The efficacy of a homoeopathic simillimum in the management of excessive daytime sleepiness

Abstract

Background Sleepiness is a multifactorial phenomenon as it may possess ‘trait’ and ‘state’ features (Shahid, Shen and Shapiro, 2010). Trait features are influenced by individual personality and are long term while state features are short term (Shahid, Shen and Shapiro, 2010). Previous research reveals that excessive daytime sleepiness (EDS) affects approximately 10%-25% of the general population (Morrison and Riha, 2012) and can therefore have a negative impact on daily functions (Shahid, Shen and Shapiro, 2010). Moreover, Johns (1991) states that 50% of healthy medical students usually fall asleep during the day at least once in an average week, which could negatively affect academic performance. This research focuses on the management of EDS through utilising a homoeopathic simillimum approach to provide an important reference for practitioners regarding this troubling condition. Aim The aim of this randomised, double-blind placebo-controlled study was to determine the efficacy of the homoeopathic simillimum in the management of EDS in terms of the Epworth Sleepiness Scale (ESS) (Johns, 1991) and the Stanford Sleepiness Scale (SSS) (Hoddes et al., 1973). Methodology By means of non-probability convenience sampling, the first 31 respondents to the published advertisement who met the inclusion criteria and provided informed consent were recruited. Participants were randomly divided into two groups; the active group (group 1) comprising 20 participants and the placebo group (group 2) comprising 11 participants. Participants attended three consultations with the researcher and received their individually determined homoeopathic simillimum or a placebo at their first follow up appointment which was then administered over a treatment period of two weeks. Response to treatment was determined using two existing, validated, data collection tools namely, the Epworth Sleepiness Scale (Johns, 1991) and Stanford Sleepiness Scale (Hoddes et al., 1973). Quantitative data were subjected to general linear model (GLM) repeated measures statistical techniques which were used to measure the effect of treatment at various time points both within subjects and between them. Results According to ESS both groups experienced an overall improvement in EDS symptoms. The active group experienced a higher reduction in mean ESS scores compared to the placebo (40% and 31% respectively) but this did not reach statistical significance (p > 0.05) despite the perceived improvement in the participants’ sleepiness. With respect SSS data, a repeated measures ANOVA method failed to show significant difference between placebo and active groups (p > 0.05). Conclusion Both the ESS and SSS data collection tools proved to be valuable in measuring the severity of EDS in tertiary students. Although EDS symptoms improved to a greater degree in those who received homoeopathic simillimum according to ESS data, this improvement was not statistically superior to placebo. SSS data however was comparable between groups throughout the study. Natrum muriaticum was the most prescribed remedy and thus, it can be a remedy to consider for EDS. A flexible potency selection as well as extended time frame for the study could provide a better evaluation of the efficacy of the homoeopathic simillimum treatment on EDS