Effect of Saffron Extract on Sleep Quality and Melatonin Concentrations in Adults with Temporomandibular Disorders-an Observational Study

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DOI: 10.21522/TIJPH.2013.12.04.Art047

Authors : Nishanthi Raja, Yesodha Aniyan, Krithika C. L, Anuradha Ganesan

Abstract:

Temporomandibular Disorder (TMD) patients experience deterioration in their quality of sleep. Targeting these problems may include a wide variety of treatment options, such as the use of plant- and herbal-based medications, which have the potential to improve sleep. Numerous meta-analyses and systematic reviews have established that saffron is a useful natural treatment for mild-to-moderate insomnia. Hence, the present study aimed to determine the effect of saffron extract on sleep quality by altering the melatonin concentration in adults with TMDs. Thirty-four patients were recruited and divided into two groups equally (Group A study group, Group B -Control group) and advised to take saffron (15 mg once daily) or a placebo. Outcome measures include severity of pain collected at baseline and days 0,14 and 28 and the Pittsburgh Sleep Diary (PSD) collected. On day 0 and day 28 serum melatonin concentration will be evaluated using the ELISA kit method. Patients with temporomandibular dysfunction experienced significant reductions in pain after taking saffron supplements as opposed to a placebo. On comparing day 1 and day 28, the saffron-treated participants had substantially improved sleep quality, elevated melatonin levels, and a lower VAS score. The study concluded that Saffron is a potent, safe substitute in the management of TMD pain that has deterioration in sleep quality for its effectiveness in the management of sleep by altering the melatonin concentration. Further studies should be conducted to assess the possible benefits of saffron extract in large clinical settings with a larger number of patients.

References:

[1].  Deboer, T., 2018, Sleep homeostasis and the circadian clock: Do the circadian pacemaker and the sleep homeostasis influence each other's functioning? Neurobiol Sleep Circadian Rhythms.,15, 68-77, https://doi.org/10.1016/j.nbscr.2018.02.003

[2].  Finan, P. H., Goodin, B. R., Smith, M. T., 2013, Dec, The association of sleep and pain: An update and a path forward. J Pain,14(12),1539-52, doi: 10.1016/j.jpain.2013.08.007.

[3].  Ganesan, A., Gauthaman, J., Kumar, G., 2022, The impact of mindfulness meditation on the Psychosomatic Spectrum of Oral Diseases: Mapping the Evidence. J Lifestyle Med, 12(1), 1-8. doi:10.15280/jlm.2022.12.1.1.

[4].  Priyadarshini, P.,  Jeevanandan, G.,  Govindaraju, L., Subramanian, E.M.G., 2020, Clinical evaluation of instrumentation time and quality of obturation using paediatric hand and rotary file systems with conventional hand K-files for pulpectomy in primary mandibular molars: a double-blinded randomized controlled trial, Eur. Arch. Paediatr. Dent. 21 693–701. https://doi.org/10.1007/s40368-020-00518-w.

[5].  Wu, J. H., Lee, K. T., Kuo, C. Y., Cheng, C. H., Chiu, J. Y., Hung, J. Y., Hsu, C. Y., Tsai, M. J., 2020 Aug 30, The Association between Temporomandibular Disorder and Sleep Apnea-A Nationwide Population-Based Cohort Study. Int J Environ Res Public Health;17(17), 6311. doi:10.3390/ijerph17176311.

[6].  Edinger, J. D., Arnedt, J. T., Bertisch, S. M., Carney, C. E., Harrington, J. J., Lichstein, K. L., Sateia, M. J., Troxel, W. M., Zhou, E. S., Kazmi, U., Heald, J. L., Martin, J. L., 2021 Feb , Behavioral and psychological treatments for chronic insomnia disorder in adults: An American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med,17(2), 255-262. doi:10.5664/jcsm.8986.

[7].  Nakagawa, H., Sack, R. L., Lewy, A. J., 1992, Sleep propensity freeruns with the temperature, melatonin and cortisol rhythms in a totally blind person. Sleep 15(4), 330–336. doi:10.1093/sleep/15.4.330.

[8].  Amstrup, A. K., Sikjaer, T., Mosekilde, L., Rejnmark, L., 2015 Sep 30, The effect of melatonin treatment on postural stability, muscle strength, and quality of life and sleep in postmenopausal women: a randomized controlled trial. Nutr J,14,102. doi:10.1186/s12937-015-0093-1.

