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Ashwagandha and sleep quality: grade B

Moderate evidence. Direction: Benefit.

B ModerateShort-term only

Educational guidance, not medical advice

Why this grade

Rubric condition met: Meta-analysis with high heterogeneity (5 RCTs, I2 = 62%) plus 1 large RCT (n = 150)

A meta-analysis of 5 RCTs (400 participants) found a small effect on overall sleep, larger in adults diagnosed with insomnia, a clinical subgroup; all trials were run in India. A 150-person RCT in healthy adults with non-restorative sleep, with the extract maker listed as funder, found better self-reported and actigraphy sleep measures over six weeks. Healthy-adult evidence is thinner than the pooled figure suggests.

How we grade evidence

Studies this grade rests on

EffectMixedNo effectSize shows participants (n)202020252030Meta-analysisRCTCheah 2021, 2021: meta-analysis, n = 400, result not recordedDeshpande 2020, 2020: RCT, n = 150, result not recordedLangade 2021, 2021: RCT, n = 80, 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
Deshpande 20202020RCT150result not recorded
Langade 20212021RCT80result not recorded
Cheah 20212021meta-analysis400result not recorded

Clinical evaluation of the pharmacological impact of ashwagandha root extract on sleep in healthy volunteers and insomnia patients: A double-blind, randomized, parallel-group, placebo-controlled study.

Langade D, Thakare V, Kanchi S. Clinical evaluation of the pharmacological impact of ashwagandha root extract on sleep in healthy volunteers and insomnia patients: A double-blind, randomized, parallel-group, placebo-controlled study J Ethnopharmacol, 2021. PMID 32818573

Result not recorded
Design
Randomized, double-blind, parallel-group, placebo-controlled multicentre trial, 8 weeks
Sample
n = 80
Population
40 healthy adults and 40 adults with insomnia (clinical population)
Funding
not stated in PubMed or Crossref record (full text not open)

A randomized, double blind, placebo controlled study to evaluate the effects of ashwagandha (Withania somnifera) extract on sleep quality in healthy adults.

Deshpande A, Irani N, Balkrishnan R. A randomized, double blind, placebo controlled study to evaluate the effects of ashwagandha (Withania somnifera) extract on sleep quality in healthy adults Sleep Med, 2020. PMID 32540634

Result not recorded
Design
Randomized, double-blind, placebo-controlled trial, 6 weeks
Sample
n = 150
Population
Healthy adults scoring high on non-restorative sleep measures
Funding
Arjuna Natural Private Ltd., Kerala (Crossref funder)

Effect of Ashwagandha (Withania somnifera) extract on sleep: A systematic review and meta-analysis.

Cheah KL, Norhayati MN, Husniati Yaacob L. Effect of Ashwagandha (Withania somnifera) extract on sleep: A systematic review and meta-analysis PLoS One, 2021. PMID 34559859

Result not recorded
Design
Systematic review and meta-analysis of 5 RCTs
Sample
n = 400
Population
Adults 18 and over, including adults diagnosed with insomnia (clinical subgroup)
Funding
Unfunded study (paper)

Search and history

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

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