From the Guidelines
Kava is not recommended for sleep due to the risk of acute liver damage and death associated with its use. The U.S. Food and Drug Administration has warned health care providers and the public about these serious potential harms, leading to a “strong against” recommendation for kava 1. While some studies have evaluated the efficacy and safety of kava for treatment of insomnia disorder, the evidence does not support its use for this purpose. A systematic review found no between-group differences in critical outcomes such as daytime functioning, insomnia severity, and sleep efficiency with kava use 1.
Key points to consider when evaluating kava for sleep include:
- The risk of acute liver damage and death associated with kava use
- The lack of evidence supporting the efficacy of kava for treating insomnia disorder
- The potential for kava to interact with other medications or exacerbate underlying health conditions
- The importance of prioritizing evidence-based treatments for sleep disorders that have a stronger safety profile.
In clinical practice, it is essential to prioritize the safety and well-being of patients, and therefore, alternative treatments for sleep disorders should be considered instead of kava, as recommended by the 2019 U.S. Department of Veterans Affairs and U.S. Department of Defense clinical practice guidelines 1.
From the Research
Kava and Sleep
- Kava has been shown to have a positive effect on sleep disturbances associated with anxiety disorders 2.
- A multicenter, randomized, double-blind clinical trial found that kava extract WS 1490 was effective in improving sleep quality and reducing anxiety in patients with sleep disturbances associated with anxiety, tension, and restlessness states of non-psychotic origin 2.
- The study found that kava extract WS 1490 had a statistically significant effect on improving sleep quality and reducing anxiety, with no drug-related adverse events or changes in clinical or laboratory parameters 2.
- Kava's sedative and anxiolytic properties may contribute to its ability to improve sleep quality 3, 4, 5.
- However, it is essential to note that kava can interact with other medications and may have adverse effects, such as liver toxicity, in rare cases 3, 4, 5.
Mechanism of Action
- Kava's mechanism of action is thought to involve the modulation of GABA activity, inhibition of monoamine oxidase B, and inhibition of noradrenaline and dopamine re-uptake 3, 4.
- Kava's active compounds, kavalactones, may also contribute to its sedative and anxiolytic effects by altering lipid membrane structure and sodium channel function 4.