[9].  Mahdi, A. A., Fatima, G., Das S. K., Verma, N. S., 2011 Apr, Abnormality of circadian rhythm of serum melatonin and other biochemical parameters in fibromyalgia syndrome. Indian J Biochem Biophys, 48(2),82-7.

[10]. Ramani, H. R. P., W.M. Tilakaratne, W.M, Sukumaran, G,  Ramasubramanian, A, . Krishnan, R.P., 2022, Critical appraisal of different triggering pathways for the pathobiology of Pemphigus vulgaris-A review, Oral Dis. 28 1760–1769. https://doi.org/10.1111/odi.13937.

[11]. Milajerdi, A., Jazayeri, S., Shirzadi, E., Hashemzadeh, N., Azizgol, A., Djazayery, A., Esmaillzadeh, A., Akhondzadeh, S., 2018 Dec., The effects of alcoholic extract of saffron (Crocus satious L.) on mild to moderate comorbid depression-anxiety, sleep quality, and life satisfaction in type 2 diabetes mellitus: A double-blind, randomized and placebo-controlled clinical trial. Complement Ther Med, 41, 196-202, doi: 10.1016/j.ctim.2018.09.023.

[12]. Vidor, L. P., Torres, I. L., Custódio de Souza, I. C., Fregni, F., Caumo, W., 2013, Sep, Analgesic and sedative effects of melatonin in temporomandibular disorders: a double-blind, randomized, parallel-group, placebo-controlled study. J Pain Symptom Manage, 46(3), 422-32. doi: 10.1016/j.jpainsymman.2012.08.019.

[13]. Pachikian, B. D., Copine, S., Suchareau, M., Deldicque, L, 2021 Apr, Effects of Saffron Extract on Sleep Quality: A Randomized Double-Blind Controlled Clinical Trial. Nutrients. 27, 13(5), 1473. doi:10.3390/nu13051473.

[14]. Kell, G., Rao, A., Beccaria, G., Clayton, P., Inarejos-García A. M., Prodanov, M., 2017 Aug, affron® a novel saffron extract (Crocus sativus L.) improves mood in healthy adults over 4 weeks in a double-blind, parallel, randomized, placebo-controlled clinical trial. Complement Ther Med., 33, 58-64. doi: 10.1016/j.ctim.2017.06.001.

[15]. Kuratsune, H., Umigai, N., Takeno, R., Kajimoto, Y., Nakano, T., 2010 Sep Effect of crocetin from Gardenia jasminoides Ellis on sleep: a pilot study. Phytomedicine. 17(11), 840-3. doi: 10.1016/j.phymed.2010.03.025.

[16]. Lopresti, A. L., Smith, M. S. J., Metse, A. P., Drummond, P. D., 2020, Effects of saffron on sleep quality in healthy adults with self-reported poor sleep: A randomized, double-blind, placebo-controlled trial. J. Clin. Sleep Med. 16, 937–947. doi: 10.5664/jcsm.8376.

[17]. Siddique, R , Nivedhitha, M.S. ,  Jacob,B., 2019,  Quantitative analysis for detection of toxic elements in various irrigants, their combination (precipitate), and para-chloroaniline: An inductively coupled plasma mass spectrometry study, J. Conserv. Dent. 22 344–350. https://doi.org/10.4103/JCD.JCD_95_19.

[18]. Wu, F. S., Yang, Y. C., Tsai, J. J., 2000 Oct, Noncompetitive inhibition of the glycine receptor-mediated current by melatonin in cultured neurons. Brain Res, 1(2):208-11. doi:10.1016/s0006-8993(00)02804-3.

[19]. Adrian, L., Lopresti Stephen, J., Smith, Peter, D., Drummond, 2021, An investigation into an evening intake of a saffron extract (affron®) on sleep quality, cortisol, and melatonin concentrations in adults with poor sleep: A randomised, double-blind, placebo-controlled, multi-dose study. Sleep Medicine 86:7-18. doi: 10.1016/j.sleep.2021.08.001.

[20]. Ursin, Reidun., 2002, Serotonin and sleep. Sleep Medicine Reviews. 55-69. doi:10.1053/smrv.2001.0174.