herb · for poor sleep quality
Ashwagandha
Lowers stress hormones, which is often what is keeping sleep shallow.
Say that in clinical terms
Ashwagandha improves sleep quality via cortisol reduction, GABAergic modulation, and the sleep-inducing compound triethylene glycol. Studies show significant improvements in Pittsburgh Sleep Quality Index scores.
How strong is the research?
Solid evidence
Only one studyStudied in a narrower groupIndustry funded
1 paper read, 1 supporting.
Who was studied: Studied in adults with diagnosed insomnia who were also anxious.
How much to take
daily with evening dose
300–600 mg
Take 300mg with dinner. May improve overall sleep quality scores and reduce time to fall asleep.
Before you take it
- Hepatotoxicity documented in NIH LiverTox (NBK548536): case reports of clinically apparent liver injury including fatal acute liver failure; doses in case reports ranged from 450–1,350 mg/day; withanolides are the prime suspect; avoid in pre-existing liver disease or with concurrently hepatotoxic medications.
- Contraindicated in pregnancy: historically used as an abortifacient; animal studies demonstrate fetal harm; insufficient human safety data to establish a safe dose during pregnancy.
- May elevate thyroid hormones (T3 and T4): avoid in hyperthyroidism or when co-administering thyroid hormone medications.
- Potentiates CNS depressants (benzodiazepines, z-drugs, sedatives, alcohol): additive CNS depression risk.
- In vitro CYP2D6 and CYP3A4 inhibition observed: clinical significance uncertain; flag in any polypharmacy context.
- Immunostimulatory activity: may counteract immunosuppressive therapy in transplant recipients or patients treated for autoimmune disease.
- No established Tolerable Upper Intake Level (UL): NIH ODS has not defined a UL for ashwagandha; long-term safety beyond 8–12 weeks has not been adequately studied in controlled trials.
- Additive sedation risk: ashwagandha potentiates CNS depressants; patients seeking treatment for poor sleep quality may be concurrently using prescription sleep medications (z-drugs, benzodiazepines), creating a clinically relevant additive sedation risk
When to take it
Best taken: evening