Efficacy of single dose antihistamine vs. single dose valerian-hops in subjective sleep measures among war refugees: A comparison trial

Background: Many sedatives and anxiolytics are used in single dose or chronically to aid sleep. Clinically important sedatives include valerian-hops and antihistamines as they are used over the counter and are highly accessible and safe agents. Objectives: To evaluate and compare a single dose of chlorpheniramine versus valerian-hops combination in modulating subjective sleep measures in insomniac war refugees. Methods: Insomnia among refugees was screened using the Insomnia Severity Index (ISI). Insomniac subjects were randomized to received a single dose valerian-hops (320/80 mg) (n = 65), or chlorpheneramine (4 mg) (n = 50) or placebo (n = 76) two hours prior sleeping. Participants were instructed to complete Leeds Sleep Evaluation Questionnaire (LSEQ), visual analogue scales of anxiety and sedation. Also sleep latency, total hours slept and self-rated improvement were obtained. Results: Almost 75% of screened refugees had insomnia. Chlorpheneramine reduced sleep latency and anxiety significantly, however it resulted in poor sleep quality. Valerian-hops group showed marked anxiolysis one hour after dosing, a sleep quality similar to placebo and better than chlorpheneramine, and better alertness compared to placebo. Participants satisfaction was higher with chlorpheneramine and there was no difference in the total hours slept. Discussion: Valerian-hops combination may provide better sleep quality than antihistamines.