Effects of homeopathic medicines on polysomnographic sleep of young adults with histories of coffee-related insomnia

Abstract

Background

Homeopathy, a common form of alternative medicine worldwide, relies on subjective patient reports for diagnosis and treatment. Polysomnography offers a modern methodology for evaluating the objective effects of taking homeopathic remedies that clinicians claim exert effects on sleep quality in susceptible individuals. Animal studies have previously shown changes in non rapid eye movement sleep with certain homeopathic remedies.

Methods

Young adults of both sexes (ages 18–31) with above-average scores on standardized personality scales for either cynical hostility or anxiety sensitivity (but not both) and a history of coffee-induced insomnia participated in the month-long study. At-home polysomnographic recordings were obtained on successive pairs of nights once per week for a total of eight recordings (nights 1, 2, 8, 9, 15, 16, 22, 23). Subjects (N = 54) received placebo pellets on night 8 (single-blind) and verum pellets on night 22 (double-blind) in 30c doses of one of two homeopathic remedies, Nux Vomica or Coffea Cruda. Subjects completed daily morning sleep diaries and weekly Pittsburgh sleep quality index scales, as well as profile of mood states scales at bedtime on polysomnography nights.

Results

Verum remedies significantly increased PSG total sleep time and NREM, as well as awakenings and stage changes. Changes in actigraphic and self-rated scale effects were not significant.

Conclusions

The study demonstrated the feasibility of using in-home, all-night sleep recordings to study homeopathic remedy effects. Findings are similar though not identical to those reported in animals with the same remedies. Possible mechanisms include initial disruption of the nonlinear dynamics of sleep patterns by the verum remedies.

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.