Daily Archives: August 27, 2022

Insomnia is identified by difficulty in maintaining sleep and early morning awakenings [1]. Consequently, it further causes workplace absenteeism, accidents, and a declinein productivity which imparts tremendous societal and economic impact [2]. One-third of the general population encounter insomnia symptoms across their lifespan [3]. Insomnia should not be confused with sleep deprivation, the former being the inability to sleep adequately, either in length or quality[4]. Most studies suggested predominance rates of insomnia disorder from 5% to 15% [5-7]. Insomnia could be a persistent issue in 31% to 75% of patients, with more than two-thirds revealing side effects for at least one year [6-8]. Due to the increasing work pressure and social challenges in an advanced society, most of the masses cannot get adequate sleep and suffer from sleep disturbance [9-12]. A detailed study shows that around 30% of adults suffer from sleep disturbance [7]. It mainly affects females and is increasing with advancing age [8]. Insomnia may be acute or chronic, and primary or secondary [1]. Primary insomnia can be defined as an individual experiencing a sleep disorder due to stress or emotions, while secondary insomnia can be due to co-morbid conditions or prior illness [1]. Insomnia has been associated with many comorbidities such as hypertension, cardiovascular disease, depression, obesity, and diabetes [2]. It can also lead to alterations in attention with episodic memory, and these cognitive impairments are clinically significant [1,2].Hence, to maintain an individual's overall health, the treatment of insomnia is necessary [9, 10]. Conventional methods of treatinginsomnia generally involve either pharmacotherapies or psychological interventions [11]. The use of such kinds ofdrugs can cause serious adverse effects such as cognitive impairment, oversedation, daytime drowsiness,rebound discontinuation,and psychomotor disturbance [12].In recent years, benzodiazepines (diazepam and related drugs) or nonbenzodiazepine hypnotics (zolpidem or zopiclone} have been chosen over older barbiturates which can cause death in cases of overdose. In older patients, sedating antipsychotics, e.g., olanzapine or quetiapine, and sedating anti-depressants with older tricyclic drugs, are generally regarded as "off label" [11, 12]. The new treatment guidelines evolved for benzodiazepine include low doses of sedating antipsychotics, antidepressants, and mood stabilizers [11].Although pharmacotherapiesand psychological interventions remain essential for conventional treatment, due to various motivational factors, interest in using alternative therapies and products for insomnia has developed over the last two decades.

One common treatment group used by patients with insomnia is complementary and alternative medicine (CAM) [5-7]. Research on adult insomnia patients hasfound that 4.5% of them practised CAM to treat their condition [9]. CAM use can be seen extensively among patients with mental disorders, commonly for managing depression or insomnia. CAM generally includes extensive therapies based on different geographical regions from various schools of thought [8]. Common CAM therapies for insomnia include herbal and nutritional medicine, acupuncture, acupressure, yoga, tai chi, and mind-body practices [10]. Mind-body interventions such as yoga help manage stress and anxiety, improving sleep quality[10].Protein source herbal supplement L-tryptophan is also usedfor the treatment of insomnia [11]. Acupuncture and acupressure have been found to restore the normal sleep-wake process. They can also be employed to increase the -amino butyric acid content, enhancing sleep quality [12, 13]. Considering the growing public interest in CAM, these therapies and products have been researched over the past two decades to treat sleep disorders. Although few systematic reviews have been conducted on the use of acupuncture and valerian in treating insomnia, butcomprehensive study on all primary CAM treatments has not been conducted. The present systematic review comprehensively explored the effects of CAM on improving sleep quality to guide evidence-based clinical decision-making and inform future research. We have systematically searched and evaluated the evidence for the impact of CAM on insomnia.

Data Sources

Several electronic databases such as MEDLINE, PubMed, Scopus, EMBASE, Clinical key, Cochrane, and Research gate were explored to search the relevant articles. The references to the articles were also examined. The search strategy was only restricted to research studies in English.

