The herbal medicine Suanzaoren (Ziziphi Spinosae Semen) for sleep quality improvements: A systematic review and meta-analysis Review
| Authors: | Yang, M.; Wang, H.; Zhang, Y. L.; Zhang, F.; Li, X.; Kim, S. D.; Chen, Y.; Chen, J.; Chimonas, S.; Korenstein, D.; Mao, J. J. |
| Review Title: | The herbal medicine Suanzaoren (Ziziphi Spinosae Semen) for sleep quality improvements: A systematic review and meta-analysis |
| Abstract: | Background: Sleep disturbances are common and bothersome among cancer and noncancer populations. Suanzaoren (Ziziphi Spinosae Semen) 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 Suanzaoren. We included randomized trials comparing Suanzaoren 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, Suanzaoren 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; P <.01); Compared with benzodiazepines or CBT, Suanzaoren was associated with a significant decrease in insomnia severity (mean difference −2.68 points, 95% CI −5.50, −0.22; P =.03) at 4 weeks in the general population and cancer patients. The long-term effects of Suanzaoren were mixed among trials. Suanzaoren did not increase the incidence of major adverse events. The placebo-controlled studies had a low risk of bias. Conclusion: Suanzaoren 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 Suanzaoren, particularly in the long term, should be further assessed in a sufficiently powered randomized trial. Registration: PROSPERO CRD42021281943 © The Author(s) 2023. |
| Keywords: | adult; controlled study; aged; middle aged; unclassified drug; constipation; fatigue; review; placebo; diarrhea; drug efficacy; drug safety; liver dysfunction; cancer patient; quality of life; gastrointestinal symptom; lorazepam; randomized controlled trials as topic; drug effect; dizziness; rash; insomnia; population research; disease severity; sexual dysfunction; systematic review; total quality management; comorbidity; xerostomia; benzodiazepine derivative; medline; chinese medicine; herbaceous agent; drugs, chinese herbal; urinary urgency; chinese herb; plant seed; methadone; cochrane library; sleep disorder; dyspepsia; dietary supplement; leg edema; meta analysis; benzodiazepine; hyperhidrosis; quality improvement; embase; medicinal plant; plants, medicinal; randomized controlled trial (topic); wakefulness; face disorder; sleep; daytime somnolence; seeds; sleep quality; hypnotic agent; clinical evidence; sleep initiation and maintenance disorders; sleep disturbance; cognitive behavioral therapy; humans; human; male; female; zopiclone; loss of appetite; malignant neoplasm; sleep wake disorders; herbal formula; suanzaoren; ziziphi spinosae |
| Journal Title: | Integrative Cancer Therapies |
| Volume: | 22 |
| ISSN: | 1534-7354 |
| Publisher: | Sage Publications |
| Date Published: | 2023-01-01 |
| Start Page: | 15347354231162080 |
| Language: | English |
| DOI: | 10.1177/15347354231162080 |
| PUBMED: | 37014010 |
| PROVIDER: | scopus |
| PMCID: | PMC10084578 |
| DOI/URL: | |
| Notes: | Review -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PDF -- MSK corresponding author is Jun J. Mao --Export Date: 1 May 2023 -- Source: Scopus |
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