Crocus Sativus for Insomnia: A Systematic Review and Meta-Analysis

Abstract

Insomnia is a common complaint affecting human performance in daily life activities. This study aimed to analyze the effects of Crocus sativus on insomnia. Methods: PRISMA guidelines were used according to the PICOS model. A systematic search of PubMed/Medline and the Cochrane Library was undertaken for literature until December 2021. A random effects model was used with I2 statistic to assess heterogeneity and a GRADE assessment was used to assess the quality of the outcomes. Eight articles were included, involving 431 participants. Crocus sativus reduced insomnia severity (SMD: 0.53; 95%CI: −0.05 to 1.11; I2 statistic = 59%; p = 0.08) and increased sleep quality (SMD 0.89, 95% CI 0.10 to 1.68; I2 statistic = 90%; p = 0.03; 6 studies, 308 participants, very low-quality evidence) and duration (SMD: 0.57; 95%CI: 0.21 to 0.93; I2 statistic = 40%; p = 0.002; 5 studies; 220 participants, moderate-quality evidence) compared with the placebos. Although there is limited evidence of a very low- to moderate-quality, Crocus sativus may benefit people with insomnia. This non-pharmacological intervention may reduce the chance of adults with insomnia taking sedative–hypnotic medication, thus reducing dependency and withdrawal symptoms.

Crocus sativus updated

“…In einem Umbrella-Review wurden 23 systematische Reviews (SR) zu Safran zusammengefasst: 13 SRs bei Depressionen, 6 SRs bei sexueller Dysfunktion und je 3 SRs bei Ängsten und Hirnleistungsstörungen [36]. Darüber hinaus geben Metaanalysen Hinweise, dass Safran auch bei Diabetes Typ 2 [11,26,32] mit oder ohne metabolischem Syndrom [13,37] wirksam ist, beim prämenstruellen Syndrom (PMS), bei Postpartum-Depressionen, Schlafstörungen und Essstörungen [22,27,36] sowie bei Stoffwechselstörungen wie Arteriosklerose, Fettstoffwechselstörung, bei Augenkrankheiten (Makuladegeneration, diabetischer Retinopathie, Glaukom, Retinitis pigmentosa) [12,23,34,38] und bei Infektionen mit SARS-CoV-2 [41]. Die blutdrucksenkende Wirkung ist vermutlich klinisch nicht relevant [35].…”

Saffron the “Red Gold” and Its CNS Activity: A Challenge for Future Applications in Nutraceuticals

“…Although there is limited evidence of a very low to moderate quality, C. sativus may beneft people with insomnia [28] Adjunctive therapy in adults with attention-defcit/hyperactivity disorder Safron combination therapy with Ritalin can efectively improve symptoms of patients with ADHD [29] Management of premenstrual dysphoric disorder 15 mg of safron for 2 weeks in the luteal phase of two menstruation cycles.…”

“…In particular, safron, crocin and safranal, has shown relevant hypnotic efects due to the inhibition of the wakefulness-promoting neurons in the tuberomammillary nucleus and the simultaneous activation of the sleep-promoting neurons in the ventrolateral preoptic nucleus. Diferent clinical trials and two recent meta-analyses have highlighted safron's hypnotic properties [27,28,[84][85][86] and one clinical trial for safron's bioactive molecule crocetin [87]. In a 28-day, 3-arm, parallel-group, double-blind, randomized controlled trial, the efect of 14 mg, or 28 mg of a standardized safron extract (Afron ® ) 1 h before bed, on 120 adults with unsatisfactory sleep versus placebo was measured using the Insomnia Symptom Questionnaire (ISQ), the Pittsburgh Sleep Diary, Restorative Sleep Questionnaire, Profle of Mood States, the Functional Outcomes of Sleep Questionnaire, and evening salivary cortisol and melatonin levels [27].…”

The European Insomnia Guideline: An update on the diagnosis and treatment of insomnia 2023

“…That said, this is in the context of rating the original studies to be of low quality. There is also evidence, also from low‐quality original studies (Ji et al, 2021), that Saffron (Lian et al, 2022; Munirah et al, 2022), Viola odorata (Huang, Huang, et al, 2022) and diverse plant cocktails, from traditional Chinese medicine, may be effective to a low degree (Birling et al, 2020; Chen et al, 2022; Chen, Yi, et al, 2020; Fan et al, 2020; Li, Xu, et al, 2020; Lin et al, 2021; Wang et al, 2021; Wang, Ju, et al, 2020; Yang et al, 2019; Zhang, Liu, et al, 2019; Zhou et al, 2022). It is problematic for the authors of this guideline to evaluate these original studies, within the context of traditional Chinese medicine, as most of the original studies were not published in English language.…”