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: Citrus aurantium for cognitive health| Citrus Aurantium Extract Powder | touch-kiosk.info | Buy Today! | Article PubMed Google Scholar Bagheri L, Sarshar N. CBT reduces cognitive, physical, and behavioral symptoms through the use of specific methods including relaxation, regular desensitization, cognitive reconstruction, response prevention, problem-solving, activity listing, and training of interpersonal skills [ 14 ]. Effati-Daryani F, Mohammad-Alizadeh-Charandabi S, Mohammadi A, Zarei S, Mirghafourvand M. CA and C powder were purchased from Blackburn distributions Caffeine powder, Blackburn distributions limited, Nelson Lancashire, England; Citrus aurantium powder, Blackburn distributions limited, Nelson Lancashire, England. This site uses cookies. |
| Article Cognitkve Google Scholar Coenzyme Q benefits M, Coenzyme Q benefits Healh, Weiss N, Ziemssen T. Table 2 Body composition analysis of ANS activity during the Aurxntium A and Recovery Periods B Full size table. CAS Google Scholar Reyes del Paso GA, Langewitz W, Mulder LJ, van Roon A, Duschek S. I2; Recovery: R1 vs. The results showed that cognitive—behavioral counseling had a positive effect on pregnancy anxiety. J Babol Univ Med Sci. | |
| About this item | The cpgnitive of intervention was Joint health solutions on paper and placed in opaque Ctirus sealed envelopes that numbered sequentially to conceal aurantiuum allocation sequence. Session 8: Reviewing Prohibited substances in endurance sports troubleshooting ajrantium cognitive—behavioral treatment plan, noting the progress aurantiu treatment according Citrhs the sleep nealth to the patients. A significant decrease ajrantium HR, Citrus aurantium for cognitive health, and Citrus aurantium for cognitive health occurred along with a significant decrease in E and NE. Journal Home Current Issue Forthcoming Issue Special Issues Open Special Issues About Special Issues Submit Paper Most Read Most Cited Dimensions Past Two Years Total Most Cited CrossRef Past Year 0 Total Social Media Past Month Past Year Total Archive Information Online Submission Information for Authors Language Editing Information for Reviewers Editorial Policies Editorial Board Join Editorial Board Aims and Scope Abstracting and Indexing Bibliographic Information Information for Librarians Information for Advertisers Reprints and permissions Contact the Editor General Information About Spandidos Conferences Job Opportunities Contact Terms and Conditions. Firouzbakht et al. List unavailable. |
| Similar items that may ship from close to you | Product information. Register Login. Aβ, amyloid β; CAE, Citrus aurantium extract. Crescent J Med Biol Sci. Though we did not measure changes in plasma lipids we can postulate that the known action of p-synephrine could have elevated plasma levels and consequently influenced sympathetic activity. New York: Guilford Press; I like experimenting with nootropics and I hadn't bought this one yet. |
Citrus aurantium for cognitive health -
AchE activity was determined using commercial assay kits Abnova; cat. KA, Taiwan according to the manufacturer's instructions. The activity was calculated as the optical density OD at nm and represented as OD values per milligram of protein.
The dissected cortex and hippocampus tissues were lysed in radioimmunoprecipitation assay buffer containing 50 mM Tris-HCl pH 7. The supernatant was collected, and the protein concentration was calculated by bicinchoninic acid protein assay kit Thermo, USA.
The membranes were blocked with commercial blocking buffer Thermo, USA for 1 h at room temperature and washed thrice with Tris-buffered saline containing 0.
After washing, the membrane was incubated at 4°C overnight with the following appropriate antibodies: B-cell lymphoma 2 Bcl-2 -associated X protein Bax; ,; cat. The membranes were again washed thrice and enhanced using chemi-luminescence reagents.
The protein bands on the membrane were detected by a chemi-luminometer ATTO, Japan. Densitometry was performed using the Image-Pro Plus soft-ware version 6. Data are expressed as the mean ± standard error and were analyzed with SPSS Statistics Different treatment groups were compared using one-way analysis of variance followed by multiple comparisons using Dunnett's post hoc test using Origin 7.
