Is valerian root effective for treating insomnia and anxiety disorders?

Valerian Root for Insomnia and Anxiety: Ineffective Based on Current Evidence

Valerian root is not recommended for treating insomnia or anxiety disorders due to insufficient evidence of efficacy compared to placebo, despite its generally good safety profile. 1

Evidence Against Valerian for Insomnia

The American Academy of Sleep Medicine (AASM) explicitly recommends against using valerian for treating both sleep onset and sleep maintenance insomnia in adults 1. This recommendation is based on:

• Trials of variable dosages of valerian and valerian-hops combinations showed no clinically significant benefits
• Quality of evidence ranges from very low to moderate
• Benefits are approximately equal to harms

The Department of Veterans Affairs and Department of Defense clinical practice guidelines similarly found no support for valerian in treating chronic insomnia disorder 1. Their systematic review found:

• No significant differences between valerian and placebo in critical outcomes:
  • Daytime functioning
  • Insomnia severity
  • Sleep efficiency
  • Sleep onset latency
  • Total sleep time
  • Wake after sleep onset
  • Sleep quality

Evidence Against Valerian for Anxiety

The evidence for valerian in treating anxiety disorders is even more limited:

• Insufficient evidence exists regarding the efficacy of valerian for anxiety disorders 2
• A 2024 umbrella review concluded there is no empirical support for valerian's use in insomnia or anxiety 3

Preferred Treatment Options for Insomnia

The AASM recommends several evidence-based alternatives for insomnia treatment 1:

1. First-line pharmacological options:

   • Non-benzodiazepine hypnotics (zaleplon, zolpidem)
   • Benzodiazepines (triazolam, temazepam)
   • Melatonin receptor agonists (ramelteon)
   • Doxepin (for sleep maintenance)

2. Non-pharmacological approach:

   • Cognitive Behavioral Therapy for Insomnia (CBT-I) is recommended as first-line treatment by multiple guidelines 1

Safety Profile

While valerian is generally well-tolerated with infrequent and benign side effects 2, 4, this favorable safety profile does not compensate for its lack of demonstrated efficacy.

Common Pitfalls in Valerian Research and Use

• Methodological limitations: Many studies on valerian have significant methodological problems including:

  • Small sample sizes
  • Heterogeneous preparations and dosages
  • Lack of standardized outcome measures 2, 4

• Placebo effect: Any perceived benefits may be attributable to placebo effects rather than pharmacological action 4

• Self-medication without medical supervision: Patients often use valerian without informing healthcare providers, potentially delaying effective treatment

Conclusion for Clinical Practice

Despite its widespread use and perception as a "natural" remedy, the current evidence does not support recommending valerian for either insomnia or anxiety disorders. Clinicians should guide patients toward evidence-based treatments with proven efficacy rather than herbal supplements like valerian that lack substantial supporting evidence.