The PubMed search strategy was :(((((((((((INSOMNIA) OR (insomnia[MeSH Terms])) AND (complementary medicine[MeSH Terms])) OR (alternative medicine[MeSH Terms]))) OR (complementary and alternative medicine[MeSH Terms]))) OR Natural practicesOR Manual practices OR Mind-body intervention practices OR Acupuncture ORAcupressure OR Yoga OR Tai ChiAND (The Pittsburgh Sleep Quality Index[MeSH Terms])) OR (PSQI[MeSH Terms])) OR (sleep quality[MeSH Terms])) OR (sleep latency[MeSH Terms])) OR (adjustment sleep disorder[MeSH Terms]) (((("insomnia s"[All Fields] OR "sleep initiation and maintenance disorders"[MeSH Terms] OR ("sleep"[All Fields] AND "initiation"[All Fields] AND "maintenance"[All Fields] AND "disorders"[All Fields]) OR "sleep initiation and maintenance disorders"[All Fields] OR "insomnia"[All Fields] OR "insomnias"[All Fields] OR "sleep initiation and maintenance disorders"[MeSH Terms]) AND "complementary therapies"[MeSH Terms]) OR "complementary therapies"[MeSH Terms] OR (("complementaries"[All Fields] OR "complementary"[All Fields]) AND "complementary therapies"[MeSH Terms])) AND (("Pittsburgh"[All Fields] AND ("sleep quality"[MeSH Terms] OR ("sleep"[All Fields] AND "quality"[All Fields]) OR "sleep quality"[All Fields])) AND OR "sleep quality"[MeSH Terms] OR "sleep latency"[MeSH Terms] OR "dyssomnias"[MeSH Terms]

Eligibility Criteria

Eligibility criteria have been described with the PICO framework. Inclusion and exclusion criteria for participants, intervention, comparison, and outcomes have been mentioned separately in other sections of the article.

Study Design

Randomized controlled trials reporting outcomes of the effects of CAM on insomnia and sleep quality were identified and included. Observational studies, case reports, case series, case presentations, and case-control studies were not included.

Study Participants

Regardless of health issues, adults (18 years or older) were included in the study, except for those working shifts and time zone travellers.

Interventions

For the systematic review, we have included CAM studies, classified under "manual practices," "natural practices," and "mind-body practices." All psychological and psycho-educational interventions were excluded from the review, e.g., cognitive behavioural therapy, relaxation therapy, or mindfulness (regarded as mainstream therapies). Bright-light treatment, exercise, music therapy, sensory art therapies, and aromatherapy were excluded from the study (as these therapies were not considered classical CAM interventions). Melatonin, too, was excluded from the review as the substance is a hormone, not an exogenous natural medicine. A total of eight CAM intervention RCTs met the inclusion criteria.

Comparison

For comparison, we have compared the intervention with a non-active placebo or control.

Outcome Measures

Subjective and objective sleep outcomes were evaluated, including, but not limited to, sleep quality, duration, and latency. The Pittsburgh Sleep Quality Index (PSQI) and Insomnia severity index (ISI) were used as the outcome measure in most of the studies. Duration of intervention should be 1 week.

Study Eligibility

The authors KVand AS independently screened all titles and abstracts per the inclusion and exclusion criteria. Only full-text articles that were published in English are included. Any discrepancy was resolved with discussion among other authors. The searched files were imported to the Zotero library after removing duplicate items and were freely available, and Rayyan (https:// rayyan.qcri.org), a free web-based software, was used to review articles. From the selected eligible articles, required data, including administration of intervention and control, author, year of publication, study design, follow-up, sample size, outcome measures, results, effect size and quality rating, and primary outcomes, were extracted from eligible studies.

Data Extraction

KV and AS prepared a narrative synthesis for relevant research articles, including their outcomes, variations on intervention, types, and outcomes measurement. The methodological quality assessment of the RCTs was performed using the modified Jadad scale, a scientific quality index of 5/10 (on the augmented Jadad scale) [14].

