Things you should know:
- Some people use herbal remedies to treat sleep problems. They may choose this in preference to sleeping pills.
- There have been studies on some of these herbs. However, not all of them have been conducted properly. For some herbs, there is virtually no evidence to show whether they are effective or not.
- The most frequently studied herbs are Valerian, Kava, Hops, Chamomile, and Passionflower. However, there is little convincing evidence to suggest that they work well for improving sleep.
- Some herbal remedies have been associated with adverse health effects.
Why try herbs to help your sleep?
About 40% of people use alternative or complementary medicines at least occasionally. This can be for many reasons, including problems with sleep. Some people who are concerned about using sleeping pills will turn to herbal remedies to help them sleep (see our page on Sleeping Tablets). Melatonin is not a herbal remedy (for more information see Melatonin).
Has the effectiveness of herbs in treating sleep problems been adequately studied?
Studies of the effectiveness of herbs for sleep problems have not always been as thorough as they should have been. Sometimes it seems that the treatment works well, however with any new treatment it is important to check that this effect is not simply a placebo (or dummy) effect that could have occurred if a sugar pill had been taken. Many studies of herbal remedies have failed to properly compare outcomes with those from a placebo treatment.
For some herbal remedies, disappointingly few studies have been done on humans. One reason for this is that only an active chemical ingredient of a herb, and not the herb itself, can be patented and only sold by a specific manufacturer for a certain time-period. Trials testing effectiveness are expensive, and without a patent, companies may not be able to recover their costs through guaranteed sales, even if the herb has potential. However, there have been studies of some herbs used for insomnia and anxiety. Here we focus on herbs where reasonable information exists from clinical research trials.
What does the evidence say about herbs helping sleep?
In the table below, we look at the effectiveness of eight herbal remedies as treatments of insomnia. The first column shows the name of the herbal remedy, and the second column shows the strength of results across randomised controlled trials for insomnia. In such trials, group allocation was random, and a placebo treatment was included as comparison. If a majority of research is inconclusive or unsupportive of the herbal remedy as superior to placebo treatment, then the evidence level is considered ‘Low’. If a majority of research is supportive of the herbal remedy as superior to placebo treatment, then the evidence level is considered ‘Medium’. If research consistently supports the herbal remedy as superior to placebo treatment, then the evidence level is considered ‘High’. ‘More research needed’ is when insufficient quality research exists to conclude whether the herbal remedy is superior to placebo treatment.
If we look at the table, the overall conclusion is that the evidence for these herbs helping with insomnia is fairly weak. It is unlikely that a single herbal remedy will treat insomnia.
What about these herbs and anxiety?
We know that some people have difficulty sleeping due to anxiety (see Anxiety and Sleep). Clinical trials in humans have shown that three herbs perform reasonably well in reducing anxiety. These are Kava, Passionflower, and Chamomile. Kava is considered the most effective herbal remedy for anxiety, however safety issues exist with its use (see below), while Passionflower and Chamomile show promising effects.
What about Chinese Herbal Medicine?
There is some evidence that suggests Chinese Herbal Medicine (CHM) can reduce symptoms of insomnia. A recent review from 2019 concluded that CHM is more effective than placebo treatments at improving sleep quality. Consultation with a qualified CHM practitioner is advised before commencing treatment.
What kind of things may affect the results of a study?
Not all researchers use the same methods to select people for their studies and they might assess different types of insomnia/sleep disturbances. Researchers also measure the effects of herbal remedies over various periods of time, meaning long-term improvements may go undetected in short-term trials. It is also possible that the dosage of herbal extracts may influence research findings, however this requires further analysis.
Can I expect herbal cures to work straight away?
Most studies look at the effect of the herbs over a number of weeks. Hence it is best to not expect results after one or two nights. Valerian, in particular, is known to take time to start to work. Thus, if it is going to help sleep at all, it tends to take two or three weeks before there is an improvement.
Are the herbal remedies safe to use?
In general, herbal medicines are safe to use for populations with insomnia. There have been some worries about the safety of Kava and Hops. Although Kava extracts seem to be safe for most users, this is only when taken in the short term and at doses that are not too high. Unfortunately, some Kava users have been found to suffer serious side effects, e.g., liver problems. More research needs to be done on this. Also, studies have found that it might not be safe to take Kava together with benzodiazepines (the type of drug in many sleeping tablets). Hops has been associated with allergic skin reactions, respiratory problems, and menstrual changes, although Valerian-Hops combinations have shown no serious adverse health effects.
Main Reference Source:
Leach, M. J., & Page, A. T. (2015). Herbal medicine for insomnia: A systematic review and meta-analysis. Sleep Medicine Reviews, 24, 1-12.
Taslaman, M. (2014). The efficacy and safety of herbal medicine for insomnia in adults: an overview of recent research. Australian Journal of Herbal Medicine, 26(3),86-93.
Additional Reference Sources:
Antoniades, J.,Jones, K., Hassed, C., & Piterman, L. (2012). Sleep… Naturally: A Review of the Efficacy of Herbal Remedies for Managing Insomnia. Alternative and Complementary Therapies, 18(3), 136-140.
Dave, P. H.,Vishnupriya, V., & Gayathri, R. (2016). Herbal Remedies for Anxiety and Depression-A Review. Research Journal of Pharmacy and Technology, 9(8),1253.
Zhang, H., Liu, P.,Wu, X., Zhang, Y., & Cong, D. (2019). Effectiveness of Chinese herbal medicine for patients with primary insomnia: A PRISMA-compliant meta-analysis. Medicine, 98(24), e15967.
Where can I find out more?
Other useful links:
- Sleeping Tablets
- Understanding and Helping Poor Sleep
- Sleep Hygiene: Good Sleep Habits
- Anxiety and Sleep
- Mental Health and Sleep
- Preventing Chronic Insomnia
- Cognitive Behavioural Therapy for Insomnia (CBT-I)