Ashwagandha for Sleep: What Trials Show and Who Should Skip It

Ashwagandha, an herb from traditional Ayurvedic medicine, now shows up in capsules, gummies and bedtime drinks promising calmer nights.¹ If menopause or stress is keeping you awake, here is what the research says and who should be careful.

What the trials show

A 2021 review of 5 randomized trials with 400 adults found a small but significant improvement in sleep with ashwagandha extract compared with placebo.² The effect was larger in:

• adults with diagnosed insomnia
• doses of at least 600 mg a day
• use for at least 8 weeks²

No serious side effects were reported, but the authors said more safety data are needed for long-term use.² The National Center for Complementary and Integrative Health (NCCIH)¹ says some preparations may help insomnia and stress, but notes that studies were small and used many different products.¹ There isn’t enough evidence to say whether it helps menopause symptoms.¹

Who should skip it or ask first

NCCIH lists these cautions:¹

• Thyroid or autoimmune conditions. Ashwagandha isn’t recommended.
• Upcoming surgery.
• Medicines for diabetes, blood pressure or thyroid, plus immune-suppressing drugs, sedatives and seizure medicines, because of possible interactions.

Side effects can include drowsiness, upset stomach, diarrhea and vomiting. It may be safe for up to 3 months, but long-term safety isn’t known.¹

The liver warning

Rare cases of liver injury have been linked to ashwagandha supplements.¹ The NIH LiverTox³ database says these usually appeared 2 to 12 weeks after starting, often with jaundice and itching, and most cleared within 1 to 4 months of stopping. Rare deaths or transplants occurred, mostly in people with existing liver disease. Some products may be mislabeled or mixed with other herbs.³

If you decide to try it

1. Check with your clinician first if you take any of the medicines above or have thyroid or liver problems.
2. Pick a single-ingredient product and note the dose and plant part.
3. Set a time limit, such as 8 weeks, and track your sleep.
4. Stop and call for yellow skin or eyes, dark urine or itching.³

Our articles on melatonin, magnesium and CBD gummies cover other popular sleep supplements.

Try: “I’ve been sleeping badly and I’m thinking about ashwagandha. Is it safe with my thyroid medicine and blood pressure pills, or is there something better to try first?”

Did I Do That in My Sleep? includes a 14-Night Lights-Out Record and a Visit Brief. Use them to log your sleep, supplements and medicines before your appointment. See the book.