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. 2025 Mar 31:16:1485693.
doi: 10.3389/fpsyt.2025.1485693. eCollection 2025.

Inhalation aromatherapy for the treatment of comorbid insomnia: a systematic review and meta-analysis

Hu-Bo Chen #  1 , Yi-Dan Zhang #  1 , Yang Qin  1 , Hong-Yu Jiang  1 , Li-Na Wang  2 , Wei Gu  2
Affiliations

Inhalation aromatherapy for the treatment of comorbid insomnia: a systematic review and meta-analysis

Hu-Bo Chen et al. Front Psychiatry. .

Abstract

Objective: Meta-analysis can pool multiple studies to explore a particular area in depth, therefore this method was used to explore the clinical efficacy of inhalation aromatherapy for the treatment of comorbid insomnia and provide an empirical evidence for clinical treatment.

Methods: The PubMed, Web of Science, CNKI Database, Wanfang Database, and VIP Database were searched for randomized controlled trials on aromatherapy for the treatment of comorbid insomnia from inception to August 30, 2023. RevMan 5.3 was used for meta-analysis of the results.

Results: A total of 27 publications involving 2072 patients were included. The results of the meta-analysis showed that inhalation aromatherapy well relieved the symptoms of comorbid insomnia (MD -2.90, 95% CI: -3.85 to -1.95, p<0.00001) and the negative mental state of anxiety (MD -3.97, 95% CI: -5.88 to -2.06, p<0.0001) and depression (MD -9.58, 95% CI: -15.13 to -4.03, p=0.0007) in patients. Included studies were heterogeneous, and the factors influencing the heterogeneity were not identified. These studies commonly presented issues such as lack of blinding, and absence of independent testing for the purity or potency of herbs.

Conclusion: Inhalation aromatherapy can improve the sleep quality of patients with other disease states, with basically no adverse reactions and acceptable safety. Therefore, inhalation aromatherapy is expected to become an indispensable complementary therapy in clinical practice for most diseases. However, high-quality clinical trials are still needed to confirm these findings due to methodological weaknesses in blinding and independent testing for the purity and potency of herbs.

Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42023455278.

Keywords: aromatherapy; comorbid insomnia; insomnia; meta-analysis; randomized controlled trial.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of literature screening.
Figure 2
Figure 2
Risk of bias bar graph.
Figure 3
Figure 3
Summary of bias risks.
Figure 4
Figure 4
Forest plot of the meta-analysis of the effect of aromatherapy on anxiety level.
Figure 5
Figure 5
Forest plot of the meta-analysis of the effect of aromatherapy on depression level.
Figure 6
Figure 6
Forest plot of the meta-analysis of the effect of aromatherapy on sleep quality index.
Figure 7
Figure 7
Funnel plot of the meta-analysis of the effect of aromatherapy on (A) anxiety level, (B) depression level, (C) sleep quality.
Figure 8
Figure 8
Subgroup analysis of the effect of aromatherapy on sleep quality (type of disease).
Figure 9
Figure 9
Subgroup analysis of the effect of aromatherapy on sleep quality (treatment duration).
Figure 10
Figure 10
Subgroup analysis of the effect of aromatherapy on sleep quality (agent class).
Figure 11
Figure 11
Subgroup analysis of the effect of aromatherapy on sleep quality (control method).
Figure 12
Figure 12
Forest plot of the meta-analysis of the effect of aromatherapy on each dimension of the sleep quality index scale (A) sleep quality, (B) time to falling asleep, (C) sleep efficiency, (D) sleep disorder, (E) daytime function, (F) sleep duration.
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