The composition in CAE were investigated the chromatographic profiles of a standard on HPLC analysis. The optimized CAE was used in all subsequent experiments. The mice did not show any change in body weight during the experiment, but hair coat showed rough condition.
Response to weak stimuli decreased and activity ability also decreased. Also, the mice was sitting on the floor with a curved posture was observed and through these symptoms, the humane endpoint was set. The animals were sacrificed by meeting the defined endpoint.
The effect of CAE and nobiletin on the Aβ 1—induced memory impairment was measured using a passive avoidance task. The step-through latency of the Aβ 1—only treated group was significantly shortened compared to the control group Fig.
However, the reduced step latency with Aβ 1—42 was restored by the administration of CAE and nobiletin. Effect of nobiletin and CAE on step-through latency in passive avoidance test in Aβ 1—42 induced memory impairment.
The data are presented as mean ± standard error of the mean. Aβ, amyloid β; CAE, Citrus aurantium extract. The efficacy of CAE and nobiletin in protection from the spatial memory impairment via Aβ 1—42 injection was further confirmed. The escape latency assessment was performed twice a day.
During the test period, escape latency decreased slightly in the second trial compare to the first trial in all experimental groups Fig. No difference was observed in the escape latency for 4 days in the amnesic mice, which were treated with Aβ 1— By contrast, the control group showed significantly decreased escape latency in two trials over 4 days Fig.
It is well-established that Aβ 1—42 induces memory loss and increases the escape latency. Similarly, the escape latency in mice administered nobiletin significantly decreased for 4 days compared to the Aβ 1—only injected group.
Effect of nobiletin and CAE on Aβ 1—42 induced memory impairment in the Morris water maze. The escape latency of A Trial 1 and B Trial 2, and the mean of C Trial 1 and Trial 2 during the training sessions for 4 days. The effect of CAE and nobiletin treatment on the swim distance to locate the platform in the MWM task is shown in Table I.
The control group mice were able to swiftly locate the platform and reached the platform during the training session. However, the Aβ 1—treated group had difficulty learning to locate the platform.
The swim distance was significantly increased compared to that of the control group. The mice in the nobiletin-treated group were also able to find the platform easily with a short swim distance, especially on Day Effect of nobiletin and CAE on the distance swum by Aβ 1—42 treated mice to find the platform in the water maze task.
To evaluate the spatial memory of the mice, the number of crossings to the platform was measured in the probe trial on Day As shown in Fig. These results show that these drugs enhance spatial cognition, learning, and memory functions against Aβ 1—induced memory impairment.
Effect of nobiletin and CAE on the number of crossing in a probe trail on Day To investigate the neuroprotective effect of CAE and nobiletin on brain tissue, AchE activity was measured in the cortex and hippocampus Table II.
The AchE activity in the Aβ 1—treatment group was significantly increased compared to that in control group. Similarly, the AchE activity in the nobiletin treatment group also decreased significantly by The effect of CAE and nobiletin on the Bcl-2 family and caspase pathway was investigated in the cortex and hippocampus.
In contrast, Bcl-2 protein expression was higher in the control group than in the Aβ 1—only treated group in the cortex and hippocampus. A similar protein expression pattern was observed in the cortex.
Effect of nobiletin and CAE on protein expression in A hippocampal and B cortex tissues. The expression was detected by western blot analysis. Bax, Bcl-2 and cleaved caspase-3 protein levels were normalized by separate control β-actin, respectively.
Aβ, amyloid β; CAE, Citrus aurantium extract; Nob, Nobiletin. The present study is the first report to evaluate the neuroprotective effects in Aβ 1—induced memory impairment animal model and not the transgenic or senescence accelerated mouse model.
Our results showed that the Aβ 1—injection resulted in severe performance deficits in the passive avoidance and Morris water task as well as neurodegeneration in the mice brain that was evident from increased AchE activity in the hippocampus and cortex.