KV and DSsystematically searched the articles through different search engines, but as per inclusion and exclusion criteria mentioned previously, we have reviewed the articles through Rayyan (https:// rayyan.qcri.org), free web-based softwareto be more precise for the inclusion and exclusion criteria.As mentioned in the flow chart, among 621 identified potential studies in the field of CAM and insomnia. A total of 96 studies were removed, due to small sample size (5), different study design (7), insufficient reporting (7), only protocol/meeting abstract available (22), non-adequate control (11), different outcomes (17), non-English (19), short duration (8). This left 35 clinical trials for inclusion, primarily comprising adult samples (except for the tai chi and yoga studies, which used an older population). These CAM studies were grouped under "manual practices," "mind-body," and "natural practices." Eight CAM interventions had RCTs that met the inclusion criteria. DS and KV calculated and reported effect sizes (Cohens d) in all placebo-controlled studies with the available data(Figure 1).

Manual Practices

The systematic review revealed 11 RCTs with manual practice intervention [15-25]. These studies involved acupuncture (inserting fine needles to stimulate "acupoints") and acupressure (using digital or blunt pressure on "acupoints"). The trials were between two and 12 weeks, with an average sample size of 70 participants. Seven of the 11 studies measured the outcomes in the Pittsburgh sleep quality index (PSQI). The insomnia severity index (ISI) was adequate for the outcome measure in three of the 11 studies. The average quality score was 6.8 out of 10[15-18]. Out of the four acupressure studies, they all revealed positive results on the PSQI scale with large effect sizes ranging from 1.42 to 2.12 when measured on various PSQI subscales [15-18].

Among these four acupuncture studies, one was negative, equivalent to either placebo acupuncture or basic sleep hygiene. At the same time, one was positive, equal to the positive control (clonazepam), or more effective than placebo acupuncture or positive control (estazolam). Yin et al. stated a large effect size d = 1.14 on sleep quality outcomes [19-25](Table 1).

Mind-Body Practices

There were 12 mind-body intervention RCTs of sufficient methodological rigour in this review[26-37]. The trial length was between four and 24 weeks, with an average sample size of 90 participants. Five out of the seven studies used PSQI as the outcome measure. The average rating of the quality of the studies was eight out of 10. The yoga intervention studies revealed a positive effect on wait-list control. Manjunathet al. and Mustianet al.studies found large effect sizes (d = 1.52) and d = 2.56 on sleep quality outcome measures [31, 32]. One study (Ward et al.) found no significant difference between yoga and control groups [30].

All five tai chi trials were positive on various PSQI outcome measures compared with health education or low-impact exercise [33-37]. Large effect sizes prevailed in sleep duration d = 2.15 and sleep quality d = 1.05 in Li et al. [35]. At the same time, a marked divergence was observed in Irwin et al. with a large effect size on sleep severity (global score) d = 1.57 compared to small effect sizes on sleep duration d = 0.22, and sleep quality d = 0.44 [37] (Table 2).

Natural medicine practices

The review identified 12 RCTs of sufficient methodological rigour [38-48]. Three studies included kava and valerian interventions. Six studies included valerian intervention [38-40]. Three studies included tryptophan intervention [13,47,48]. The trials were from two to eight weeks (commonly two to four weeks) with an average sample size of 150 participants. The herbal medicine kava met the inclusion criteria compared to the placebo. The analysis of Lehrl et al.'s study showed a benefit for kava over placebo on the quality of sleep outcome [40]. The valerian studies exhibited diversified results, with three positive (more effective than placebo and equivalent to oxazepam) and three negative results (equal to placebo) [41-46]. For most of the studies, effect size calculations could not be available. For L-tryptophan trials, the average quality rating was seven out of 10, while herbal medicines studies showed a higher rating of 8 out of 10. Among the three L-tryptophan studies, two were positive on several outcomes. Hudson et al., in their analysis, mentioned a large effect size on increased sleep duration d = 1.16, and a small effect size on sleep quality d = 0.28 [13] (Table 3).

A review of all quality studies suggested that CAM may have the potential to improve sleep quality in a variety of patient populations. Although evidence is limited, this systematic review, which includes studies published till Jan. 2022, provides evidence that CAM may be useful for the treatment of both uncomplicated insomnias as well as insomnia co-morbid conditions.

