Written by Chrystal Moulton, Science Writer. Researchers observed a significant improvement in dialysis symptom index (P <0.001) and anxiety (P <0.01) in the intervention group.

Among patients with end stage renal disease undergoing hemodialysis, anxiety is a common occurrence¹. Various studies show that alternative therapy could effectively improve a patient’s psychological, social, and physical symptoms^2-4. Aromatherapy, which is a form of alternative care, has shown some effectiveness in managing anxiety⁵. Studies utilizing lemon balm oil aromatherapy has demonstrated positive effects in patients with mild to moderate depression⁶, improvement in quality of sleep among nursing mothers⁷, and improving anxiety symptoms in patients undergoing coronary artery bypass surgery⁸. In the current trial, researchers investigated the effect of lemon balm aromatherapy on patients with end stage renal disease routinely undergoing hemodialysis⁹.

The current study was designed as a randomized clinical trial. Patients with end stage renal disease on hemodialysis who were 18 years and older were recruited for this study. Eligible patients had to have at least been on hemodialysis for six months and required to undergo hemodialysis 3 times a week to be considered for this trial. Demographic information was collected from all participants. Anxiety was measured with the Spielberger State Trait Anxiety Inventory (STAI). Higher scores on the Spielberger State Trait Anxiety Inventory (STAI) indicated high anxiety. Dialysis symptoms were measured using the Dialysis Symptoms Index (DSI). Both measurements were taken before and after completion of the trial. The duration of the trial was one month. Researchers randomly assigned hemodialysis patients who came in for treatment on odd days to the intervention group while those who came in for treatment on even days were assigned to the control group. Participants in the intervention group were provided with a cotton ball soaked with 200 microliters of lemon balm essential oil, which was attached to the patient’s clothing about 20cm from their nose. Patients inhaled the scented oil for 20 minutes while undergoing hemodialysis. Individuals in the control group were given a cotton ball soaked in almond oil, which was attached to their clothing and inhaled for 20 minutes while undergoing hemodialysis. All patients underwent a total of 12 hemodialysis sessions during this study. The primary outcome of this study was changes an anxiety level and symptom burden.

A total of 68 patients were included in this study [intervention = 34, control = 34]. The average age of participants in the intervention group was 49.79 years old and in the control group 54.14 years old. About 1/3 of the participants in both groups reported both coronary artery disease and diabetes while 70% or more across both groups had hypertension. The length of time on hemodialysis in the intervention group was 2.97 years and in the control group 3.64 years. Overall, no significant difference was observed between groups at baseline. After one month of aromatherapy, Researchers observed a significant improvement in dialysis symptom index (P <0.001) and anxiety (P <0.01) in the intervention group. Researchers also observed a significant improvement in anxiety score in the intervention compared to the control group (P £ 0.01). Patients in the intervention group reported significant improvement in feelings of anxiousness and dry mouth compared to the control (P <0.05). Furthermore, post intervention, researchers observed a significant difference in the severity of symptoms such as swelling in the legs, muscle cramps, nausea, constipation, diarrhea, vomiting, worrying, nervousness, trouble staying asleep, and muscle shortness among patients in the intervention group compared to patients in the control group (P <0.05).

Results from this study show that aromatherapy utilizing lemon balm essential oil could significantly improve anxiety and symptom severity in patients with end stage renal disease. Additional studies will be needed to verify these findings.

Source: Pasyar, Nilofar, Mansoureh Aghababaei, Masoume Rambod, and Mohammad M. Zarshenas. “The effectiveness of Melissa officinalis L. essential oil inhalation on anxiety and symptom burden of hemodialysis patients: a randomized trial study.” BMC complementary medicine and therapies 25, no. 1 (2025): 103.

© The Author(s) 2025. Open Access

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Posted July 15, 2025.

Chrystal Moulton BA, PMP, is a 2008 graduate of the University of Illinois at Chicago. She graduated with a bachelor’s in psychology with a focus on premedical studies and is a licensed project manager. She currently resides in Indianapolis, IN.

References:

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7. Sinaei M, Salari R, Birjandi RM, Raesi R, Sadeghi T. The Effect of Inhalation Aromatherapy with Lemon Balm (Melissa officinalis) Essential Oil on Sleep Quality in Mothers of Preterm Infants in the Neonatal Intensive Care Unit (A Randomized Clinical Trial Study). The Open Public Health Journal. 2024;17(1)
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