Mengatasi Gangguan Tidur Dengan

Bahan Alami
Ika Puspitasari
Departemen Farmakologi& Farmasi Klinik,Fakultas Farmasi UGM
RS Akademik UGM
PPRA RSUP dr. Sardjito Yogyakarta
Materi
• Epidemiologi gangguan tidur
• Definisi gangguan tidur
• Mekanisme tidur
• Tidur vs imunitas
• Terapi gangguan tidur
• Herbal untuk gangguan tidur
Dampak
• Occasional insomnia is a very common disturb that has been reported
to be experienced by about 30% of the U.S. general population .
• The prevalence of insomnia has been estimated to beabout one-fifth of
the general population (21.4% ; 22.3% in men and 20.5% in women)—
Japan study
• The prevalence of insomnia is reported to be 2.3% to 25.5% in
international studies (Sleep Med. 2021;82:186–92)
• Sleep disorders have an important societal and economic impact, with a
consequent reduction in labour productivity or increased risk of
accidents .
• Chronic insomnia is also a risk factor for a variety of significant health
problems, such as cardiovascular disease, diabetes , & obesity , as well
as bad mood and cognitive dysfunction .
Definisi
• Insomnia : dissatisfaction with sleep quality or quantity in addition to
at least one other symptom among difficulty initiating sleep, difficulty
maintaining sleep, or early morning awakening with inability to return
to sleep (American Psychiatric Association, 2013).
• Almost half of the individuals with sleep problems had never taken any
steps to resolve them, and the majority of respondents had not spoken
with a physician about their problems.
• Of those individuals who had consulted a physician, drug prescriptions
had been given to approximately 50% in Western Europe and the USA.
(benzodiazepine and non-benzodiazepine hypnotic drugs)
• negative side effects :daytime drowsiness, dependency, depression,
hypnotic-withdrawal insomnia, and even excess mortality.
• An increasing patient preference for nonpharmacological treatments , it
is important to offer patients with insomnia evidence-based
nonpharmacologic alternatives that may improve their sleep.
Habitual Sleep Duration and Insomnia and the Risk of
Cardiovascular Events and All-cause Death: Report from a
Community-Based Cohort, 2010
Mekanisme
Mekanisme
Dimitrov et al., 2019

Neuropsychopharmacology Reviews (2017) 42, 129-155;

doi:10.1038/npp.2016.148
TREATMENT

Among the various treatment options for patients with sleep

disturbance and insomnia :
• pharmacologic,
• psychological,
• behavioral approaches (eg, cognitive behavioral therapy for insomnia,
CBT-I) mind-body or relaxation-based therapies (eg, Tai chi and Yoga)
have been found to yield significant improvements in sleep outcomes
(Irwin et al, 2008, 2014)
In a randomized, controlled, comparative efficacy trial over 4
months with follow-up at 7 and 16 months in 123 older adults with
insomnia, we found that CBT-I and TCC were associated with
improvements in sleep quality, fatigue, and depressive symptoms as
compared with an active control, sleep seminar (SS). In addition,
remission of insomnia was associated with reduced proportion of
having high CRP (>3.0 pg/ml) at month 16. SS controlled for
nonspecific factors (eg, expectation, group, and attention). Indeed,
the levels of this marker of inflammatory risk were 50% lower one
year after treatment among those who showed insomnia remission
(Irwin et al, 2014)
Plant Extracts for Sleep Disturbances: A Systematic Review;
Evid Based Complement Alternat Med. 2020

Systematic review : valerian, lavender, chamomile, hop, St. John's wort, hawthorn, and rosemary
Lelap dapat dikonsumsi
oleh dewasa dan anak usia
12 tahun keatas. Lelap tidak
dapat dikonsumsi oleh
wanita hamil dan menyusui.
OHT
• OHT : sediaan obat bahan alam yang telah dibuktikan
keamanan dan khasiatnya secara ilmiah dengan uji praklinik
(pada hewan percobaan) dan bahan bakunya telah
distandarisasi.
OHT harus memenuhi kriteria :
• aman sesuai dengan persyaratan yang ditetapkan.
• klaim khasiat dibuktikan secara ilmiah/ praklinik (pada
hewan percobaan).
• telah dilakukan standarisasi terhadap bahan baku yang
digunakan dalam produk jadi.
• memenuhi persyaratan mutu yang berlaku.
 Take home messages
• Lelap sebagai OHT untuk gangguan tidur
• Lama pemakaian 7-10 hari
• Tidak melipat gandakan dosis
• Terapi non farmakologi