Despite the substantial clinical trial literature, several studies were excluded due to methodological shortcomings. Only35 English language RCTs met the inclusion criteria. In various RCTs of herbal medicine, mostly involving valerian, researchers employed a short study duration and small sample size, restricting the study's statistical power. Moreover, several acupuncture studies had an 'active' control group, mostly involving another type of acupuncture.

Many studies could not calculate the effect size due to negative results or insufficient data (e.g., no standard deviation). As a result, the effect sizes noted in the positive studies (in natural medicine and manual practices) should be tempered concerning the negative studies. Quality grading of RCTs has been displayed in respective tables of manual, mind body and natural medicine practice. The majority of RCTs for manual practice scored 7/10 for quality of grading. Most RCTs for mind-body practices scored 6/10 while assessing quality grading. Mostly, RCTs with natural medicine practice scored 8/10 score for quality grading.

Findings revealed that the evidence for natural medicine practices in treating insomnia was also conflicting. Valerian was one of the most studied soporific natural medicines for its rich folkloric tradition of use in conditions of restlessness, hysteria, headache, nervousness, and mental depression. As detailed in Table 3, the evidence regarding valerian was quite mixed and did not support its use in treating insomnia. These results follow thesystematic reviews and meta-analyses done byBent et al. and Taibi et al. [49, 50]. The study of Bent et al., which included 16 eligible RCTs on valerian and valerian in combination with other herbal medicines, suggests that nine out of 16 studies did not have positive outcomes concerning the improvement of sleep quality [49]. The Taibi et al. review, which included 29 controlled studies, consistently stated that most studies lacked any significant difference between valerian and placebo. Valerian, combined withhopsor kava, did not seem to support the available data. Kava may provide a prospective alternative for managing insomnia [50]. However, Lehrl's studies had a different opinion, and presently as kava is withdrawn in several jurisdictions, further studies about its safety and efficacy are much needed [40].

L-tryptophan, an exogenous amino acid converted into serotonin, has been widely studied in treating insomnia and depression [51].However, the results were encouraging but varied concerning different sleep outcomes. The studies on various animals and humans consistently suggest that L-tryptophan increases sleepiness and decreases sleep latency [51, 52]. It has been observed that the best results seem to occur in cases of mild insomnia with long sleep latency and the absence of any medical or psychiatric comorbidity [51, 52]. A study by Hudson et al. determined a large effect size on increased sleep duration and a negligible effect on sleep quality [13]. A survey by Irwin et al.consistently revealed a substantial effect size for tai chi in reducing insomnia severity. In contrast, sleep duration and quality effects had poor clinical outcomes [37]. The heterogeneous nature of samples throughout the studies made these effect size differences [37].

Acupuncture and acupressure seem to contribute to treating insomnia, probably by the neurochemical modulatory activity of serotonin, dopamine, and endogenous opioids [53]. The review by Cheuk et al.concluded with seven rigorous methodological trials that acupuncture and acupressure help improve sleep quality scores. Still, the evidence for acupuncture as a hypnotic intervention was inconsistent. Compared to control or no treatment, the efficacy of acupuncture and its variants was inconsistent among studies, including many sleep parameters, such as sleep onset latency, time to wake after sleep onset, and total sleep duration [53]. Further, Yeung et al. revealed that definitive conclusions could not be derived on acupuncture's efficacy for insomnia. This conclusion was reached due to the methodological quality of RCTs as the limitations of the study designs hampered studies. For instance, publications of such studies have also provided limited information about inclusion/exclusion criteria, outcomes measured, missing baseline data, randomization methods, and the specific acupuncture approach [54].

