Blackburn, L., Achor, S., Allen, B., Bauchmire, N., Dunnington, D., Klisovic, R. B., . . . Chipps, E. (2017). The effect of aromatherapy on insomnia and other common symptoms among patients with acute leukemia. Oncology Nursing Forum, 44, E185–E193.

To determine if aromatherapy by diffusion of essential oils improves insomnia in hospitalized patients with newly diagnosed acute leukemia undergoing induction chemotherapy.

Patients served as their own controls and were randomized to receive aromatherapy over 3 weeks in the following fashion. 1 week placebo or aromatherapy, followed by a 1 week washout period, and a third week of placebo or aromatherapy. Patients were allowed to choose their preferred essential oil for the aromatherapy, lavender, chamomile, or peppermint.  Rose water served as the placebo control.  The aromatherapy diffuser was placed in the same location in all hospital rooms. 8 blinded drops of placebo or essential oil were placed in a diffuser each evening at 9 pm and ran until drops were gone (approx. 8 hours). Sleep quality and disturbance were measured at baseline and after each week of the intervention (placebo or aromatherapy), a general symptom assessment was completed daily during the intervention weeks, and the evaluation of aromatherapy was completed at the end of each week of the intervention.

• N = 50    
• AGE: 19-72 yrs
• MALES: 56%  
• FEMALES: 44%
• CURRENT TREATMENT: Chemotherapy
• KEY DISEASE CHARACTERISTICS: Newly diagnosed patients with acute leukemia
• OTHER KEY SAMPLE CHARACTERISTICS: initiating 4 weeks of induction chemotherapy

• SITE: Single site   
• SETTING TYPE: Inpatient    
• LOCATION: Midwestern university medical center

PHASE OF CARE: Active antitumor treatment

Randomized control trial.  Trial was a crossover over trial with a washout period in which patients served as own control.

Pittsburgh Sleep Quality Index (PSQI), Edmonton Symptom Assessment Scale-Revised (ESASr), Final evaluation of aromatherapy (FEA)

Sleep quality as measured by mean scores on the PSQI improved with aromatherapy (p=0.0001) with specific improvements in sleep duration (p=0.03),  sleep quality (p=0.05), and sleep disturbance (p=0.04).  General symptom scores as measured by the EASSr , all subscales, improved with aromatherapy treatment (p=0.0006)

Aromatherapy for hospitalized patients with acute leukemia undergoing induction chemotherapy improves sleep disturbances and other symptoms.

• Small sample (< 100)
• Findings not generalizable
• Other limitations/explanation:  Participants were allowed to choose their own oil, may have biased results?  Were nurses really blinded to the assignment?  FEA form used for evaluation of aromatherapy is an investigator developed tool that has no reliability or validity data.

Aromatherapy appears to be an effective intervention for improving sleep wake disturbances and other symptoms in hospitalized patients with acute leukemia.  Nurses may want to explore ways to use aromatherapy for patients in their institutions as well as educate patients and families about the potential positive benefits of aromatherapy as a non-pharmacological method to treat sleep wake disturbances as well as a variety of other symptoms.