. Comparing insomnia treatment in Iranian traditional medicine and modern medicine. Med Hist J 2014;6:185-208.
Asali Z, Fahami F, Aslani A, Fathizade N. Comparative evaluation of St. Jhon's wrot and passion flower effect on hot flash and insomnia in menopausal woman. Cmja 2013;3:383-93.
Saito E, Iwatuki S, Koide A, Yajima M, Kojima Y. Nocturia-improving effects of water extracts of Cucurbita pepo
seeds. J Jpn Soc Food Sci Technol Nippon Shokuhin Kagaku Kogaku Kaishi 2011;58:454-9.
Abdollahi Fard M, Shojaii A. Efficacy of Iranian traditional medicine in the treatment of epilepsy. Biomed Res Int 2013;2013:692751.
Shojaii A, Ghods R, Abdollahi Fard M. Medicinal herbs in Iranian traditional medicine for learning and memory. Afr J Tradit Complement Altern Med 2016;13:199-209.
Aghili Shirazi M. Qarabadin-e Kabir (Great Pharmacopoeia). Tehran, Iran: Institute of Medical History, Islamic Medicine and Complementary Medicine, Iran Medical University; 1970.
Tonekaboni H. Tohfat al Momenin. A Gift for the Faithful. Research Center of Traditional Medicine. Shahid Beheshti University of Medical Sciences. Tehran: Nashre Shahr Press; 2007.
Feyzabadi Z, Jafari F, Kamali SH, Ashayeri H, Badiee Aval S, Esfahani MM, et al.
Efficacy of Viola odorata
in treatment of chronic insomnia. Iran Red Crescent Med J 2014;16:e17511.
Abdollahnejad F, Mosaddegh M, Kamalinejad M, Mirnajafi-Zadeh J, Najafi F, Faizi M, et al.
Investigation of sedative and hypnotic effects of Amygdalus communis
L. extract: Behavioral assessments and EEG studies on rat. J Nat Med 2016;70:190-7.
Baradaran Rahimi V, Askari VR, Tajani AS, Hosseini A, Rakhshandeh H. Evaluation of the sleep-prolonging effect of Lagenaria vulgaris
and Cucurbita pepo
extracts on pentobarbital-induced sleep and possible mechanisms of action. Medicina (Kaunas) 2018;54. pii: E55.
Dehghanmehr S, Shadadi H, Mansouri A, Arbabisarjou A. Effect of oral saffron capsules on sleep quality in patients with diabetes at Zabol-Iran. Bali Med J 2017;6:595-600.
Hosseinzadeh H, Noraei NB. Anxiolytic and hypnotic effect of Crocus sativus
aqueous extract and its constituents, crocin and safranal, in mice. Phytother Res 2009;23:768-74.
Yakoot M, Helmy S, Fawal K. Pilot study of the efficacy and safety of lettuce seed oil in patients with sleep disorders. Int J Gen Med 2011;4:451-6.
Ghorbani A, Rakhshandeh H, Sadeghnia HR. Potentiating effects of Lactuca sativa
on pentobarbital-induced sleep. Iran J Pharm Res 2013;12:401-6.
Kim HD, Hong KB, Noh DO, Suh HJ. Sleep-inducing effect of lettuce (Lactuca sativa
) varieties on pentobarbital-induced sleep. Food Sci Biotechnol 2017;26:807-14.
Emamghoreishi M, Heidari-Hamedani G. Sedative-hypnotic activity of extracts and essential oil of coriander seeds. Iran J Med Sci 2015;31:22-7.
Hosseini A, Sobhanifar MA, Forouzanfar F, Aghaee A, Rakhshandeh H. Hypnotic effect of red cabbage (Brassica oleracea
) on pentobarbital-induced sleep in mice. J Pharm Bioallied Sci 2018;10:48-53.
Hodo DW. Kaplan and Sadock's comprehensive textbook of psychiatry. Am J Psychiatry 2006;163:1458.
Avicenna H. Ghanoon fe Teb. Aljoze Sales. Beirut: Darolhaya Altras Alarabi; 2004. p: 464-5.
Chashti M. Exir-e Azam. Tehran: Research Institute for Islamic and Complementary Medicine, Tehran University of Medical Sciences; 2004. p. 271-2.
[Table 1], [Table 2]