Mind-body practices such as yoga and tai chi in insomnia and different sleep disorders are enhancing popularity, particularly in the ageing population who might prefer low-effect exercises [35]. Comparatively, findings supported the benefits of exercise in improving sleep quality and reducing the severity of insomnia in older people. However, a Li et al. study compared tai chi to low-effect exercise and found it superior to low-effect exercises in all outcomes [35]. While Manjunath et al., the yoga study included older participants with sleep issues and noted yoga was superior to both wait-list and herbal medicine on sleep latency and total sleep [31]. Mind-body practices comprise multicomponent interventions, considered to give rise to similar physiological processes to traditional relaxation methods, which have been investigated as treatment options for insomnia [26-37]. Mechanistically, yoga acutely affects the activity of the autonomic nervous system and may decrease the gamma-aminobutyric acid levels and inflammatory markers. Probably by neurobiological pathways, yoga may improve sleep quality [28, 29]. Data from small RCTs suggested that yoga improves subjective and objective sleep quality, reducing insomnia symptoms in adults with chronic medical conditions [26, 28, 29, 31]. One of the largest RCTs of Yoga illustrated reduced hypnotic medication use in cancer survivors with sleep disturbance by 21% in the yoga group compared with 5% in the control group [32]. However, several emerging clinical trials on yoga found that most participants faced a general sleep disturbance. Moreover, yoga studies includingpranayama, breathing exercises, gentle hatha, restorative yoga asanas, and meditationassessing sleep outcomes showed common methodological limitations of sample sizes and limited use of objective outcome measures [27-32]. Further studies on yoga are encouraged with participants with a confirmed diagnosis of insomnia using validated sleep assessment scales.

Similarly, in studies for tai chi intervention, the focus was more on sleep quality rather than insomnia. Several RCTs suggested improvement in reported sleep quality, with tai chi intervention, particularly among older adults. Therefore,tai chimay improve sleep quality in different populations, specifically older adults [33-37]. Its impact on objective measures in chronic insomnia needs further explained.

In reference to data from the United States National Health Interview Survey, 17.4% of adults (n= 93 386) reported insomnia or regular sleep disturbance, and 4.5% used CAM therapies to improve their sleep quality. 56% of the individuals said that CAM was essential to maintaining their overall health and well-being, while 72% observed that CAM improved insomnia disorders significantly. Younger and highly qualified persons believe in CAM to improve insomnia symptoms [55]. It has been noticed that traditional Indo-Asian therapies such as acupuncture, acupressure, and yoga were morewidely studied compared to standard Western CAM therapies. The broadly researched herbal medicine is valerian in the form of monotherapy or combination with hops or kava [13, 15-48]. Future research in other herbal medications or Western CAM therapies with potential hypnotic effects is recommended as current research in these areas is insufficient.

The strengths of this systematic review included the search and synthesis of all relevant studies across several databases, the rigorous methodological inclusion criteria, and a quality assessment of all clinical trials with calculations of the effect size of studies.

This review also had some limitations. These were language constraints, as we excluded non-English publications; several valerian studies were published in German, and acupuncture studies were published in Chinese. Secondly, it lacks appropriate clinical trials with methodological weakness, for instance, adequate sample sizes. While reporting complete data, the long-term efficacy and safety of CAM interventions should have been employed.

The rest is here:

The Impact of Complementary and Alternative Medicine on Insomnia: A Systematic Review - Cureus

Opinions expressed by Entrepreneur contributors are their own.

You're reading Entrepreneur India, an international franchise of Entrepreneur Media.

Whenever we think about natural medical treatment, only one word clicks in our mind, i.e., India. Moreover, when it's about less toxic and unpainful treatment, Ayurveda treatment is one.

Ayurveda means the 'science of life'. 'Ayuh (r)' meaning life and 'Veda' as science. With its roots in India, Ayurveda is an old life system surviving for years and years in the world.

How effective is Ayurveda treatment?

Detailed research is required in the specific segments of Ayurveda, especially diagnostic principles. This way, Ayurveda diagnosis can be implemented as an effective treatment with effective strategies. Ayurveda is entirely science-based with solid explanations in a logical manner termed Darshana.

The world we are living in today is becoming toxic day by day. The stressful lifestyle disturbs the equilibrium of our mind and body, which further leads to health-related issues. The adverse effects can be seen physically and emotionally, making us seek medical intervention. This is the point where Ayurveda needs an adaption by us.

With Ayurveda, we learn how to live safely naturally based on principles. Following Ayurveda will help us stay away from costly medical treatments or prevent debilitating conditions. As a systematic approach, Ayurveda aims to boost vitality, longevity, and mental and physical strength, providing a balance of emotions and peace of mind.

