Thinking Of Trying Valerian Root For Sleeping? Here's What Science Says About The "Best" Herbal Remedies For Insomnia
Key Findings / Quick Summary
A comprehensive review of scientific studies (Leach & Page, 2015) found insufficient evidence to confirm that common herbal monopreparations like valerian, chamomile, kava, or wuling effectively treat insomnia.
Across various sleep measures, these herbs generally performed no better than a placebo (an inactive substance) or other active control treatments.
While most herbal medicines reviewed appear relatively safe with few side effects reported, the quality of many studies was not ideal, making firm conclusions difficult. More high-quality research is needed.
Herbal Medicines For Insomnia
Struggling to get a good night's sleep is a common frustration. And when sleep difficulties like insomnia can leave you feeling tired, irritable, and unable to function at your best during the day, it's not surprising that many individuals seek out solutions to find relief from their sleep problems, with herbal medicine being a popular choice.
But when you're struggling with sleeplessness (and spending your money), you need to know: do these remedies actually work, and are they safe?
A comprehensive systematic review and meta-analysis published in Sleep Medicine Reviews by Matthew J. Leach and Amy T. Page (2015) sought to answer these very questions by examining the best available scientific evidence on commonly used herbal remedies for insomnia and sleep difficulties.
How Common Is The Use Of Herbal Medicines For Insomnia?
Herbal medicine is one of the most frequently used complementary and alternative medicines (CAM) treatments for insomnia (Pearson et al., 2006; Sanchez-Ortuno et al., 2009). A 2002 US National Health Interview Survey revealed that nearly 3% of insomnia sufferers in the US, equating to over a million people, used biologically-based therapies, including herbal medicines, for their condition (Leach & Page, 2015).
Why Consider Herbal Remedies For Sleep Problems?
Herbal remedies are commonly used by insomnia sufferers primarily because standard medical treatments for insomnia, like benzodiazepines and Z-drugs (think zolpidem and zopiclone), can come with a list of concerns, including dependency and side effects like headaches, nightmares, daytime fatigue, nausea, confusion, and even falls (Leach & Page, 2015). Not exactly appealing.
These concerns, coupled with a genuine interest in trying new therapies or a belief in holistic healthcare, often lead individuals towards complementary and alternative medicines (CAM).
Which Herbal Supplements Are Commonly Used For Insomnia?
Plants like chamomile, valerian, hops, and lemon balm have been used for ages in traditional practices to help with sleep. There's even some scientific basis suggesting these plants might work by interacting with brain chemicals involved in sleep, like GABA (gamma-amino butyric acid) (Leach & Page, 2015). So, the idea isn't totally out there.
But what does rigorous research tell us about their effectiveness? And does "natural" automatically mean effective and safe? With so many people using herbal supplements for insomnia, it’s a key “need to know”.
That's what the researchers at the heart of the 2015 review aimed to find out.
Which Herbal Supplements Did This Systematic Review And Meta-Analysis Put Under The Microscope?
Leach and Page (2015) conducted a thorough search across seventeen electronic databases to find all relevant randomised controlled trials (RCTs) – the gold standard for clinical research. Their goal:
to evaluate the safety and efficacy of herbal medicines for adults dealing with insomnia (Leach & Page, 2015).
The review included:
14 RCTs;
The studies included a collective 1602 participants diagnosed with insomnia (so not just occassional sleep complaints)
The researchers focused on orally administered mono-preparations, meaning single herbs rather than combination formulas.
The researchers identified studies on four distinct herbs:
Valerian: This was the most commonly studied herb, with twelve trials included.
Kava: Investigated in one study.
Wuling: Also tested in one study.
Chamomile (Matricaria recutita): Featured in one study.
The primary outcomes looked for were changes in:
Sleep onset latency: How long it takes to fall asleep.
Number of nocturnal awakenings: How many times a person wakes up during the night.
Wake after sleep onset (WASO) time: The amount of time spent awake after initially falling asleep.
Wake duration: Similar to WASO.
Sleep duration: Total time spent asleep.
