The Impact of Complementary and Alternative Medicine on Insomnia: A Systematic Review

Abstract

Insomnia is characterized by difficulty in maintaining sleep and early morning awakenings. Although pharmacotherapies and psychological interventions remain essential for conventional treatment, motivational factors and interest in using complementary and alternative therapies for insomnia have developed over the last two decades. This review aims to comprehensively explore the effects of complementary and alternative medicine (CAM) on improving sleep quality to guide evidence-based clinical decision-making and inform future research. Several electronic databases such as MEDLINE, PubMed, Scopus, EMBASE, Clinical key, Cochrane, and Research gate were explored to search the relevant articles. For the systematic review, CAM studies were classified under "manual practices," "natural practices," and "mind-body practices." A total of 35 clinical trials were selected for inclusion in the systematic review, comprising adult samples. The systematic review revealed 11 RCTs with manual practice, 12 with mind-body practice, and 12 with natural medicine practice. The methodological quality of the RCTs was measured using the modified Jadad scale, a scientific quality index of ≥ 5/10 (on the augmented Jadad scale). Effect sizes (Cohen’s d) were calculated and reported in all placebo-controlled studies with the available data. Regardless of systematic reviews, and randomized controlled trials on CAM, acupuncture, acupressure, herbal medicine, yoga, and tai chi, for insomnia, most of the RCTs did not agree with the findings. Further RCT for insomnia should be developed by considering the current advanced studies in the field of CAM.

The Role of Complementary Therapy to Reduce Insomnia in Older Adults

“…The proportion between the effects of complementary therapy is reported to be higher in the 5 studies of strong quality compared to the 6 studies of moderate quality. This is evidenced by all high-quality studies reporting ≥50% positive results [15][16][17][18][19][20][22][23][24][25][26][27]. In addition, 5 out of 11 high-quality studies reported strong effects of complementary therapies on older adults, while no studies with moderate quality ratings reported effect sizes that exceeded Cohen's d≥0.80.…”

“…Although there are many types of complementary therapies, such as massage, music therapy, relaxation techniques, acupuncture, and physical exercises recommended in nursing interventions, the problem of insomnia in older adults is still largely unnoticed [14][15][16]. In other words, no studies have examined the nature of complementary therapies to alleviate insomnia in older adults, only the quality of his sleep.…”

Prospective Analysis of Cannabidiol's Effectiveness in Post-Exercise Recovery: An integrative Systematic Review and Research Agenda

“…[116] Some natural alternatives have been proposed, such as infusions, hot showers, tea consumption, and the use of oil as sleep and anxiety improvement strategies. [117] Based on these effective benefits, some team sports athletes have widely used CBD for sleep, pain relief, and recovery, and its consumption increases with age. [74] Endocannabinoid system stimulation may modulate sleep disorders in aging, being very promising evidence for sports while some elements of this system modulate the sleep-wake cycle.…”

Cyclic Meditation and Sleep Quality: A Review

“…9 Conventional management for sleep disorders involves the usage of sedative and hypnotic agents that can induce sleep but with many adverse effects. 10 Due to these adverse effects, the use of complementary and alternative medicine (CAM) including yoga has increased over the past two decades. Yoga is a way of life; it is a mind-body practice and plays a key role in the management of various psychosomatic noncommunicable disorders.…”