Like other medical treatments, Ayurveda is a unique patient-oriented treatment where an Ayurvedic physician diagnoses and dispenses medicine to the patient. The essential principle forming the basis is a form of personalized medicine giving high safety, the maximum therapeutic efficacy of a particular person having a specific disorder, and and specified conditions dependent on the individual need.

Through Ayurveda, we don't just learn to live on medicines for years. Instead, we learn to live life following natural remedies. Natural remedies are available for the health conditions like thyroid, chronic kidney disease, or even complicated diseases. A vast paradigm is noticed amongst the patients willing to try Ayurveda.

The allopathic medication system has undergone various advancements and has been proven to save lives. But, there are some side effects related to allopathic medicine, as toxicity is seen in man-made drugs that make the body weak. Whereas Ayurveda has a natural approach that does not limit the healing of the disease but focuses on maintaining a balance in life and making the body energetic.

Ayurveda is founded in the belief that good health is based on a balance between the spirit, mind and body. The three most revitalising Ayurvedic forms are Ayurvedic massage, panchakarma Treatment and Ayurvedic therapy.

Another essential facet of Ayurveda is that everyone in the world is made up of five elements: air, fire, space, earth, and water. All these elements together form three different energies, also known as doshas. The three doshas are Vata Dosha, Pitta Dosha and Kapha Dosha. Vata Dosha represents air and space. Pitta Dosha represents water and fire. At the same time, Kapha Dosha means earth and water.

One of the best aspects about Ayurveda is it can be customised as per the individual. It's a kind of treatment designed differently for everyone. It considers the life force and the balance of the three doshas.

The specially customized treatment plan prioritises the body's cleansing first with a process termed panchkarma. Various tactics are designed to decrease the symptoms and restore balance and harmony.

In the present world, it's essential to look for an alternative medicine therapy as another choice available for the patients. For example, cancer patients should also have a variety of options. In the same manner, the other patients get a choice of treatment, either conventional or non-conventional; both should be available. Ayurveda as an alternative therapy or medicine is put into the light by the introduction of the Ayush Visa Indian Government. Ayurveda holding strong roots with its presence still requires a lot of introduction in the world and its benefits.

The initiative Heal in India focuses on the importance of Ayurveda as an alternate therapeutic medicine. The demand for various forms such as detoxification, stress management, and rejuvenation has been increasing since after COVID. The Ayurveda will emerge as one of the leading markets with a plan to provide more and more treatments for different ailments. Much research is required on the Ayurvedic aspects as alternative therapies with Heal in India and will track the study.

More here:

Ayurveda As Alternative Medicine: Research And Development To Be Taken Ahead By Heal In India - Entrepreneur

French online medical platform Doctolib has been accused of promoting alternative medicines and practitioners after users found appointments on it for naturopaths offering leaf extracts as a cure.

Doctolib is available to health professionals whose activity is governed by the Code de la sant publique, and is also open to osteopaths and psychologists.

However, the platform can also be used by professionals whose activity falls into the wellbeing category. These practitioners may not be regulated or recognised by the state, and may be able to charge a wider range of fees for their care.

This wellbeing category has been disputed.

Tristan Mends-France, lecturer at the University of Paris, told Le Parisien that Doctolib has taken on an institutional [trustworthy] air since its participation in the Covid-19 vaccination appointment crisis. And yet, some alternative practitioners offer unproven or controversial services.

Read more: Record 1.2m appointments made for boosters as rules change in France

Read more: Frances favourite brands in 2021: Decathlon, Peugeot, and Leclerc

For example, users can currently book appointments for a hypnosis seance, a naturopath appointment, a sophrology appointment, a neurofeedback session (the latter is described as helping the user to control their neuron activity), or a naturopath appointment that invites you to drink your own urine.

In its defence, Doctolib said that it is not its place to "decide" or take sides in the debates that surround alternative medicine.

In a Tweet, it said that only 3% of its users practise an activity that comes under the wellbeing or medical-social umbrella. Their activity is legal, but they are of course not health professionals. Appointments with these practitioners represent just 0.3% of the appointments made with Doctolib.