Sleep efficiency: The percentage of time in bed that is actually spent asleep.
Incidence and type of adverse effects: Any side effects experienced.
They also looked at secondary outcomes like daytime functioning, sleep scores from standardized scales (e.g., Pittsburgh Sleep Quality Index [PSQI]), and quality of life (Leach & Page, 2015).
What Were the Specific Findings for Common Herbal Treatments?
The data for each herb was compared to placebo or, in a few cases, an active medication. Here’s a breakdown of what the evidence showed for each:
Valerian: Any Better Than a Placebo?
Valerian is perhaps one of the most well-known herbs for sleep. Leach and Page (2015) noted that twelve studies in their review tested valerian. However, when the data from comparable studies were pooled together, the results were not encouraging for those seeking definitive proof of its effectiveness.
Specifically, Leach and Page (2015) found:
Sleep Onset Latency:
There was no statistically significant difference in the time it took to fall asleep for participants taking valerian compared to those taking a placebo.
The average difference was about 9 minutes, but this finding could have occurred by chance.
Interestingly, Oxman et al. (2007) conducted a large trial that used a different (categorical) scale to measure sleep onset latency and found a result that was marginally significant, but it actually favoured the placebo group. Hmmm, sugar pill for sleep anyone?
Sleep Duration:
Similarly, valerian did not significantly increase total sleep time compared to placebo.
The average difference was negligible, less than two minutes.
Sleep Efficiency:
There was also no statistically significant improvement in sleep efficiency (the percentage of time in bed that is actually spent asleep) with valerian versus placebo (Leach & Page, 2015).
Does Chamomile Help With Sleep?
Chamomile tea is a popular evening drink, often associated with relaxation and sleep. There was only one rigorous study found, by Zick et al. (2011), that examined a standardized chamomile extract (Matricaria recutita) against a placebo in 34 adults with chronic primary insomnia.
The findings from this study indicated that chamomile did not produce statistically significant improvements in insomnia severity, sleep onset latency, wake after sleep onset (WASO) time, total sleep duration, number of nocturnal awakenings, daytime functioning, subjective sleep quality, or sleep efficiency (Zick et al., 2011).
Essentially, across all these sleep measures, chamomile performed similarly to the placebo (Zick et al., 2011).
Cup of hot water anyone?
Does Kava Help with Insomnia?
Kava has a reputation for its anxiolytic (anxiety-reducing) effects. Jacobs et al. (2005) conducted a large internet-based trial comparing kava to both valerian and a placebo for anxiety and insomnia.
Regarding insomnia, Jacobs et al. (2005) reported no statistically significant differences between kava and placebo for insomnia severity, sleep onset latency, or nocturnal awakenings.
Is Wuling a Promising Herb for Sleep?
Wuling, derived from the fungi Xylaria nigripes, is used in traditional Chinese medicine. The study included one multicenter RCT by Lin et al. (2013) from China that evaluated a Wuling capsule formula in 212 subjects with insomnia.
The results showed no statistically significant differences between wuling and placebo for sleep score (as assessed by a standardized scale) or four domains of quality of life (physical, psychological, environmental, and social relationships) (Lin et al., 2013).
Are Herbal Medicines Safe to Use for Insomnia?
An important aspect of any treatment is its safety profile. The researchers provided some insights here:
Are Chamomile and Kava Safe for sleep problems?
Fewer adverse events per person were reported among participants treated with chamomile or kava compared to placebo (Leach & Page, 2015).
For chamomile, Zick et al. (2011) found 0.4 events per person versus 0.6 for placebo, though this difference wasn't statistically significant.
For kava, Jacobs et al. (2005) reported 1.2 events per person, compared to 1.3 for placebo and 1.6 for valerian in the same study.
Is Wuling Safe for sleep problems?
Lin et al. (2013) found a similar number of adverse events per person for wuling (0.1 events/person) compared to placebo (0.08 events/person), with no statistically significant difference.
Is Valerian root safe for sleeplessness and insomnia problems?
