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Insomnia is a serious and frequently encountered healthcare issue. It interferes with most aspects of humans’ well-being and affects the way people think function, and behave; sleep disturbances can disable an individual and impair health (Carney & Edinger 2). Also, insomnia is a frequent manifestation of diverse disorders. In order to manage the healthcare status of patients with insomnia and increase their potential for recovery, pharmacological therapy can involve different medications such as benzodiazepines, antidepressants, antihistamines, and herbal valerian-containing medicines.  The most appropriate assessment tools and deliberate interventions should be selected to provide patients suffering from insomnia with efficient medical aid.

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Publications on interactions between insomnia and valerian often involve contradictory findings. Results of numerous research studies testify to the efficacy of valerian against insomnia while others suggest that valerian does improve the quality of sleep. Research studies on the effectiveness of valerian on insomnia produced mixed results and varied in quality. The given fact requires medical professionals to be able to evaluate published results of conducted studies in conformity with the world health care standards based on evidence, validity, authenticity, statistical interrelations, and scientific methodology. Healthcare providers must be aware of all aspects of valerian use including potential outcomes, clinical efficacy, and possible side effects.

The healing properties of herbs belonging to the Valerianaceae family have been recognized since ancient times. Valerian extracts influence cardiovascular, gastrointestinal, and diverse neurologic activities. Valeriana officinalis L. is the most widely utilized source of valerian extract among other 250 species of the genus.

The chemical composition of valerian varies depending on specific subspecies, area, environmental conditions, harvesting time, processing methods, and storage. Contemporary scientific publications generally identify valerian as a natural source of multiple components that may positively influence sleep disturbances. Roots, rhizomes, and stolons of Valeriana officinalis L. contain over 150 chemical constituents such as iridoid valepotriates (isovaltrate, valerosidate, didrovaltrate, and so forth), flavonoids (6 - methylapigenin, hesperidin), free amino acids, volatile essential oil, alkaloids, valepotriates, etc.

Chemical composition, structures, and physiochemical properties of the major types of valerian chemical constituents are analyzed by Pato%u010Dka & Jakl in their publication “Biomedically Relevant Chemical Constituents of Valeriana Officinalis”. The authors provide comprehensively described graphical images, tables, statistics, and numerical data from pertinent research studies in order to support their assertions. Pato%u010Dka & Jakl state that “It is not fully understood which constituents of V. officinalis, and/or of the other heretofore unidentified members of the Valerianaceae family, are responsible for the sedative and/or anxiolytic action of valerian extracts”. Animal studies and laboratory experiments in vitro have corroborated the effectiveness of valerian and valerian chemical compounds at neuroreceptors involved in sleep regulation, including gamma-aminobutyric acid (GABA) and adenosine receptors (Taibi et al. 409). Being administered separately, valerian chemical substances do not trigger improvements in sleep parameters. Complex interactions between these chemical compounds of valerian induce sedative effects and improve insomnia. Research findings presuppose the synergetic effectiveness of valerian constituents on insomnia. However, this hypothesis appears to be understudied due to existing contradictory findings and, consequently, should be accurately elaborated via laboratory experiments and clinical trials.

Findings of recent research on the efficacy of valerian and hops in treating primary insomnia are analyzed by Salter and Brownie. This systematic review has performed a comprehensive literature search; the research process entailed the review of numerous peer review journals, monographs, laboratory experiments, and scholarly research from reputable international and national healthcare organizations, which were used to gather scientifically relevant information. In accordance with conclusions drawn by the researchers, valerian medications “may improve sleep latency and quality of sleep. However, methodological problems of studies weaken the conclusions of these findings and their application to clinical practice” (Salter & Brownie 437). Multiple inconsistencies between the studies under scrutiny should be eliminated by conducting further research with a robust design. Furthermore, the same findings are represented by the three meta-analyses conducted by Fernández-San-Martín et al. who recommend future investigations involving reliable quantitative and objective measurements.

