From the Guidelines
Ashwagandha is not recommended as a treatment for insomnia due to a lack of strong evidence supporting its effectiveness for this condition. The American College of Physicians 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. While ashwagandha may have some benefits for stress and anxiety, its use for insomnia is not supported by high-quality evidence.
Key Considerations
- The goal of treatment for insomnia is to improve sleep and alleviate distress or dysfunction caused by the disorder.
- Cognitive behavioral therapy for insomnia (CBT-I) is the recommended initial treatment for chronic insomnia disorder, with a strong recommendation and moderate-quality evidence 1.
- Pharmacologic treatments, such as eszopiclone, zolpidem, and suvorexant, may improve short-term global and sleep outcomes for adults with insomnia disorder, but their comparative effectiveness and long-term efficacy are not known, and they may cause cognitive and behavioral changes and may be associated with infrequent but serious harms 1.
Important Notes
- Insomnia is a major health care problem in the United States, affecting approximately 6% to 10% of adults, and is associated with difficulty initiating or maintaining sleep and early-morning waking with inability to return to sleep.
- The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and the International Classification of Sleep Disorders have similar criteria for diagnosing chronic insomnia disorder, which requires symptoms to cause clinically significant functional distress or impairment, be present for at least 3 nights per week for at least 3 months, and not be linked to other sleep, medical, or mental disorders.
From the Research
Ashwagandha Effects
- Ashwagandha has been shown to have a significant reduction in stress and anxiety in healthy adults, as demonstrated in a double-blind, randomized, placebo-controlled clinical study 2.
- A standardized Ashwagandha root extract has been found to alleviate stress, anxiety, and improve quality of life in healthy adults by modulating stress hormones 3.
- Ashwagandha supplementation has been shown to significantly reduce anxiety and stress levels compared to a placebo, with a favorable effect on anxiety until 12,000 mg/d and stress at a dose of 300-600 mg/d 4.
Ashwagandha and Sleep Quality
- Ashwagandha has been found to improve sleep quality in healthy adults, with participants receiving Ashwagandha having significant improvement in sleep quality compared to the placebo group 2.
- A qualitative analysis of a double-blind randomized control trial found that Ashwagandha increased college students' perceived well-being through supporting sustained energy, heightened mental clarity, and enhanced sleep quality 5.
- A quantitative analysis of a double-blind randomized control trial found that Ashwagandha affected final sleep, with the Ashwagandha group having higher sleep scores than the placebo group 6.
Ashwagandha and Mental Clarity
- Ashwagandha has been found to improve mental clarity in college students, with participants reporting heightened mental clarity after taking Ashwagandha for 30 days 5.
- A systematic review and meta-analysis found that Ashwagandha supplementation significantly reduced anxiety and stress levels, which can improve mental clarity 4.
Ashwagandha and Food Cravings
- Ashwagandha has been found to reduce food cravings in college students, with the Ashwagandha group experiencing lower cravings than the placebo group over time 6.