In this study, we treated the amnesic mice with CAE and nobiletin and confirmed the anti-amnesic effect by regulating of apoptotic signaling. Aβ plays a major role in the development of AD, particularly the neurotoxic Aβ 1—42 The direct injection of Aβ 1—42 in the rodent brain has been used to cause apparent memory deficits, and Aβ-exposed rats have shown hippocampus-dependent spatial learning dysfunction in long and short-term tasks 4.
Also, the brains of AD patients demonstrated a high Aβ level compared with normal aged brain samples The deposition of Aβ in the cortex and hippocampus, which are responsible for learning and memory performance, resulted in neuronal apoptosis 21 , To examine the protective effect of CAE and nobiletin, we performed the passive avoidance and MWM tasks to investigate learning and memory function.
The passive avoidance task is a method that is used to measure the escape time from the space that induces pain and fear by electronic shock in rodents It is commonly used to confirm the memory function, and we found in this study that CAE and nobiletin administration significantly increased the step-through latency to similar levels, a phenomenon that was reduced by the Aβ 1—42 injection.
The MWM is an assessment method to evaluate hippocampal-dependent learning abilities and cognitive deficits in rodents. The animals were trained to learn spatial working information at the learning stage and assisted to build future memory These results are consistent with those of previous studies that show Aβ-induced memory deficits in an MWM task than those in the saline group As a result of two trials for 4 days on the MWM task, CAE treatment reduced escape latency in the second trial compared to the first trial, and escape time decreased over training days.
The nobiletin administration group showed similar escape latency for 4 days in the first trial, and the escape latency decreased rapidly on Day 26 in the second trial. Although the pattern of escape latency of the CAE and nobiletin group was slightly different, the mean escape latency was decreased to a similar pattern.
This means that CAE and nobiletin administration showed significant decreases in escape latency, improvement in cognitive performance, and amelioration of the memory deficits. Furthermore, to investigate the neuroprotective effect of CAE and nobiletin, we examined the changes in the Ach system in the hippocampus and cortex.
Ach is an essential enzyme that maintains the normal function of the nervous system and is hydrolyzed by AchE. In addition, Aβ deposition is increased in the presence of AchE, and AchE activity in AD is related to Aβ deposition Therefore, it is important to reduce the level of AchE, which is used as a marker for the cholinergic nervous system.
Here we found that AchE activity in the cortex was similar to that of CAE and nobiletin. However, nobiletin administration showed significantly lower AchE activity than CAE administration in the hippocampus. CAE and nobiletin administration benefits on the cholinergic neurotransmission by decreasing AchE activities in the cortex and hippocampus.
AchE can also be used as a marker of apoptosis. AchE expression or activity is increased when the cells undergo apoptosis, and enhanced AchE expression levels are detected in the brain of focal cerebral ischemic rats 26 , AchE is usually present in the cytoplasm and moves to the nucleus before nuclear morphological changes occur.
It then accelerates chromatin condensation and fragmentation by modulating nuclear components Therefore, AchE can be detected on the fragmented nuclei of apoptotic cells, and increased AchE activity implies the occurrence of cell death Apoptosis is triggered via two major pathways: The mitochondrial intrinsic pathway and the death receptor-mediated extrinsic pathway.
In this study, we focused on the mitochondrial pathway, which is regulated by Bcl-2 family and caspases Bcl-2 is a known anti-apoptotic protein, while Bax is a pro-apoptotic protein that promotes apoptosis.
These two proteins are the major factors responsible for cell death regulation. The Bcl-2 and Bax ratio determines whether a cell undergoes or escapes apoptosis 23 , In our study, the Aβ 1—42 injection group had increased Bax and cleaved caspase-3 protein expressions compared with the control group, while Bcl-2 protein levels were increased in the control group and reduced in the Aβ 1—treated group.
CAE treatment significantly decreased the Bax and cleaved caspase-3 protein expression levels and simultaneously increased Bcl-2 protein expression in the hippocampus and cortex. Likewise, the treatments also increased the expression ratio of Bcl-2 to Bax in the cortex and hippocampus.