The safety data for valerian was more complex. Overall, a greater number of adverse events per person were reported with valerian (1.3 events/person) compared to placebo (1.2 events/person) across eight trials (Leach & Page, 2015).
Jacobs et al. (2005) even noted a significantly greater incidence of diarrhoea in the valerian-treated group (18%) versus the placebo group (8%).
However, Leach and Page (2015) point out that "event/person" data can be skewed if a few individuals report many events. When looking at the number of participants experiencing adverse events, Donath et al. (2000) found in one trial that significantly fewer participants reported adverse effects with valerian (3 out of 16) compared to placebo (11 out of 16).
When valerian was compared to the prescription medication oxazepam, Ziegler et al. (2002) found no statistically significant difference in the number of adverse events reported.
Leach and Page (2015) cautiously conclude that findings from other reviews suggest herbal medicines are generally safe and well-tolerated for insomnia, but their own detailed findings show some nuances, particularly for valerian.
Why Isn't There Clearer Evidence For Herbals For Insomnia After So Many Studies?
One of the main reasons for the inconclusive findings is the methodological quality of the available research. Leach and Page (2015) highlighted that the risk of bias in most of the included studies was generally unclear. This was often due to:
Inadequate Reporting: Many studies did not describe their methods in sufficient detail (Leach & Page, 2015). This included insufficient information on how participants were randomized, whether allocation to treatment groups was concealed, and how blinding of participants and researchers was maintained and assessed (Leach & Page, 2015).
Poor Intervention Description: Descriptions of the herbal interventions themselves were frequently inadequate (Leach & Page, 2015). Details like the extraction solvent used or the drug-to-extract ratio were often missing, which can significantly impact a herbal product's properties and effects (Leach & Page, 2015).
Potential Biases: Most studies were judged to have a high risk of 'other' biases, such as sponsorship bias (who funded the study), sampling bias (how participants were selected), or ascertainment bias (how outcomes were assessed) (Leach & Page, 2015).
These limitations in the primary studies make it challenging to draw firm conclusions about whether the herbs truly don't work, or if the studies just weren't robust enough to detect an effect (Leach & Page, 2015).
The Bottom Line: Should You Use Herbal Medicines for Insomnia?
So, after all this, what's the takeaway if you're struggling with sleep?
Based on this systematic review and meta-analysis by Leach and Page (2015), there is currently insufficient evidence to conclude that the herbal medicines specifically studied – valerian, chamomile, kava, and wuling – are effective for treating insomnia in adults. Across various measures of sleep improvement, they generally performed no better than a placebo.
However, in terms of safety, these herbal monopreparations appear to be generally well-tolerated, with adverse event profiles often similar to placebo, particularly for chamomile, kava, and wuling (Leach & Page, 2015).
Valerian's safety profile was a bit more mixed in how it was reported, but didn't raise major alarms in these short-term studies.
In saying all that, if you’re disappointed about the herbals for sleep, this study doesn’t mean that a better study that’s longer, and with a better preparation method, or a different herb, might one day find something.
For now?
Our basic position is that these herbal preparations are most likely a waste of time and money. It should also be considered that there is a loss of quality of life while someone struggles along using something that is known to be ineffective. This especially when, for insomnia, there is a recommended first-line treatment that is non-drug and effective - CBT for insomnia.
But, if you're considering herbal remedies for insomnia, it’s always a good idea to chat with your healthcare provider. While the evidence for the effectiveness of herbals might be thin, discussing all your options can help you make an informed choice that's right for your sleep and overall health (and if you’re taking other medications for other conditions you should make sure these herbals don’t have negative interactions with the other pills you’re taking).
Frequently Asked Questions (FAQ) About Herbal Remedies and Insomnia
Q1: Are herbal remedies the best solution for insomnia?
A: Current scientific evidence from a major review suggests that common herbal remedies like valerian, chamomile, kava, and wuling may not be the "best" solution for insomnia, as they were generally found to be no more effective than a placebo (an inactive substance) in treating the condition.
Q2: Is valerian root effective for sleeping problems like insomnia?
