Saffron and Sleep
21st Oct, 2020

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Saffron and sleep 

Saffron supplementation improves sleep quality 

 

A recent Australian study has demonstrated that a saffron extract can improve insomnia, sleep quality and restorative sleep in healthy adults with self-reported sleep problems (1).  

Inadequate sleep is now recognised as a global public health issue with high social, health and economic costs. Results from Australian population-based surveys indicate that up to 45% of the adult population report poor sleep (regular difficulty, either falling asleep or staying asleep) (2). 

Sleep is essential for physical and mental health and it plays a critical role in recovery from illness and injury (3). Long-term sleep deprivation can have serious health consequences, including an increased risk of cardiovascular disease, diabetes, depression, and all-cause mortality (4,5).

In the current study, sixty-three healthy adults aged 18-70 years with self-reported sleep problems were randomised to receive either a saffron extract (14 mg twice daily) or placebo for 28 days. Insomnia severity scores decreased by 25% in the saffron group, which was significant compared to placebo.

Saffron supplementation produced significantly greater improvements in non-restorative sleep and sleep quality scores compared with placebo. Non-restorative sleep refers to the subjective experience of feeling unrefreshed upon awakening despite the appearance of normal sleep based on physiological parameters (6). Additionally, the saffron group reported a reduction in the number of awakenings after sleep onset and increased alertness upon awakening. 

Improvement in sleep quality was relatively rapid, with the bulk of the improvements occurring within the first 7 days. Saffron was well tolerated, with no adverse effects reported (1). 

Several small studies have demonstrated the potential of saffron for enhancing or improving sleep (3,7,8,9,10). Numerous clinical trials and several systematic reviews and meta-analyses have confirmed saffron to be a safe and effective natural agent for the treatment of mild-to-moderate depression, with comparable efficacy to synthetic antidepressants (11,12,13,14,15).

Unlike many of the previous saffron studies, the current study investigated a standardised saffron extract. Standardisation is a method to reduce product variability by ensuring that each batch of the herbal extract contains a consistent amount of one or more bioactive constituents.  The extract, derived from the stigmas of the Crocus sativus L. flower, contains more than 3.5% Lepticrosalides, which are the bioactive compounds (safranal and crocin isomers) found in saffron (1).

The standardised saffron extract has been shown in previous studies to be a safe and effective adjunct to standard antidepressant medication in adults with persistent depression (16) and effective for improving mood, stress, anxiety and sleep quality in healthy adults with low mood (17). In a third study, eight weeks supplementation with the saffron extract improved anxiety and depressive symptoms in young people with mild-to-moderate symptoms, from the perspective of the adolescents (18).

While the results of the current study are positive, the clinical application of findings is limited by the study population which included peri- or post-menopausal women (87%), and subjects with mild severity of sleep problems predominantly. The research findings need to be replicated using larger sample size, and differing populations. It is also important to note when considering saffron treatment, that saffron is subject to adulteration, and the quality of extracts can vary significantly (19). 

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References
1Lopresti AL, Smith SJ, Metse AP, Drummond PD. 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. 2020;16(6):937–47.
2Adams R, Appleton S, Taylor A, McEvoy D, Antic N. Report to the sleep health foundation 2016 sleep health survey of Australian adults. Sleep Health Foundation. 2016. Available from https://www.sleephealthfoundation.org.au/pdfs/surveys/SleepHealthFoundation-Survey.pdf
3Umigai N, Takeda R, Mori A. Effect of crocetin on quality of sleep: A randomized, double-blind, placebo-controlled, crossover study. Complement Ther Med. 2018;41(July):47–51.
4Cox RC, Olatunji BO. A systematic review of sleep disturbance in anxiety and related disorders. Journal of anxiety disorders. 2016 Jan 1;37:104-29.
5Hirotsu C, Tufik S, Andersen ML. Interactions between sleep, stress, and metabolism: From physiological to pathological conditions. Sleep Science. 2015 Nov 1;8(3):143-52.
6Tinajero R, Williams PG, Cribbet MR, Rau HK, Bride DL, Suchy Y. Nonrestorative sleep in healthy, young adults without insomnia: Associations with executive functioning, fatigue, and pre-sleep arousal. Sleep health. 2018 Jun 1;4(3):284-91.
7Dehghanmehr et al. S, Shadadi H, Mansouri A, Arbabisarjou A. Effect of oral saffron capsules on sleep quality in patients with diabetes at Zabol-Iran. Bali Med J. 2017;6(3):595.
8Milajerdi A, Jazayeri S, Shirzadi E, Hashemzadeh N, Azizgol A, Djazayery A, et al. 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. 2018;41(July):196–202.
9Nishide A, Fujita T, Nagaregawa Y, Shoyama Y, Ohnuki K, Shimizu K, et al. Sleep enhancement by saffron extract in randomized control trial. Japanese Pharmacol Ther. 2018;46(8):1407–15.
10Shahdadi H, Balouchi A, Dehghanmehr S. Effect of saffron oral capsule on anxiety and quality of sleep of diabetic patients in a tertiary healthcare facility in southeastern Iran: A quasi-experimental study. Trop J Pharm Res. 2017;16(11):2749–53.
11Dai L, Chen L, Wang W. Safety and Efficacy of Saffron (Crocus sativus L.) for Treating Mild to Moderate Depression: A Systematic Review and Meta-analysis. J Nerv Ment Dis. 2020;208(4):269–76.
12Hausenblas HA n., Saha D, Dubyak PJ ea., Anton SD ougla. Saffron (Crocus sativus L.) and major depressive disorder: a meta-analysis of randomized clinical trials. J Integr Med. 2013;11(6):377–83.
13Lopresti AL, Drummond PD. Saffron (Crocus sativus) for depression: a systematic review of clinical studies and examination of underlying antidepressant mechanisms of action. Human Psychopharmacology: Clinical and Experimental. 2014 Nov;29(6):517-27.
14Marx W, Lane M, Rocks T, Ruusunen A, Loughman A, Lopresti A, et al. Effect of saffron supplementation on symptoms of depression and anxiety: A systematic review and meta-analysis. Nutr Rev. 2019;77(8):557–71.
15Tóth B, Hegyi P, Lantos T, Szakács Z, Kerémi B, Varga G, et al. The Efficacy of Saffron in the Treatment of Mild to Moderate Depression: A Meta-analysis. Planta Med. 2019;85(1):24–31.
16Lopresti AL, Smith SJ, Hood SD, Drummond PD. Efficacy of a standardised saffron extract (affron®) as an add-on to antidepressant medication for the treatment of persistent depressive symptoms in adults: A randomised, double-blind, placebo-controlled study. J Psychopharmacol. 2019;33(11):1415–27.
17Kell G, Rao A, Beccaria G, Clayton P, Inarejos-García AM, Prodanov M. 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. 2017;33(February):58–64.
18Lopresti AL, Drummond PD, Inarejos-García AM, Prodanov M. affron®, a standardised extract from saffron (Crocus sativus L.) for the treatment of youth anxiety and depressive symptoms: A randomised, double-blind, placebo-controlled study. J Affect Disord. 2018;232(February):349–57.
19Koocheki A, Milani E. Saffron adulteration. InSaffron 2020 Jan 1 (pp. 321-334). Woodhead Publishing.