On the other hand, Bcl-2 protein expression in the nobiletin administration group was increased to a level similar to that of the control group.
Bax and cleaved caspase-3 protein expressions in the cortex were significantly inhibited by nobiletin treatment, while the Bcl-2 protein level was significantly enhanced compared the control group. In conclusion, our results indicate that the administration of CAE and nobiletin had a similar neuroprotective effect against Aβ-induced cognitive impairment through reduction of AchE activity and anti-apoptotic activity and regulating the Bcl-2 family and caspase pathway in the cortex and hippocampus.
Our results provide evidence of the dietary intake of CAE or nobiletin as a valuable functional food since it has the ability to reduce cognitive impairment and memory dysfunction. However, to confirm the neuroprotective effects of CAE and nobiletin, we have to confirm the morphological change of brain tissues in further study.
In addition, the effects of CAE and nobiletin on Aβ accumulation in cortex and hippocampus should be studied. The present study was supported by Korea Institute of Planning and Evaluation for Technology in Food, Agriculture, Forestry and Fisheries IPET through High Value-added Food Technology Development Program, funded by Ministry of Agriculture, Food and Rural Affairs MAFRA; grant no.
HJL carried out the experiments and wrote the original manuscript. SKL analyzed the experimental data. DRL and BL performed the data processing and quality control assessment.
BKC and SHY designed the study, and proofread and finalized the manuscript. All authors have read and approved the final manuscript.
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Food Chem Toxicol. Zhang SJ, Luo D, Li L, Tan RR, Xu QQ, Qin J, Zhu L, Luo NC, Xu TT, Zhang R, et al: Ethyl acetate extract components of bushen-yizhi formula provides neuroprotection against scopolamine-induced cognitive impairment.
Sci Rep. Barnes DE and Yaffe K: The projected effect of risk factor reduction on Alzheimer's disease prevalence. Lancet Neurol. Yeon SW, You YS, Kwon HS, Yang EH, Ryu JS, Kang BH and Kang JH: Fermented milk of Lactobacillus helveticus IDCC reduces beta-amyloid and attenuates memory deficit.
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flesh and peel in mice following trimethyltin-induced learning and memory impairment. Food Res Int. Choi BK, Kim TW, Lee DR, Jung WH, Lim JH, Jung JY, Yang SH and Suh JW: A polymethoxy flavonoids-rich Citrus aurantium extract ameliorates ethanol-induced liver injury through modulation of AMPK and Nrf2-related signals in a binge drinking mouse model.
Also, some aromas may increase slow-wave sleep SWS and subjective sleep quality [ 20 ]. One of the essential oils used in aromatherapy is Citrus aurantium. This essential oil is an amber-colored liquid that turns red in the presence of light. Its smell is strong, very fragrant and its taste is bitter [ 21 ].
Citrus aurantium has central nervous system stimulating and mood-enhancing effects, as well as sedative, antispasmodic, anti-inflammatory, anti-flatulence, digestive, antihypertensive and diuretic effects [ 22 ]. Based on the literature review, limited studies have been found about the effect of Citrus aurantium on sleep quality, anxiety, and quality of life of pregnant women.
In a recent study, this essential oil was effective in reducing the anxiety of women at risk of preterm labor [ 24 ]; it was also effective in reducing anxiety during labor in another study [ 25 ].
No study has been conducted with the integration of CBT and aromatherapy. Considering that poor sleep quality has detrimental effects on mood, psychological function and overall well-being [ 26 ] and given the various studies have reported the sedative and anxiolytic effects of Citrus aurantium [ 22 ], and also CBT helps the patient to recognize and change distorted thought patterns and dysfunctional behaviors [ 14 ].
