Systematic reviewPending medical review

The question: Does ashwagandha extract improve sleep in adults, compared with placebo?
Who was studied: 400 adults in five randomised trials, pooled in a 2021 systematic review. Some of the trials enrolled people diagnosed with insomnia.
What they took: Ashwagandha extracts against placebo. The extracts, the amounts and the length of treatment differed from trial to trial.
What happened: Taken together, ashwagandha improved overall sleep by a small but significant amount: a standardised mean difference of -0.59 (95% CI -0.75 to -0.42). That measure lets reviewers combine trials that used different sleep scales. The effect looked larger in adults with insomnia and in the longer, higher-dose trials. Quality of life did not improve significantly, and no serious side effects were reported.[1]
How strong is this: A pooled analysis of randomised trials usually carries more weight than any single trial. This one rests on only five trials, and their results varied a fair amount, so the single pooled number is less certain than it looks.

The limits

Five trials and 400 people in all.
The trials used different extracts, amounts and durations, and their results disagreed more than chance would explain (I2 = 62%, a measure of how much trials differ).
The reviewers say data on serious side effects are limited, and more safety data are needed before long-term use can be judged.
The bigger effects in some groups (people with insomnia, higher doses, longer treatment) are leads for future trials. They are not a recommended dose.
Liver injury has been reported with supplements containing ashwagandha. A review of five trials does not settle that risk.

Who paid for it

The review's authors say it was unfunded. Who paid for each of the five trials it pooled was not checked in our research.

Questions people ask

Does ashwagandha help insomnia?

In this review the effect on sleep was more noticeable in adults diagnosed with insomnia. That is a subgroup of a small set of trials, so it is a question worth testing properly, not a settled answer.[1]

Can I take ashwagandha for sleep every night, long term?

Nobody knows yet. The reviewers found too little information on serious side effects to judge long-term use. If you take sleeping tablets or other medicines, tell your doctor before you add ashwagandha.[1]

Can ashwagandha harm the liver?

Liver injury has been reported. A 2020 case series from Iceland and the US described five people with liver injury put down to supplements containing ashwagandha. Case reports cannot show how often this happens, and a review of five trials cannot settle it.[2][3]

Evidence

Sources

Awaiting review by The Good Vaidya Medical Board. Prepared from the sources below and checked against each one.

Published 4 November 2026 · Last updated 4 November 2026

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Does ashwagandha improve sleep?

The limits

Who paid for it

Questions people ask

Related

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Ashwagandha with sleeping pills and benzodiazepines

Sources