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Volume 12, Issue 3 (12-2022)                   cmja 2022, 12(3): 220-233 | Back to browse issues page


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Moradi M, Niazi A, Rahimi M, Rasa S. Effect of Valerian on Sleep Disorders of Postmenopausal Women in Iran: A Systematic Review. cmja 2022; 12 (3) :220-233
URL: http://cmja.arakmu.ac.ir/article-1-867-en.html
1- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
2- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran. , azin_niazi65@yahoo.com
3- Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
4- Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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Introduction
Menopause is caused by the cessation of follicle stimulating hormone secretion and refers to the cessation of menstruation for 12 months without any other specific reason, which occurs at the age of 50-51 years on average [1]. According to the International Institute of Sleep, the sleep disorder associated with menopause does not necessarily reduce the amount of sleep; it only affects the quality of sleep. According to studies, 61% of women report symptoms such as waking up frequently, falling asleep late, and staying awake in bed for more than half an hour after menopause [23].
Valerian is a plant with sedative and sleep-inducing properties. The most probable mechanism of action of this herbal plant is the effect on GABA receptors, because there is a high concentration of GABA in valerian products [4]. Studies conducted in Europe and America show that only 10-20% of postmenopausal women regularly use hormone therapy, and less than 40% of women who started hormone therapy continued to use it [5]. Considering the side effects of common drugs in the treatment of sleep disorders in postmenopausal women, the growing trend towards herbal medicines, and the fact that no review study has been conducted in this field that leads to definitive conclusions, the present review study aims to investigate the results of clinical trials conducted on the effect of valerian on sleep disorders of postmenopausal women in Iran.
Methods
In this systematic review study, a search was first conducted in SID, Iran Medex, PubMed, Web of Science, Cochrane library, EMBASE, Scopus, Science direct, and Google Scholar databases for the related studies until December 2021 based on PICO strategy and MeSH terms including insomnia, menopause, Valerian, Sleep disorder, herbal medicine, Complementary Medicine, and Clinical Trial in both Persian and English with Boolean operators (OR, AND). The randomized clinical trials published in Farsi or English were included. Irrelevant studies, duplicates, and review studies were included [6]. The quality of the articles was evaluated by the Jadad scale [7]. Among the 389 articles found in the initial search, one article was excluded due to non-relevance, 10 articles due to duplication, 3 article due to not meeting the study objective, and one article due to being a review study. Finally, 6 studies (Sample size: 637) were examined. All the articles scored more than 3 on the Jadad scale and had appropriate methodology.
Results
Of 6 studies, 3 investigated the effect of valerian on sleep disorders, 2 investigated the effect of valerian on sleep quality, and one study investigated the effect of valerian on sleep domains of postmenopausal women. The characteristics of the studies are given in Table 1.




Participants were postmenopausal women in Iran aged 45-60 years who had scored at least 5 on the Petersburg Sleep Quality Index (PSQI). Women in the intervention group of these studies received 160-530 mg of valerian and in the control group of 5 studies, they received placebo capsules containing starch. The duration of taking valerian capsules in all studies was 1 month, twice a day. The PSQI was used in all the articles that investigated the effect of valerian on sleep disturbance and quality.
Discussion
The results of reviewed studies showed that daily consumption of valerian improves the quantity and quality of sleep in postmenopausal women in Iran. The studies did not report any side effects for valerian.

Ethical Considerations
Compliance with ethical guidelines

The present paper is the result of a research project approved by the Vice-Chancellor for Research of Mashhad University of Medical Sciences (Number Grand: 4000803 and Ethics Committee with code of IR.MUMS.NURSE.REC.1400.060).

Funding
This study was supported by Mashhad University of Medical Sciences.

Authors' contributions
All authors equally contributed to preparing this article.

Conflicts of interest
The authors declared no conflict of interest.

Acknowledgements
Authors appreciate the Deputy of Research, Mashhad University of Medical Sciences for financial support.


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Type of Study: Review Paper | Subject: Nursing and Midwifery

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