A: Based on a comprehensive 2015 systematic review, valerian root showed no statistically significant improvement in the time it takes to fall asleep, total sleep duration, or overall sleep efficiency when compared to a placebo for individuals with insomnia.
Q3: Are natural herbal remedies for insomnia always safe to use?
A: While the 2015 review indicated that herbal medicines like valerian, chamomile, kava, and wuling appear relatively safe and generally well-tolerated in the short-term studies analysed, "natural" does not automatically mean a product is safe for everyone or in all circumstances. Some herbs can have side effects or interact with other medications. It is always recommended to discuss any herbal remedy use with your healthcare provider.
Q4: Why do people try herbal remedies for insomnia if the scientific evidence for effectiveness is weak?
A: Individuals often consider herbal remedies for insomnia due to concerns about the potential side effects or dependency associated with prescription sleep medications. Other motivating factors can include a preference for "natural" approaches, a desire to take an active role in their healthcare decisions, or beliefs in holistic health practices. Sometimes it can be as simple as not being aware the recommended treatment for insomnia is CBT for insomnia (CBT-i), a natural, drug-free therapy.
Q5: What should I do for my insomnia if these herbal remedies aren't scientifically proven to be effective?
A: If you are struggling with insomnia, the most effective step is to consult with a healthcare professional. They can help determine the underlying causes of your sleep problems and recommend evidence-based treatments. Cognitive Behavioral Therapy for Insomnia (CBT-I) is considered a first-line treatment for chronic insomnia and has strong scientific backing for its effectiveness without the need for medication.
References
Donath, F., Quispe, S., Diefenbach, K., Maurer, A., Fietze, I., & Roots, I. (2000). Critical evaluation of the effect of valerian extract on sleep structure and sleep quality. Pharmacopsychiatry, 33(2), 47-53.
Jacobs, B. P., Bent, S., Tice, J. A., Blackwell, T., & Cummings, S. R. (2005). An internet-based randomized, placebo-controlled trial of kava and valerian for anxiety and insomnia. Medicine (Baltimore), 84(4), 197-207.
Leach, M. J., & Page, A. T. (2015). Herbal medicine for insomnia: A systematic review and meta-analysis. Sleep Medicine Reviews, 24, 1-12.
Lin, Y., Wang, X. Y., Ye, R., Hu, W. H., Sun, S. C., Jiao, H. J., et al. (2013). Efficacy and safety of Wuling capsule, a single herbal formula, in Chinese subjects with insomnia: A multicenter, randomized, double-blind, placebo-controlled trial. Journal of Ethnopharmacology, 145(1), 320-327.
Oxman, A. D., Flottorp, S., Håvelsrud, K., Fretheim, A., Odgaard-Jensen, J., Austvoll-Dahlgren, A., et al. (2007). A televised, web-based randomised trial of an herbal remedy (valerian) for insomnia. PLOS ONE, 2(10), e1040.
Pearson, N., Johnson, L., & Nahin, R. (2006). Insomnia, trouble sleeping, and complementary and alternative medicine: Analysis of the 2002 National Health Interview Survey data. Archives of Internal Medicine, 166(16), 1775-1782.
Sanchez-Ortuno, M., Belanger, L., Ivers, H., LeBlanc, M., & Morin, C. (2009). The use of natural products for sleep: A common practice? Sleep Medicine, 10(9), 982-987.
Zick, S. M., Wright, B. D., Sen, A., & Arnedt, J. T. (2011). Preliminary examination of the efficacy and safety of a standardized chamomile extract for chronic primary insomnia: A randomized placebo-controlled pilot study. BMC Complementary and Alternative Medicine, 11, 78.
Ziegler, G., Ploch, M., Miettinen-Baumann, A., & Collet, W. (2002). Efficacy and tolerability of valerian extract LI 156 compared with oxazepam in the treatment of non-organic insomnia a randomized, double-blind, comparative clinical study. European Journal of Medical Research, 7(11), 480-486.
Written By The Better Sleep Clinic
Reviewed By Dan Ford, Sleep Psychologist, Registered Psychologist