It added: Society is evolving, andsome patient associations are promoting access to complementary therapies. We consider that it is not the role of Doctolib to decide on these debates.

It said that the website clearly states when the practitioner is exercising an unregulated profession and when their diploma is not recognised by the state.

The platform said that it would investigate reports made by users that claimed unscrupulous practitioners were operating on the site, including one Tweet that alleged a naturopath was offering treatments including barley grass juice and leaf extract.

On August 22, Doctolib said that it had banned the profiles of some naturopaths on its site who have alleged links with Irne Grosjean and Thierry Casasnovas, two influential personalities online who are accused of having sectarian and cult-like qualities, and whose practices have been widely discredited.

The platform confirmed that it had stopped users from being able to book with 17 such practitioners, whose training mentions these two highly-controversial names.

Irne Grosjean in particular has been accused of promoting non-scientific and even illegal practices, while Thierry Casasnovas is currently being criminally investigated for illegal practice of medicine.

Despite having no recognised medical training, he is alleged to have pushed some patients to give up their existing medication for severe illnesses, including some patients who were encouraged to give up their cancer treatment.

Doctolib is also inviting users to report any profile that appears to be promoting illegal practice of medicine.

Alternative medicine is controversial in France.

Judges investigated several cases in 2021, including the death of a 44-year-old woman who was paying 1,000 a week for a fasting treatment in a Loire chateau. She was found dead in her room after having drunk no water for several days.

The prefect ordered the course to be closed and a judge at Tours is investigating possible involuntary homicide.

The naturopath who ran the course denied involvement in the death and said the only explanation was her Covid vaccination.

Read more: Alternative medicine warning following two deaths in France

Participants told French media that they drank only water during the fast and one man had been taken to hospital after he stopped taking medicine for his diabetes.

In another case, the widow of a 41-year-old man who died from testicular cancer brought a criminal complaint against a naturopath who had advised the man to stop chemotherapy treatment and to rely on natural treatments such as fasts and purges.

The naturopath faced a Paris court on charges of illegally practising medicine and usurping a doctors work.

At the time, Claire Cavelier, spokeswoman for the LaFna, a federation of eight naturopath training schools that offers its own 1,200-hour course, said that trustworthy and ethical naturopaths would never encourage such practices.

She said: There is enormous interest in naturopathy at the moment, which unfortunately has attracted many charlatans or would-be gurus into the area because there are no regulations in France. You could buy a brass plate with your name and naturopath on it today, and be open for business tomorrow.

Charging 1,000 a week for a fasting treatment, or telling people to ignore a doctors prescription, is not something any naturopath should do and is an example of charlatan practice, and could even be classified as running a sect.

Naturopathy, which seeks to establish equilibrium in the body through natural means, is recognised as traditional medicine by the World Health Organisation, and is regulated in Germany, Portugal, and Switzerland. In France, naturopaths are forbidden from giving diagnoses or prescribing medicines.

Ms Cavelier said she would like to see similar regulation in France to other European countries, saying cases like the ones we have had this summer always slow down or reverse any progress we have made.

Naturopaths say that they encourage people to undertake treatments such as changing diet, fasting, phytotherapy (using plants, often in tisanes or tinctures), massages, yoga, or sport to improve health, and say illnesses can only be understood by looking for deep-rooted causes and treating them.

Homeopathy was previously reimbursed up to 30% by the French state, but in 2021 this was stopped.

The change was made after the health authority la Haute Autorit de sant (HAS) with then-Health Minister Agns Buzyn judged that homeopathic remedies were not proven to be sufficiently effective to be eligible for state medical reimbursement.

Alternative medicine warning following two deaths in France

Doctors attack alternative medicine

More:

French Doctolib platform accused of 'promoting alternative medicine' - The Connexion

Chronic fatigue syndrome (CFS) (also called myalgic encephalomyelitis) is a chronic illness that causes a broad range of symptoms.

Dont let the name fool you. The fatigue associated with CFS isnt simple tiredness. It can be life altering and make even the smallest routine tasks feel impossible, especially when sleep doesnt restore energy after each night.

