Safety and efficacy of Withania somnifera for anxiety and insomnia: Systematic review and meta-analysis

source extracted confidence: high 2026-04-09
#humans #sleep-initiation-and-maintenance-disorders #withania #plant-extracts #anxiety

Safety and efficacy of Withania somnifera for anxiety and insomnia: Systematic review and meta-analysis

Fatima et al., 2024 | Hum Psychopharmacol | Meta Analysis

Citation

Fatima Kaneez, Malik Javeria, ... Rashid Ahmed Mustafa. Safety and efficacy of Withania somnifera for anxiety and insomnia: Systematic review and meta-analysis. Hum Psychopharmacol. 2024-Nov;39(6):e2911. doi:10.1002/hup.2911

Abstract

OBJECTIVE: Despite the historical neurological use of Withania somnifera, limited evidence supports its efficacy for conditions like anxiety and insomnia. Given its known anti-stress properties, this review evaluated its safety and efficacy for anxiety and insomnia. METHODS: We searched Medline, Cochrane Library, and Google Scholar until August 2023 for randomized controlled trials (RCTs) comparing W. somnifera to placebo in patients with anxiety and/or insomnia. Outcome measures included changes in anxiety levels via the Hamilton Anxiety Scale (HAM-A), Sleep Onset Latency (SOL), Total Sleep Time (TST), Wake After Sleep Onset (WASO), Total Time in Bed (TIB), Sleep Efficiency (SE), and Pittsburgh Sleep Quality Index (PSQI) score. We utilized a random-effect model for pooling Mean Differences (MD) with a 95% Confidence Interval (CI). Heterogeneity was assessed through sensitivity and subgroup analysis, and the quality of RCTs was evaluated using the Cochrane revised risk of bias tool. RESULTS: Pooled results from five RCTs (n = 254) demonstrated that W. somnifera significantly reduced HAM-A scores (MD = -5.96; [95% CI -10.34, -1.59]; P = 0.008; I2 = 98%), as well as sleep parameters such as SOL, TST, PSQI, and SE, but not WASO and TIB. CONCLUSION: While W. somnifera extracts yielded promising results, further research with larger sample sizes is needed to confirm its effects on anxiety and insomnia.

Key Findings

Pooled results from five RCTs (n = 254) demonstrated that W. somnifera significantly reduced HAM-A scores (MD = -5.96; [95% CI -10.34, -1.59]; P = 0.008; I2 = 98%), as well as sleep parameters such as SOL, TST, PSQI, and SE, but not WASO and TIB.

Outcomes Measured

  • sleep quality
  • sleep onset latency
  • sleep efficiency
  • PSQI (Pittsburgh Sleep Quality Index)
  • anxiety

Population

Field Value
Population anxiety and
Sample Size 254
Age Range See abstract
Condition insomnia

MeSH Terms

  • Humans
  • Sleep Initiation and Maintenance Disorders
  • Withania
  • Plant Extracts
  • Anxiety
  • Randomized Controlled Trials as Topic
  • Phytotherapy
  • Treatment Outcome

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Systematic Review, Journal Article, Meta-Analysis
  • Vertical: ashwagandha-stress

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09