Sleep disturbances can be provoked by numerous diseases and painful conditions. Research studies are focused on valerian effectiveness on insomnia in conditions specific to patients with a generalized anxiety disorder (GAD), stress disorders, cancer, arthritis, restless legs syndrome, bronchial asthma, postmenopausal syndrome, and so forth.

A randomized placebo-controlled clinical trial pursued by Taavoni et al. substantiates the effectiveness of valerian in the clinical management of insomnia in postmenopausal women. The research process involves techniques of a randomized, triple-blind, controlled trial design and methods of descriptive and inferential statistics. 100 postmenopausal women aged 50 to 60 years with sleep disturbances participated in the study. In accordance with the research findings, being taken twice per day, concentrated valerian extract improves the quality of sleep in postmenopausal women. Thus, this article testifies to the effectiveness of Valeriana officinalis L. on insomnia.

However, published results of the research conducted by Taibi et al. provide opposite data. Focusing on their findings of their randomized, double-blind, crossover controlled trial, Taibi et al.  assert that concentrated valerian extract does not improve insomnia in older women due to absent significant differences between the effectiveness of valerian and placebo. However, the sample of this study was significantly less in number in comparison with that of pursued by Taavoni et al.; 16 older women participated the research conducted by Taibi et al. thus, their findings can be evaluated as insufficiently reliable.

Another research was performed by Taibi et al.  in order to explore issues of feasibility and efficacy in studies of valerian for arthritis-related sleep disturbance. The publication   “A Feasibility Study of Valerian Extract for Sleep Disturbance in Person with Arthritis” (2009) discusses interrelations between valerian therapy, placebo, and insomnia in older patients with arthritis. The researchers specify ways of intervention, criteria for selecting participants, examination techniques and procedures, and sleep outcomes. Although the study conducted by Taibi et al. did not confirm the effectiveness of valerian on insomnia, their findings “should be interpreted with caution because of the small sample size and the short treatment duration that was less than the 2 weeks’ use”.

Valerian sedative effects and positive influence on people with restless legs syndrome (RLS), a devastating sleep disorder, are clarified in the article “Does Valerian Improve Sleepiness and Symptom Severity in People with Restless Legs Syndrome?” published by Cuellar and Ratcliffe. Their exploratory study was specifically designed to evaluate healing impacts of valerian on the severity of RLS symptoms and compare the effectiveness of valerian with placebo on insomnia. The sample size (40 participants), statistical analyses, and detailed descriptions of dosage, regimen, and qualitative testing testify to reliability of findings. According to the research, “The results of this pilot suggest that valerian may improve RLS symptom severity and sleepiness”.

Intoxication or any other adverse effects of valerian have not been identified by research studies.

Recent valerian-oriented publications research utilization of new pharmacological forms. Medications with Valeriana officinalis L. are generally administered in such forms as immediate-release tablets, tincture, capsules, swellable pellets, and coated tablets. Furthermore, novel materials and products possessing improved properties can be further developed.   Utilizing colloidal silicon dioxide as the carrier, Gallo et al. propose a new preparation method capable of improving the hygroscopicity and physico-mechanical properties of Valeriana officinalis L. dry extracts. The nature of the study stipulated the methodology and design. The researchers adequately described the data collection process and experimental techniques, identified the theoretical base of their study, distinguished major themes, and summarized findings. The key findings are supported by a vast array of calculations, numerical data, and graphs. The proposed preparation method to improve properties of medicines with Valeriana officinalis L.designed by Gallo et al. can be identified as evidence-based.

 In conclusion, interest in research on the valerian effectiveness on insomnia has become one of the focal points in science and in the many medical areas that serve populations with insomnia and sleep disorders. However, despite a tremendous increase in the use of herbal medicines over the last decades, medical professionals should select and implement ways of insomnia treatment in accordance with evidence-based medicine, valid data, and reliable research findings. Taking into account the indisputable importance of human life and health, medical professionals are obliged to possess knowledge corresponding to their position, specialization, and rank, be able to conduct research studies and apply specified evidence-based clinical practice guidelines to determine appropriate care in a given situation.

Code: writers15

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