Theres no cure for CFS. As a result, treatment is personalized and focused on relieving symptoms and restoring quality of life. Heres more about what treatments may be best for you.

CFS isnt common, as it affects roughly 0.7% of the U.S. population at most. Experts estimate that around 1 million people have CFS. But the actual number of people may sit anywhere between 836,000 and 2.5 million, including those who have yet to receive a clear diagnosis.

People assigned female at birth are two to four times more likely to have the condition than people assigned male at birth.

CFS is serious. The condition makes daily life difficult for people who deal with it.

Symptoms include:

People with CFS may need to spend much of the day in bed. At the very least, they may not be able to carry out their responsibilities or other desired activities without dealing with symptoms. This may eventually lead to missing work, being socially isolated, and dealing with depression.

Even small amounts of activity can trigger something called postexertional malaise (PEM), which can prolong symptoms, make symptoms worse, or both.

The median recovery rate for CFS is around 5%. Its important to know that many people can manage their condition and energy level by creating a personalized treatment plan with a doctor.

Beyond that, you may find that your symptoms change, get worse, or get better over time. Symptoms may even come and go somewhat unpredictably. Your experience will be unique and tied to your own triggers and coexisting health conditions.

Theres no one medication a person can take to treat CFS. Instead, treatment is highly individual and depends on what symptoms a person is experiencing.

The areas of treatment generally include:

You may start with treatment of these issues and progress to others in time. Many treatment options are available, ranging from over-the-counter (OTC) drugs to alternative therapies.

The most effective treatment for CFS is the one thats catered to you and your specific symptoms. A doctor may suggest a variety of treatments depending on what youre experiencing and what your treatment goals are.

Cognitive behavioral therapy (CBT) is a treatment that helps people understand and adjust the ways they think and respond to various situations. While CBT is a psychological treatment, its appropriate for chronic illnesses like CFS (and others).

This treatment may work best for people with mild to moderate CFS. It involves attending a set number of therapy sessions in which youll focus on things like unhelpful ways of thinking, unhelpful behaviors, coping mechanisms, and relaxation techniques.

Activity management can be an effective treatment for PEM. Another term you may be more familiar with for this type of energy management is pacing.

This treatment is usually carried out by a rehabilitation specialist or exercise physiologist. You may start by keeping a log of your usual activities and how they affect your energy levels. Some refer to this as the spoon theory in life with a chronic illness, where a spoon to represents a unit of energy.

From there, a healthcare professional will help you find ways to do these tasks in different ways to conserve energy. For example, you may try folding your laundry while seated or taking frequent breaks throughout the day.

Pacing is all about finding a balance between those activities that zap energy and those that may restore it.

An energy management plan may also include a personalized exercise plan.

Again, theres no one medication you can take to treat CFS as a condition.

Drugs that may help symptoms include:

Sleep is difficult with CFS. You may not get enough sleep, or even if you do, your sleep may not be restorative.

If OTC treatments dont help with sleep, a healthcare professional may refer you to a sleep specialist to determine if you have other conditions, such as sleep apnea or narcolepsy, that may be contributing to your sleep problems.

Treatment will depend on the diagnosis. With sleep apnea, for example, you may use a continuous positive airway pressure (CPAP) machine to help with breathing overnight.

There are a variety of alternative methods or changes to your lifestyle that may help with CFS as well:

A doctor may also suggest using certain supplements to address nutrition deficiencies, diet changes to support a balanced diet, or a combination of both traditional and alternative therapies to get you feeling better.

Researchers share that there are some newer treatments or trial treatments for CFS. A doctor may also know of newer treatments or other options available to you.

They include:

CFS does more than just make people tired. Its a potentially debilitating condition that causes both physical and psychological symptoms. Treatment plans vary from person to person and can include medications, therapy, complementary and alternative medicine, and more.

If youre struggling, speak with a doctor about your symptoms and your treatment goals. While CFS cant be cured, certain medications, pacing, and other treatments and lifestyle changes can help you get your life back.

See the original post:

Chronic Fatigue Syndrome: Best Ways for Treating This Condition - Healthline