In the June 2 issue of "Sleep Medicine Reviews," researchers at the UIC College of Pharmacy and College of Nursing discuss the propensity of people with sleep disorders to self-treat using herbs. UIC researchers also review the most commonly used herbal stimulants and sedatives, and recommend a course of action to the medical and research communities.
Difficulties with sleep and wakefulness are found in up to 38 percent of the world population. Thirty-eight percent of U.S. adults in 1998 reported that daytime sleepiness interferes with their daily activities at least a few days a month. Ten to 15 percent of these respondents reported using over-the-counter medications or a dietary supplement to help them stay awake during the day.
"Health-care providers have largely ignored this phenomenon in the past, but it is now becoming necessary for providers to educate themselves and their patients in the wise and unwise use of these agents," said Charlotte Gyllenhaal, UIC College of Pharmacy research assistant professor and lead author of the article titled "Efficacy and Safety of Herbal Stimulants and Sedatives in Sleep Disorders."
The researchers reviewed caffeine and caffeine-containing herbs, ephedrine-containing herbs, yohimbe and ginseng for their ability to combat fatigue, as well as valerian, German chamomile, kava, lavender, hops, lemon balm and passion flower for their ability to improve sleep.
They note that caffeine is widely used to control sleepiness, but more research is needed on its use in sleep disorders. They express safety concerns about ephedra and ephedrine, used in stimulants and weight loss products, and yohimbe, used in stimulant and body-building preparations. They note that there is some inconclusive experimental evidence for the use of Asian and Siberian ginseng to treat fatigue.
Experimental evidence also supports the efficacy of the herbal sedatives valerian and kava, which have received the most research attention. Both herbs in small studies decreased sleep onset time and promoted deeper sleep. The researchers note that German chamomile, lavender, hops, lemon balm and passion flower are reputed to be mild sedatives but need much more experimental examination.
The UIC team calls on researchers and medical professionals to address the use of herbs to treat sleep disorders by:
- Systematically gathering data about the use of herbals by people with sleep disorders
- Exploring herb-drug interactions, especially in relation to elderly patients who take many prescription medications and frequently complain of sleep problems
- Continuing basic research into the identity of active compounds and their stability in a variety of preparations
- Conducting large-sample, double-blind, placebo-controlled trials of herbal sedatives
- Examining the prevalence of adulteration and contamination in herbs, especially those imported from areas where there is little manufacturing regulation
- Exploring the activity of herbal sedatives in sleep initiation verses sleep maintenance
- Asking patients nonjudgmental questions about their use of herbal preparations to aid sleep and wakefulness and incorporating their answers into their medication history
The Program for Collaborative Research in the Pharmaceutical Sciences in the UIC College of Pharmacy, established in 1982, brings together a multidisciplinary group of faculty to pursue research and development projects in areas including the isolation and biological evaluation of agents from plants to treat and prevent a variety of diseases; synthesis and biosynthesis of natural products; drug plant exploration in the tropics; and the computerization of the world’s literature on the chemistry and biology of natural medicinal products.
The Center for Narcolepsy Research in the UIC College of Nursing, established in 1986, brings together a multi-disciplinary group of researchers to increase knowledge about excessive sleepiness disorders, including narcolepsy and sleep apnea syndrome. The center also studies the biobehavioral impact of excessive daytime sleepiness on persons and their families. It operates the only Pupillometry Laboratory in the Chicago region that studies the relationship between pupil behavior and other biobehavioral aspects of sleepiness.
With 25,000 students, the University of Illinois at Chicago is the largest and most diverse university in the Chicago area. UIC is home to the largest medical school in the United States and is one of only 88 national Research I universities. Located just west of Chicago’s Loop, UIC is a vital part of the educational, technological and cultural fabric of the area.
Source: University Of Illinois At Chicago. June 1, 2000.