Valerian Root for Insomnia & Sleep: Is It Actually Effective? (2023 Review)

Valerian, a herb long cherished for its sedative properties, stands at the crossroads of traditional medicine and modern scientific inquiry.

Despite its widespread use across cultures for promoting sleep and alleviating insomnia, the scientific community remains divided over its efficacy.

Highlights:

1. Historical Significance: Valerian has been used since the times of ancient Greece and Rome as a remedy for sleep disorders and anxiety.
2. Scientific Scrutiny: Despite numerous studies, scientific evidence regarding valerian’s effectiveness for treating insomnia remains inconclusive.
3. Safety Profile: Generally considered safe, valerian has been reported to cause mild side effects, such as headaches and dizziness, in a small fraction of users.
4. Research Recommendations: Current research underscores the need for high-quality randomized controlled trials to conclusively determine valerian’s efficacy and safety.

Source: European Neuropsychopharmacology (2023)

Historical Use of Valerian for Sleep and Insomnia

Valerian (Valeriana officinalis) has a long-standing history as a herbal remedy, dating back over 2,000 years.

Its use was documented in ancient Greece and Rome, where it was prescribed for a range of ailments including sleep disorders, anxiety, and even epilepsy.

Historically, valerian was valued for its sedative and calming properties, making it a popular choice for those suffering from insomnia and nervous restlessness.

By the 18th and 19th centuries, valerian had become a staple in traditional medicine cabinets across Europe and America, solidifying its reputation as a natural sleep aid.

Valerian’s Mechanisms in Insomnia & Sleep (Hypothesized)

The sedative and hypnotic effects of valerian are attributed to its complex chemical makeup, which includes a variety of active compounds that interact with the central nervous system.

The primary mechanism through which valerian is thought to promote sleep involves its influence on the gamma-aminobutyric acid (GABA) system, a key neurotransmitter pathway involved in regulating neuronal excitability and sleep.

Valerian Components & Effects

• Valerenic Acids: These compounds are believed to inhibit the breakdown of GABA in the brain, thereby increasing its availability and promoting sedation. Valerenic acids are thought to directly interact with the GABA_A receptor, enhancing the binding of GABA to its receptor and increasing its inhibitory effects on the central nervous system.
• Iridoids (including Valepotriates): Although less understood, these compounds are also considered to contribute to valerian’s sedative effects. However, their instability during the extraction process and potential transformation into less active forms have made it challenging to fully assess their role in sleep enhancement.
• Isovaleric Acid: This component is suggested to have a direct sedative effect on the central nervous system, contributing to the overall calming properties of valerian. It may also reduce muscle spasms, which can be beneficial for individuals with sleep disturbances related to physical discomfort.
• Flavonoids and Other Phytochemicals: Valerian contains numerous flavonoids, which are known for their anxiolytic and calming effects. These compounds may synergistically contribute to the herb’s ability to improve sleep quality.

Mechanisms of Valerian’s Action on Sleep

Modulation of the GABA Neurotransmitter System The prevailing theory is that valerian enhances GABA signaling in the brain. GABA is crucial for regulating neuronal excitability throughout the nervous system. By increasing GABA availability or enhancing its effects at the receptor level, valerian may promote relaxation and facilitate the onset of sleep.

Interactions with Other Neurotransmitter Systems Apart from the GABA system, valerian is also thought to interact with adenosine and serotonin receptors, which play roles in sleep regulation and mood. However, the extent and implications of these interactions require further investigation to fully understand.

Influence on Sleep Architecture Research suggests that valerian may positively impact sleep architecture, leading to a reduction in sleep latency and an increase in sleep quality. Some studies have shown that valerian use is associated with an increase in the proportion of deep sleep stages, contributing to more restorative sleep.

Major Findings: Valerian for Insomnia (2023 Review)

 

Valente et al. conducted an umbrella review of valerian’s efficacy for treating insomnia and sleep disturbances – below are the major findings.

1. Efficacy of Valerian for Insomnia

• Lack of Strong Evidence for Insomnia Treatment: The review found no compelling evidence to support valerian’s use as an effective treatment for insomnia. While some studies reported subjective improvements in sleep quality, these findings were not consistently supported by objective or quantitative measures.
• Subjective Sleep Quality Improvement: A subset of the data suggested that valerian might help improve subjective sleep quality for some individuals. However, this effect was not universally observed across all studies, and the methodology of the studies reporting these benefits was often questioned for their quality and heterogeneity.

2. Safety Profile

• Generally Safe with Few Side Effects: Valerian is characterized by a good safety profile, with few reported adverse effects at recommended dosages. The most commonly noted side effects were mild and included gastrointestinal disturbances and dizziness, which were not significantly different from placebo effects.
• Consideration for Long-term Use: Although valerian is deemed safe for short-term use, the review highlighted a lack of data on the safety and efficacy of long-term valerian use, necessitating caution and further research.

