Aromatherapy

To determine the effects of lavender oil aromatherapy on anxiety and sleep quality in patients undergoing paclitaxel-based chemotherapy.

Patients were randomized to lavender essential oil (Lavandula hybrid), tea tree oil, or control. During the first chemotherapy infusion, three drops of lavender essential oil or tea tree oil were put onto a piece of cotton that was placed on each patient’s neck and shoulders, about 10 inches below the nose. No aromatherapy was administered to the control group. Patients randomized to lavender and tea tree oils continued to smell the oil for five minutes every night for one month. Lavender and tea tree oil were purchased from a herbal product firm with quality certifications. Tea tree oil does not have a sedative or relaxing effect; therefore, it was used as a placebo. Patients were evaluated at baseline, after the first chemotherapy infusion, and after one month of chemotherapy infusions.

• N = 70    
• MEAN AGE: 58.22 years
• MALES: 16%  
• FEMALES: 84%
• CURRENT TREATMENT: Chemotherapy
• KEY DISEASE CHARACTERISTICS: Mixed cancers; 66% breast cancer, 16% lung cancer, 18% other cancers
• OTHER KEY SAMPLE CHARACTERISTICS: All chemotherapy regimens included weekly paclitaxel

• SITE: It appears that the data was collected at a single site, but this is not clearly stated.      
• SETTING TYPE: Outpatient
• LOCATION: Private hospital in Turkey

• PHASE OF CARE: Active anti-tumor treatment
• APPLICATIONS: Not available

Randomized control trial with three arms (lavender oil, tea tree oil, control)

Pittsburgh Sleep Quality Index (PSQI), State-Trait Anxiety Inventory (STAI), measured before and after chemotherapy treatment

A significant improvement in sleep quality as measured by mean score of PSQI before and after chemotherapy in the lavender group (time, p = 0.001), with group differences between lavender and the other groups based on assessments (group*time, p = 0.001). Trait anxiety values before and after chemotherapy were significantly decreased in the lavender group (p = 0.0003); however, there was no difference state anxiety by time or group.

Lavender oil inhalation at bedtime for outpatients with mixed cancer treated with paclitaxel-based chemotherapy may be useful for improving sleep quality and trait anxiety.

• Small sample (< 100)
• Risk of bias (no blinding)
• Findings not generalizable
• Other limitations/explanation: Small study arms (n = 30, 20, and 20), non-blinded participants because most people are familiar with lavender scent, lack of data analysis details–difficult to understand results.

Lavender oil inhaled at bedtime appears to be an acceptable and helpful intervention for adults treated with paclitaxel-based chemotherapy for mixed cancer types with poor sleep quality and medium levels of state and trait anxiety. Additional research in larger samples is warranted before recommending for practice in general oncology populations.

To evaluate anxiety levels in patients with CML undergoing bone marrow biopsy who were exposed to the odor of C.aurantium essential oil versus those who were not

C. aurantium is an essential oil of the Citrus genus. In this study, participants were exposed to the essential oil odor via electronic diffuser. The study was divided into three groups. The first group received oral diazepam (10 mg), the second group was exposed to C. aurantium, and the third group was exposed to a placebo vaporized solution. In the second and third groups, exposure was 30 minutes long.

• N: 42   
• AGE: Adult average age of 45 (not further defined in article) 
• MALES (%): Not noted.   
• FEMALES (%): Not noted. 
• CURRENT TREATMENT: Other
• KEY DISEASE CHARACTERISTICS: Adult patients with CML at any phase of the disease under regular treatment at research site.
• OTHER KEY SAMPLE CHARACTERISTICS: Both male and female patients with no history of psychiatric illness and a low level of anxiety at baseline were included. No other demographic data defined.

• SITE: Single site   
• SETTING TYPE: Not specified    
• LOCATION: Paraiba, Brazil

PHASE OF CARE: Multiple phases of care

Randomized controlled trial

State-Trait Anxiety Inventory (STAI) was used for subjective measurements. This is a self-reported anxiety scale. Physiological measurements including systolic and diastolic blood pressures, heart rate, and respiratory rate were also assessed.

The groups that received diazepam and exposure to C. aurantium both showed significant decrease in systolic blood pressure (p < 0.05). The group exposed to C. aurantium experienced significant decrease in heart rate (p < 0.001) as well as significant differences in anxiety levels as reported on the STAI-S before and after the treatment when analyzed by Wilcoxon test (p < 0.001).

Findings suggest that C. aurantium may potentiate anxiolytic effects in patients with CML undergoing bone marrow biopsy.

• Small sample (< 100)
• Risk of bias (sample characteristics)
• Key sample group differences that could influence results
• Measurement/methods not well described
• Findings not generalizable
• Other limitations/explanation: Patient demographics not fully defined; limited to patients with CML; methods could be defined in much better detail.

C. aurantium and other anxiolytic essential oils may be considered as nonpharmacologic tools for the reduction of anxiety in patients with cancer, although much more research is needed in more diverse patient populations.