Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Insomnia and Anxiety: A Double-blind, Randomized, Placebo-controlled Study

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TL;DR

Ashwagandha root extract reduced time to fall asleep and improved sleep efficiency in an 8-week study of 80 people, with larger effects in insomnia patients than healthy controls . The supplement was well-tolerated with no serious adverse events reported.

What the Study Found

Researchers divided 80 participants into two groups: 40 healthy sleepers and 40 with diagnosed insomnia. Within each group, participants were randomized to receive either ashwagandha root extract or placebo for 8 weeks. Sleep quality was measured using objective parameters (sleep onset latency, total sleep time, wake after sleep onset, sleep efficiency) and validated questionnaires (Pittsburgh Sleep Quality Index, Hamilton Anxiety Scale).

In the insomnia group, ashwagandha produced the most pronounced changes. Sleep onset latency—the time it takes to fall asleep—decreased significantly compared to placebo (p <0.0001). Sleep efficiency, the ratio of actual sleep to time spent in bed, also improved substantially (p <0.0001). Total sleep time increased (p <0.002), and time spent awake after initially falling asleep decreased (p <0.04). Anxiety scores on the Hamilton Anxiety Scale improved as well (p <0.05), and participants reported better mental alertness upon waking and overall sleep quality.

The healthy control group also showed improvements in sleep parameters with ashwagandha, though the effects were smaller. Sleep onset latency and sleep efficiency improved significantly in healthy participants receiving the supplement, but anxiety and alertness measures did not reach statistical significance in this group—suggesting the compound may have a more targeted effect on disrupted sleep patterns.

Both ashwagandha and placebo groups showed some improvements from baseline (the placebo effect), which is typical in sleep studies. However, ashwagandha consistently outperformed placebo across measured parameters. No serious adverse events were reported in either treatment group, and the supplement was well-tolerated across all age groups studied.

What This Means for You

This study adds to the evidence base for ashwagandha as a sleep aid, particularly for people with insomnia rather than those with normal sleep. The improvements in sleep onset latency and efficiency are clinically meaningful—falling asleep faster and spending less time awake during the night directly impact sleep quality.

The anxiety reduction observed in insomnia patients aligns with ashwagandha's traditional use as an adaptogen and suggests the sleep benefits may partly work through anxiety reduction. If you're considering this supplement, the 8-week timeframe in this study suggests you shouldn't expect immediate results; consistent use over weeks appears necessary.

The safety profile here is encouraging—no dropouts due to adverse events and no serious safety signals. However, this was a relatively short study in a limited sample. Individual responses vary, and ashwagandha can interact with certain medications, particularly those affecting the immune system or sedating drugs. Discuss with your provider before starting, especially if you take other medications or have thyroid conditions.

Study Details

Sources

Lopresti AL, Smith SJ, Malvi H, Kodgule R. Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Insomnia and Anxiety: A Double-blind, Randomized, Placebo-controlled Study. Cureus. 2020. https://pubmed.ncbi.nlm.nih.gov/32818573/

Study Limitations: This study, while rigorous in design, had a relatively small sample size (80 participants total) and short 8-week duration. The findings are from a single trial; replication in larger, longer-term studies would strengthen the evidence base. Dosing specifics and extract standardization details would help determine if results apply to other ashwagandha products.

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