3. Heterogeneity & Methodological Quality

• High Degree of Heterogeneity: The review underscored a significant heterogeneity among included studies, regarding population samples, valerian dosages and preparations, and outcome measures. This heterogeneity complicates the ability to draw firm conclusions about valerian’s efficacy.
• Methodological Quality Concerns: A majority of the systematic reviews and meta-analyses were rated as having critically low or low methodological quality. Issues such as risk of bias, inadequate reporting of study design, and lack of protocol pre-registration were identified as major concerns, potentially affecting the reliability of the findings.

4. Recommendations for Future Research

• Need for High-Quality Randomized Controlled Trials (RCTs): The review calls for more rigorously designed RCTs to explore valerian’s efficacy in insomnia treatment. These studies should aim to minimize bias, use standardized valerian preparations, and include both subjective and objective sleep measures.
• Exploration of Mechanisms of Action: Despite the inconclusive evidence for efficacy, the review points to the need for further investigation into the mechanisms by which valerian might affect sleep, particularly its interaction with the GABA system.

(Related: Valerian for Anxiety Disorders)

Valerian for Insomnia Treatment (2023 Review)

Valente et al. conducted an umbrella review of systematic reviews and meta-analyses investigating the efficacy and safety of valerian in treating insomnia.

Methods

• The methodology involved conducting systematic searches across multiple databases, including PubMed, Web of Science, Scopus, Cochrane Database of Systematic Reviews, PROSPERO, and CNKI, to retrieve relevant records.
• Only articles that were systematic reviews or meta-analyses, which included randomized controlled trials (RCTs) and observational studies on the efficacy and/or safety of valerian for insomnia, were considered.
• The study meticulously screened and selected articles based on predefined inclusion and exclusion criteria, ensuring a rigorous analysis process.

Findings

• Safety Profile: The study confirmed valerian’s good safety profile, highlighting no significant adverse effects at recommended doses.
• Efficacy for Insomnia: Results did not demonstrate substantial evidence supporting valerian’s efficacy in treating insomnia. While some subjective improvements in sleep quality were reported, these findings were not corroborated by objective measurements or quantitative data.
• Subjective Sleep Quality: Despite the lack of evidence for treating insomnia, valerian appeared to show some effectiveness in subjectively improving sleep quality among users. However, this effect has not been consistently demonstrated across studies.

Limitations

• Heterogeneity of Studies: The included systematic reviews and meta-analyses were highly heterogeneous in terms of methodology, populations studied, valerian preparations used, and outcome measures, complicating the process of drawing definitive conclusions.
• Low Methodological Quality: A majority of the reviews were rated as having critically low or low methodological quality, which could influence the reliability of the findings.
• Bias Risk: The presence of high risk of bias in the included reviews further challenges the strength of the evidence supporting valerian’s efficacy in insomnia treatment.
• Overlap of Primary Studies: The calculated corrected covered area (CCA) indicated a high degree of overlap among primary studies included in the reviews, potentially skewing the results.

Should People Use Valerian for Insomnia?

Given the mixed evidence, individuals considering valerian for insomnia should do so with a few considerations in mind.

• Consult a Healthcare Provider: Before starting any new supplement, including valerian, consult with a healthcare provider, especially if you have underlying health conditions or are taking other medications, to avoid potential interactions.
• Consideration of Evidence: Recognize that while some people may experience subjective improvements in sleep quality, these benefits are not consistently backed by scientific evidence.

Recommendations for Safe Use

• Quality Supplements: Opt for valerian products from reputable sources that adhere to good manufacturing practices. Quality can vary widely between products, affecting efficacy and safety.
• Appropriate Dosage: Most studies on valerian for sleep suggest a dosage range from 300 to 600 mg, taken approximately 30 minutes to two hours before bedtime. However, dosages can vary depending on the specific product and concentration of valerian extract. Follow the recommended dosage on the product label or consult a healthcare professional.
• Short-term Use: Valerian is generally considered safe for short-term use (4-6 weeks). The safety of long-term use is not well-documented, and it’s advisable to use valerian for the shortest duration necessary.
• Monitor for Side Effects: While valerian is considered safe with few reported side effects, individuals should monitor for any adverse reactions, such as gastrointestinal discomfort, dizziness, or any signs of allergic reaction. Discontinue use and seek medical advice if adverse effects occur.
• Avoid Use with Other Sedatives: Valerian can enhance the sedative effects of other medications and alcohol, so it’s important to avoid concurrent use unless under the supervision of a healthcare provider.

(Related: Valerian Side Effects & Adverse Reactions)

Conclusion: Valerian for Insomnia & Sleep

• Paper: Does valerian work for insomnia? An umbrella review of the evidence (2024)
• Authors: Valéria Valente et al.

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