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Apigenin and sleep quality: grade C

Limited evidence. Direction: Benefit.

C LimitedSubjective outcome onlyShort-term only

Educational guidance, not medical advice

Why this grade

Rubric condition met: Pooled estimates mix healthy and clinical populations with no healthy-only estimate; evidence is for chamomile extract or tea, not isolated apigenin

A 2024 meta-analysis of 5 trials found chamomile lowered Pittsburgh Sleep Quality Index scores by 1.88 points, with very high heterogeneity (I2 88.4%), in a review that pooled healthy and diseased adults. A 2019 meta-analysis also found better sleep quality. The positive trials were small and lasted 2-4 weeks: a single-blind trial in older adults and a quasi-randomized trial without placebo in postnatal women that was positive on one sleep subscale, while a double-blind pilot in adults with chronic insomnia found no significant difference in diary sleep quality. No trial tested isolated apigenin, so the grade applies to chamomile extract or tea and is capped at C (G4).

How we grade evidence

Studies this grade rests on

EffectMixedNo effectSize shows participants (n)2010201520202025Meta-analysisRCTKazemi 2024, 2024: meta-analysis, n = 772, result not recordedChang 2016, 2016: RCT, n = 80, result not recordedAdib-Hajbaghery 2017, 2017: RCT, n = 60, result not recordedZick 2011, 2011: RCT, n = 34, result not recordedHieu 2019, 2019: meta-analysis, n not recorded, result not recorded
each study this grade rests on, by publication year and design. Solid: effect versus the comparator; half-filled: mixed; hollow: no effect; dashed: result not recorded yet. Larger marks had more participants.
Show the numbers
StudyYearDesignParticipantsResult
Zick 20112011RCT34result not recorded
Chang 20162016RCT80result not recorded
Adib-Hajbaghery 20172017RCT60result not recorded
Hieu 20192019meta-analysisnot recordedresult not recorded
Kazemi 20242024meta-analysis772result not recorded

Effects of an intervention with drinking chamomile tea on sleep quality and depression in sleep disturbed postnatal women: a randomized controlled trial.

Chang SM, Chen CH. Effects of an intervention with drinking chamomile tea on sleep quality and depression in sleep disturbed postnatal women: a randomized controlled trial J Adv Nurs, 2016. PMID 26483209

Result not recorded
Design
Quasi-randomized controlled trial (systematic assignment with a random start), 2 weeks, usual-care control (no placebo)
Sample
n = 80
Population
Postnatal women with poor sleep quality (Taiwan)
Funding
National Science Council (Crossref funder)

The effects of chamomile extract on sleep quality among elderly people: A clinical trial.

Adib-Hajbaghery M, Mousavi SN. The effects of chamomile extract on sleep quality among elderly people: A clinical trial Complement Ther Med, 2017. PMID 29154054

Result not recorded
Design
Single-blind randomized controlled trial, 28 days
Sample
n = 60
Population
Adults aged 60 or over at a nursing-home day-care center (Iran)
Funding
Research Council of Kashan University of Medical Sciences (Crossref funder)

Preliminary examination of the efficacy and safety of a standardized chamomile extract for chronic primary insomnia: a randomized placebo-controlled pilot study.

Zick SM, Wright BD, Sen A. Preliminary examination of the efficacy and safety of a standardized chamomile extract for chronic primary insomnia: a randomized placebo-controlled pilot study BMC Complement Altern Med, 2011. PMID 21939549

Result not recorded
Design
Randomized, double-blind, placebo-controlled pilot trial, 28 days
Sample
n = 34
Population
Adults 18-65 with chronic primary insomnia (clinical population)
Funding
University of Michigan Department of Family Medicine seed grant; Michigan Institute for Clinical and Health Research (NIH UL1RR024986); study product supplied by the manufacturer, MediHerb

Therapeutic efficacy and safety of chamomile for state anxiety, generalized anxiety disorder, insomnia, and sleep quality: A systematic review and meta-analysis of randomized trials and quasi-randomized trials.

Hieu TH, Dibas M, Surya Dila KA. Therapeutic efficacy and safety of chamomile for state anxiety, generalized anxiety disorder, insomnia, and sleep quality: A systematic review and meta-analysis of randomized trials and quasi-randomized trials Phytother Res, 2019. PMID 31006899

Result not recorded
Design
Systematic review and meta-analysis of 12 randomized and quasi-randomized trials
Population
Mixed: state anxiety, generalized anxiety disorder, insomnia and sleep-quality trials
Funding
Joint Usage/Research Center on Tropical Disease, Nagasaki University; Institute of Allied Health Sciences, National Cheng Kung University (PubMed grant list)

Effects of chamomile (Matricaria chamomilla L.) on sleep: A systematic review and meta-analysis of clinical trials.

Kazemi A, Shojaei-Zarghani S, Eskandarzadeh P. Effects of chamomile (Matricaria chamomilla L.) on sleep: A systematic review and meta-analysis of clinical trials Complement Ther Med, 2024. PMID 39106912

Result not recorded
Design
Systematic review and meta-analysis of 10 clinical trials
Sample
n = 772
Population
Healthy or diseased adults (mixed populations)
Funding
not stated in the PubMed or Crossref record; authors declare no competing interests

Search and history

Search (): chamomile[ti] AND (sleep[tiab]) AND (meta-analysis[pt] OR systematic review[pt])

  • Graded C (proposed): Proposed in the monograph draft
  • C to C (approved): Editor sign-off November 13, 2026: grade matches the editor-approved final page