Original ArticleEffects of homeopathic medicines on polysomnographic sleep of young adults with histories of coffee-related insomnia
Introduction
Previous studies in many different countries have shown that a substantial proportion of the general population, especially individuals with chronic illnesses, use various types of complementary and alternative medicine (CAM) [1], [2], [3], [4]. Among CAM users, insomnia and depression/anxiety are common conditions for which they seek alternative therapies [4], [5]. Homeopathy, a 200-year-old whole system of CAM developed by a German physician, is one of the mostly widely known [6] and controversial modalities [7], [8], [9] for which clinicians and consumers worldwide claim therapeutic benefit in sleep disturbances and fatigue, as well as other medical and psychiatric conditions [10], [11], [12], [13], [14].
Homeopathic clinicians often rely on subjective changes in sleep quality and increased mental/physical energy as early indications of the actions of homeopathic medicines (termed “remedies”) [15]. But the relative lack of objective measures to evaluate homeopathy in human subjects has thus far hindered advances in both clinical care and research. Polysomnography (PSG), which can distinguish divergent findings, if present, between subjective sleep complaints and objective all-night sleep recording assessments in certain types of insomnia [16], [17], [18], offers a potentially valuable tool for homeopathic investigations.
Multiple studies on healthy animals have shown measurable effects on sleep of three different homeopathic remedies at potencies prepared to a dilution past Avogadro’s number (Histamine, Coffea Cruda, and Nux Vomica) compared with placebo. Each remedy at a 30c potency altered sleep patterns notably with differential effects on electroencephalographic delta frequency (0.5–2.5 Hz) power during sleep [19], [20], [21], [22]. Other investigators have demonstrated effects of Nux Vomica 30c on alcohol-induced sleep time in mice [23], [24].
Clinically, homeopaths report that Coffea Cruda patients are mild and timid, but also irritable and oversensitive to all types of sensory stimuli, especially noise, as well as to positive emotions [25], [26]. Nux Vomica as a homeopathic remedy is used clinically to treat people with competitive, irritable and impatient Type A-like behavioral patterns and tendencies to abuse alcohol, caffeine, and other substances. Both Coffea Cruda and Nux Vomica patients report insomnia in the middle of the night as a symptom [27]. Taken together with the clinical reports, the animal EEG sleep data provide a basis for selecting Coffea Cruda and Nux Vomica as candidate homeopathic remedies to test in the first homeopathic PSG research on human subjects.
The primary purpose of the present within-subjects feasibility study was to examine the PSG effects of one dose of placebo versus either Coffea Cruda 30c or Nux Vomica 30c in relatively healthy young adult human subjects with a past history of coffee-induced insomnia. Because of the importance of person-centered factors in clinical expectations of remedy effects [27], [28], inclusion criteria included individual difference traits of increased levels of either anxiety sensitivity or of Type A cynical hostility. Based on the animal studies, the remedy effects were hypothesized to include changes in both quantity and quality (variability in sleep stage changes and in awakenings after sleep onset) of NREM sleep, especially slow wave sleep, after controlling for within-subject baseline sleep patterns and placebo effects.
Section snippets
Subjects
Potential subjects were identified by screening young adult male and female college students (age range 18–31) enrolled in the introductory psychology class at the University of Arizona, for scores on the 16-item anxiety sensitivity index (ASI) [29], the 27-item Cook–Medley Cynical Hostility Scale (CMHO) [30], and one 5-point rating item on self-rated physical health [31]. All potential subjects had to score ⩾3 out of 5 on a rating of global health and give a history of coffee-induced insomnia
Results
A total of 4279 people were screened for the study. Seventy people met all eligibility criteria, volunteered and enrolled in the study. But 5 participants who started the study were administratively withdrawn due to early protocol violations making them ineligible for study participation (e.g., beginning medication on the exclusion list, an undisclosed health problem on the exclusion list). Three subjects opted out of the study (e.g., schedule conflicts, catching the flu) prior to treatment
Discussion
The current study demonstrates the feasibility of using in-home all-night sleep recordings with ambulatory PSG equipment in young adults to assess the effects of homeopathic remedies. Both remedies led to an increase in TST reflected mainly in increased NREM sleep. The increased NREM time is similar to observations from previous animal sleep studies with Coffea Cruda 30c [19], [20], [21]. In addition, consistent with the animal data showing increased variability of EEG sleep after Nux Vomica
Acknowledgments
This study was supported by National Center for Complementary and Alternative Medicine Grants R21 AT000388 and K24 AT000057 to IRB. The authors would like to thank Keith Fridel, PhD RPSGT for training and supervising the sleep scoring, and Elizabeth Acker, Michael Biuso, Erica Morey, Molly Taylor, and Alivia Wieseler for their technical assistance in data collection and quality assurance procedures. Dr. Bell serves as a consultant to Standard Homeopathic Co./Hyland’s Inc., a homeopathic
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