Özkaraman, A., Dugum, O., Ozen Yilmaz, H., & Usta Yesilbalkan, O. (2018). Aromatherapy: The effect of lavender on anxiety and sleep quality in patients treated with chemotherapy. Clinical Journal of Oncology Nursing, 22, 203–210.

DOI Link

Study Purpose

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

Intervention Characteristics/Basic Study Process

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.

Sample Characteristics

  • 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 and Clinical Applications

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

Study Design

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

Measurement Instruments/Methods

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.

Nursing Implications

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.