The Herbal Medicine () for Sleep Quality Improvements: A Systematic Review and Meta-analysis.

BACKGROUND

Sleep disturbances are common and bothersome among cancer and noncancer populations. () is commonly used to improve sleep, yet its efficacy and safety are unclear.

METHODS

We systematically searched PubMed, Cochrane Library, and EMBASE from inception through October 5, 2021, to identify randomized trials of . We included randomized trials comparing to placebo, medications, cognitive behavioral therapy (CBT), or usual care for improving sleep outcomes in cancer and noncancer patients with insomnia or sleep disturbance. We performed a risk of bias analysis following Cochrane guidelines. Depending on heterogeneity, we pooled studies with similar comparators using fixed- and random-effects models.

RESULTS

We included participants with insomnia disorder (N = 785) or sleep disturbance (N = 120) from 9 trials. Compared with placebo, led to significant subjective sleep quality improvements in participants with insomnia and patients with sleep disturbance combined (standard mean difference -0.58, 95% CI -1.04, -0.11;  < .01); Compared with benzodiazepines or CBT, was associated with a significant decrease in insomnia severity (mean difference -2.68 points, 95% CI -5.50, -0.22;  = .03) at 4 weeks in the general population and cancer patients. The long-term effects of were mixed among trials. did not increase the incidence of major adverse events. The placebo-controlled studies had a low risk of bias.

CONCLUSION

is associated with short-term patient-reported sleep quality improvements among individuals with insomnia or sleep disturbance. Due to the small sample size and variable study quality, the clinical benefits and harms of , particularly in the long term, should be further assessed in a sufficiently powered randomized trial.

REGISTRATION

PROSPERO CRD42021281943.