Thus, the present study aimed to evaluate the effect of cognitive—behavioral counseling with and without Citrus aurantium on sleep quality primary outcome , anxiety and quality of life secondary outcomes in pregnant women. This randomized controlled trial was conducted on 75 pregnant women referring to health centers in Tabriz, Iran from July to February The inclusion criteria included pregnant women with a gestational age of 20—24 weeks, women with poor sleep quality based on the Pittsburgh Sleep Quality Index PSQI score above 5 , having a minimum degree of secondary school, living in Tabriz, having a medical record in the health center integrated health system , lack of olfactory problems and allergy to herbal medicines by examination by the researcher, obtaining a depression score of 12 and lower according to the Edinburgh Pregnancy Depression Scale EPDS.
The exclusion criteria included pregnant women with mental illness and a history of hospitalization in a psychiatric hospital or the use of any psychiatric medication, addiction to drugs and smoking, high-risk pregnancies including diabetes, hypertension, chronic diseases, such as cardiovascular, lung, etc.
The sample size in this study was calculated using G-Power software. According to the results of the study conducted by Effati et al.
Sampling began after obtaining the code of ethics from the ethics committee of Tabriz University of Medical Sciences code: IR. Sampling was performed in 6 health centers of Tabriz, Iran.
The researcher referred to health centers in Tabriz, and then briefly explained the goals and methods of the research to women with 20—24 gestational ages. If women were willing to participate in the study, they were examined in terms of inclusion and exclusion criteria and eligible individuals were selected.
Then, the PSQI and the EPDS were completed through interview with participants by the researcher and participants who scored sleep quality score higher than 5 and a depression score 12 and less, and met other inclusion criteria were included in the study after obtaining informed written consent and then the socio-demographic characteristics questionnaire, Pregnancy-Specific Anxiety Scale PSAS and Pregnancy-Specific Quality of life Questionnaire QOL-GRAV were completed through interview with participants by the researcher.
Participants were randomly allocated to three groups including the first intervention group receiving cognitive—behavioral counseling with aromatherapy with Citrus aurantium essential oil , the second intervention group receiving cognitive—behavioral counseling and placebo , and control group using the block randomization method with the block sizes of 6 and 9 and an allocation ratio of The type of intervention was written on paper and placed in opaque and sealed envelopes that numbered sequentially to conceal the allocation sequence.
The envelopes were opened in the order in which the participants entered the study and the type of group of individuals was determined. Envelopes were prepared by a person not involved in sampling, data collection and analysis.
Similar glasses of Citrus aurantium essential oil or placebo were prepared and coded with letters of A and B. The Citrus aurantium essential oil and placebo had exactly the same appearance smell, color, and shape.
The intervention groups received a glass of drug or placebo in addition to counseling. The researcher and participants of intervention groups were blinded to the type of drug received. The first and second intervention groups received 8 sessions of cognitive—behavioral counseling held in the health center in groups of 5—7 people.
The mean duration of counseling sessions was 60—90 min. Cognitive—behavioral counseling sessions were by the first author Master of Counseling in Midwifery under the supervision of the project clinical psychologist in health centers held as 2 sessions per week and lasted for 4 weeks.
The content of the counseling included explaining the goals of training and acquaintance with the members, conducting a pre-test, explaining the importance of treatment, assessing the insomnia, perception of sleep and insomnia, evaluating thoughts, training relaxation, sleep health and new sleep schedules, restriction of sleep, prevention of daily naps, problem-solving skills, summarizing thoughts, reality of sleep, introducing the cycle of thought and feeling and behavior, and training thought blocking.
Due to COVID disease, the last two sessions were held online in the Zoom program due to unwillingness of pregnant women to attend the health center.
The content of the counseling sessions was as follows:. Session 1: Explaining the goals of training and acquaintance with members, conducting a pre-test, teaching how to monitor the baseline of sleep with a sleep report table, reminding the importance of treatment tasks, a complete assessment of the nature of insomnia.
Session 2: Presenting the principles and logic of treatment, teaching the mechanism of sleep and its stages, sleep—wake cycles and underlying factors, maintenance and continuation of insomnia, relaxation training. Session 3: Reviewing the previous session of treatment, reviewing the findings of the sleep report form, sleep hygiene training, and review the relaxation and new sleep schedule.
