From the Guidelines
Ashwagandha is not recommended for the treatment of insomnia based on the provided evidence. The most recent and highest quality study, published in 2020 in the Annals of Internal Medicine 1, does not support the use of herbal supplements, including ashwagandha, for the treatment of chronic insomnia disorder. Instead, the study recommends cognitive behavioral therapy for insomnia (CBT-I) as the initial treatment for chronic insomnia disorder, with a strong recommendation and moderate-quality evidence 1.
Some key points to consider:
- The evidence does not support the use of herbal supplements, including valerian, chamomile, and kava, for the treatment of insomnia 1.
- Melatonin is also not recommended for the treatment of chronic insomnia disorder, as the evidence is unclear and the clinical significance of the findings is uncertain 1.
- Antipsychotics, such as quetiapine, have been used to treat insomnia disorder, but the evidence supporting their use is sparse and unclear, and they are known to cause harms 1.
- Ashwagandha may be recommended for some individuals, particularly those experiencing stress, anxiety, or certain inflammatory conditions, but its use should be approached with caution and under the guidance of a healthcare provider, especially if you have existing health conditions or take other medications, as individual responses vary and potential interactions exist.
It is essential to prioritize the treatment of insomnia based on the strongest and most recent evidence, which recommends CBT-I as the initial treatment for chronic insomnia disorder. Other treatments, including herbal supplements and medications, should be used with caution and under the guidance of a healthcare provider.
From the Research
Ashwagandha Recommendation
The recommendation of Ashwagandha (Withania somnifera) is supported by several studies that have investigated its potential benefits on stress, anxiety, and overall well-being.
- Ashwagandha has been found to have antioxidant, anti-inflammatory, and neuroprotective effects, which may contribute to its potential benefits on mental health 2.
- A randomized, double-blind, placebo-controlled study found that Ashwagandha root extract alleviated stress, anxiety, and improved quality of life in healthy adults by modulating stress hormones 3.
- Another study found that Ashwagandha root extract containing withanolide A alleviated depression-like behavior in mice by enhancing the brain-derived neurotrophic factor pathway under unexpected chronic mild stress 4.
- A systematic review and meta-analysis of randomized controlled trials found that Ashwagandha supplementation had a beneficial effect on the management of anxiety and stress, with significant reductions in anxiety and stress levels compared to placebo 5.
- A systematic review and meta-analysis of randomized controlled trials also found that Ashwagandha formulations had beneficial effects on stress and anxiety, with significant improvements in perceived stress scale, Hamilton anxiety scale, and serum cortisol levels compared to placebo 6.
Potential Benefits
The potential benefits of Ashwagandha include:
- Reduction in stress and anxiety levels
- Improvement in quality of life
- Enhancement of cognitive function
- Antioxidant and anti-inflammatory effects
- Neuroprotective effects
Safety and Efficacy
While the available evidence suggests that Ashwagandha may have potential benefits on mental health, it is essential to note that the certainty of the evidence is generally low, and further high-quality studies are needed to firmly establish its clinical efficacy and safety 5, 6. Additionally, Ashwagandha may be associated with mild to moderate adverse events, and its long-term safety profile is not well established 6.