Insomnia

Efficacy of Alternative and Other Treatments According to GRADE* Ranking:

Valerian (Valerian Tea, Valeriana Officinalis) [1, 25, 26, 27, 28, 29, 30, 31]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: No recommendation (Although animal studies have shown that Valerian can have some benefit in treating insomnia, clinical trials have yielded conflicting results. More research is needed. )

Grade of Evidence: moderate quality of evidence

Thuja (Eastern White Cedar, Thuja Occidentalis) [1, 22, 23, 24]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present. Little is known about the full effects of Thuja, so it is not recommended for medicinal use. Thuja can be poisonous if ingested in large amounts.

Recommendation: no recommendation (There is insufficient evidence to support claims that Thuja helps to treat insomnia)

Grade of Evidence: very low quality of evidence

Strychnos Nux-Vomica (Maqianzi, Poison Nut) [1, 19, 20, 21]:

WARNING! This substance is HIGHLY POISONOUS. The seeds contain Strychnine, which may cause convulsions, breathing difficulties and death, even if as little as 5 milligrams is ingested

Recommendation: Strongly against (There is no evidence in the form of clinical trials which reports the effectiveness of Strychnos Nux-Vomica, because it is highly poisonous to humans, and is not recommended.)

Grade of Evidence: very low quality of evidence

St John's Wort (Goatweed, tipton weed, Hypericum Perforatum) [1, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: No recommendation (Available evidence does not support claims that St Johns Wort can help to treat insomnia)

Grade of Evidence: low quality of evidence

Six Flavor Tea (Liu Wei Di Huang Wan, Rehmannia Six) [1, 6, 7]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: No recommendation (There is insufficient evidence to show that Six Flavor Tea helps in any way in the treatment of insomnia)

Grade of Evidence: very low quality of evidence

Flower Remedies [1, 4, 5]:

Please note, this management does NOT treat the condition itself. It may mildly help with some of the symptoms, and even then has insufficient evidence to back up this claim at present.

Recommendation: no recommendation  (There is insufficient evidence to support claims that flower remedies help to treat insomnia)

Grade of Evidence: very low quality of evidence

Chamomile (Matricaria Chamomilla) [1, 2, 3]:

Please note, this management does NOT treat the condition itself. It is proposed only as a weak supportive symptomatic support, and even then, has insufficient evidence to back up this claim at present.

Recommendation: weakly against (Available evidence does not support claims that Chamomile helps treat insomnia. In addition, allergic reactions and side effects like cramps, itching, rashes and difficulty breathing can be relatively common)

Grade of Evidence: low quality of evidence

Massage:

Recommendation: no recomendation (Massage has been shown not to be effective in the treatment of long-term insomnia)

Grade of Evidence: moderate quality of evidence

Biofeedback:

Recommendation: no recomendation (there is insufficient evidence to show that Biofeedback helps treat insomnia)

Grade of Evidence: very low quality of evidence

Meditation:

Recommendation: strongly in favor (research has shown that meditation can help to treat insomnia)

Grade of Evidence: moderate quality of evidence

Music Therapy:

Recommendation: strongly in favor (clinical trials have shown that music therapy helps in treating insomnia)

Grade of Evidence: moderate quality of evidence

* www.gradeworkinggroup.org

Summary References

Treatments:

1. Ades T, Alteri R, Gansler T, Yeargin P, "Complete Guide to Complimentary & Alternative Cancer Therapies", American Cancer Society, Atlanta USA, 2009

2. http://www.abchomeopathy.com/r.php/Cham

3. http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-chamomile.html

4. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/flower-remedies

5. http://www.ncbi.nlm.nih.gov/pubmed/12635462

6. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/six-flavor-tea

7. Shen JJ, Lin CJ, Huang JL, Hsieh KH, Kuo ML. The effect of liu-wei-di-huang wan on cytokine gene expression from human peripheral blood lymphocytes. Am J Chin Med. 2003;31(2):247-57.

8. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/st-johns-wort

9. http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-stjohnswort.html

10. http://www.ncbi.nlm.nih.gov/pubmed/18843608

11. http://www.ncbi.nlm.nih.gov/pubmed/11939866

12. http://nccam.nih.gov/health/stjohnswort/ataglance.htm

13. http://nccam.nih.gov/health/stjohnswort/sjw-and-depression.htm

14. http://www.nimh.nih.gov/health/publications/depression/how-is-depression-detected-and-treated.shtml

15. http://www.ncbi.nlm.nih.gov/pubmed/11939872

16. http://www.ncbi.nlm.nih.gov/pubmed/12132963

17. http://www.ncbi.nlm.nih.gov/pubmed/16423519

18. http://jama.ama-assn.org/cgi/content/full/299/22/2633

19. David Michael Wood et al. Case report: Survival after deliberate strychnine self-poisoning, with toxicokinetic data. Critical Care October 2002 Vol 6 No 5

20. Arnold, M.D., Harry L. (1968). Poisonous Plants of Hawaii. Tokyo, Japan: Charles E. Tuttle Co.. p. 20. ISBN 0804804745.

21. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/strychnos-nux-vomica

22. http://www.nlm.nih.gov/medlineplus/ency/article/002769.htm

23. http://plants.usda.gov/plantguide/pdf/cs_thoc2.pdf

24. http://vsearch.nlm.nih.gov/vivisimo/cgi-bin/query-meta?v%3Aproject=medlineplus&query=thuja&x=0&y=0

25. http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-valerian.html

26. http://nccam.nih.gov/health/valerian/index.htm

27. http://www.cancer.org/Treatment/TreatmentsandSideEffects/ComplementaryandAlternativeMedicine/HerbsVitaminsandMinerals/valerian

28. http://ods.od.nih.gov/factsheets/Valerian.asp

29. http://www.ncbi.nlm.nih.gov/pubmed/12725454

30. http://www.ncbi.nlm.nih.gov/pubmed/9757514

31. Taibi DM et al. 'A systematic review of valerian as a sleep aid: safe but not effective.' Sleep Med Rev. 2007;11:209-30.