Session 4: Restricting sleep, preventing daily naps, evaluating thoughts and teaching how to record thoughts related to insomnia and reviewing the assignments of previous sessions sleep report form and homework schedule.
Session 5: Summarizing thoughts, problem-solving skills, reviewing the sleep report form and homework and troubleshooting. Session 6: Introducing the cycle of thinking, feeling and behavior, reviewing relaxation and training not to try fall asleep and apply all the instructions of the previous sessions and reviewing the homework of the previous sessions sleep report form and homework table.
Session 7: Training thought blocking, mental imaging, troubleshooting cognitive-behavioral therapy plan, reviewing patient homework.
Session 8: Reviewing and troubleshooting the cognitive—behavioral treatment plan, noting the progress of treatment according to the sleep calendar to the patients. The participants in the first intervention group, in addition to cognitive—behavioral counseling sessions, received aromatherapy with Citrus aurantium essential oil, so that they placed 2 drops of Citrus aurantium aromatic distillate on a tissue and inhaled it through normal breathing for 15—20 min before bedtime.
The Citrus aurantium essential oil required for the study was purchased from Bu Ali Sina Medical Company of Iran and after determining the concentration by gravimetric method was used by the Faculty of Pharmacy of Tabriz University of Medical Sciences.
The safe dosage was 8 mg of Citrus aurantium essential oil in ml of distilled water. Based on the evaluations made by the pharmacist, the minimum number of drops was considered for pregnant women. The second intervention group received a placebo with the same prescription.
The content of the placebo were distilled water. A kind of aroma was used to make the placebo smell similar to Citrus aurantium essential oil when opening the lid of container; however, it didn't have the potential to stimulate the nervous system.
The control group received only routine prenatal care. Data collection tools included the socio-demographic and obstetric characteristics questionnaire, PSAS, PSQI, and QOL-GRAV, which were completed before and after the intervention through interview with participants.
The PSQI is a self-report tool scored from 0 to 21 and developed by Buysse et al. This questionnaire has seven components that include subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, and sleep disturbances, the use of sleeping medication, and daytime dysfunction.
A score above 5 indicates insomnia and poor sleep quality [ 29 ]. In a study conducted on pregnant women in Tabriz, Iran, the reliability of this tool was reported 0. A modified PSAS was used to measure pregnancy anxiety.
Its short version contains 11 questions. The answer to each question varies from not at all score 1 to very relevant score 5. Higher scores indicate a higher level of anxiety and there is no cut-off point.
In a study conducted in Tabriz, Iran, Cronbach's alpha coefficient was obtained at 0. The QOL-GRAV has 9 questions to assess the level of personal experiences of quality of life during pregnancy. Each item is scored based on the Likert scale ranging from not at all score zero and completely score five.
In this questionnaire, the first six questions are scored in reverse. Persian version of QOL-GRAV has good validity and reliability, so this tool can be used to assess the quality of life of pregnant women [ 31 ].
Data were analyzed by SPSS software. The Kolmogorov—Smirnov test was used to assess the normality of quantitative data and all variables had normal distribution. Chi-square, Chi-square for trend, and Fisher's exact and independent t tests were used to evaluate the homogeneity of groups in terms of sociodemographic and obstetric characteristics.
One-way analysis of variance was used to compare the mean scores of quality of life and anxiety among the intervention groups before the intervention and ANCOVA test was used after the intervention by adjusting the baseline score and the age variable.
Figure 1 shows the study flow diagram. The socio-demographic and obstetric characteristics of the participants are presented in Table 1. There was no statistically significant difference among the groups in terms of all socio-demographic characteristics except age variable, the effect of which was controlled by ANCOVA test.
After the intervention, the quality of life score in the intervention group 1 AMD: 2. The results of this study showed that cognitive—behavioral counseling reduced anxiety and improved quality of life but had no effect on sleep quality.
The results of studies conducted by Edinger and Sampson [ 32 ] on patients at Durham Medical Center showed that cognitive—behavioral therapies improve sleep quality. Also, the results of a study conducted by Reybarczyk [ 33 ] on older adults show that CBT is effective in reducing sleep onset time and improving sleep quality.
In another study by Querstret et al. Thus, the results are controversial. Cognitive—behavioral counseling with or without Citrus aurantium essential oil did not have an effect on quality sleep, which is probably due to differences in participants, the virtual holding of some sessions due to COVID disease, as well as the lack of regular and correct exercise at home.
Along with primary insomnia and physical conditions, pregnancy-specific sleep problems may impede treatment. It seems that CBT may not be sufficient for women with high PSQI scores.
Also, observing sleep restrictions and scheduling might be difficult during pregnancy. There is a need to perform high-quality trials for sleep-related interventions during pregnancy and implement effective programs in standard prenatal care [ 35 ].
Citrus aurantium essential oil did not have an effect on sleep quality in our study. Based on the literature review, the effect of Citrus aurantium on sleep quality has been less studied than other essential oils, such as lavender, bergamot, and chamomile [ 36 ].
In comparison with the previous studies, the results may be due to the pregnancy-specific conditions and socio-demographic differences of the participants [ 37 , 38 ]. It is recommended that future studies focus more on the above-mentioned items.
The results showed that cognitive—behavioral counseling had a positive effect on pregnancy anxiety. Many studies confirm the role of psychological therapies as a way to reduce anxiety and choose natural childbirth in pregnant women.
For example, the results of a study showed that CBT methods reduce anxiety in nulliparous women [ 39 ]. Firouzbakht et al. Another study revealed that psychological education in nulliparous women with severe fear of childbirth reduces the choice of cesarean section and increases satisfaction with the experience of childbirth [ 42 ].
Cognitive reconstruction, also known as rational empiricism, helps people identify the flow of anxious thoughts using logical reasoning for practical testing the content of their anxious thoughts against the reality of their life experiences.
In other words, they test the probability of occurring that something that will happen in reality [ 43 ]. Thus, cognitive assessment of events affects the response to those events and will pave the way for changing cognitive activity [ 44 ].
The results of this study showed that cognitive—behavioral counseling has a positive effect on quality of life. In explaining these results, it can be stated that pregnancy is associated with stress, which can affect the quality of life of pregnant women. Thus, cognitive—behavioral counseling helps pregnant women manage stress, identify stressful situations, and then teach strategies to cope with these situations.
CBT equips participants with a variety of integrated techniques that they can use to reduce stress and improve quality of life [ 45 ]. Through training muscle relaxation and diaphragmatic breathing, people are taught to control their daily stress, and through negative thinking and thinking power, people are taught to recognize and control their negative cognitive symptoms [ 46 ].
The effect of cognitive—behavioral counseling with aromatherapy on sleep quality in pregnant women was examined for the first time. In this regard, standard and valid questionnaires were used to assess the consequences and the native language of pregnant women was used during counseling sessions to communicate more with women and these cases can be considered as the study strengths.
All women participating in this study were literate, so this can affect the generalizability of results in illiterate women.
Also, we only included pregnant women with a gestational age of 20—24 weeks. The future studies should be conducted on women in the first and third trimesters of pregnancy. It is recommended to hold several sessions of cognitive—behavioral counseling for those who support these women husbands and other family members.
Also, the effect of CBT-I should be also assessed in future studies. It is also recommended to investigate the effect of cognitive—behavioral counseling on other populations such as women of childbearing age.
Based on the findings of the study, it is concluded that cognitive—behavioral counseling with or without aromatherapy with Citrus aurantium essential oil can reduce anxiety and improve quality of life during pregnancy, but had no effect on the quality of sleep of pregnant women and its subdomains.
Further studies are required to develop a protocol to guide pregnant women with sleep problems. VandenBerg KA. State systems development in high-risk newborns in the neonatal intensive care unit: identification and management of sleep, alertness, and crying.
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