Medicinal Plants for Management of Insomnia: A Systematic Review of Animal and Human Studies

  • Faezeh Feizi 1. School of Pharmacy, Islamic Azad Medical University, Tehran, Iran
  • Nazli Namazi 2. Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular- Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
  • Roja Rahimi 3. Department of Traditional Pharmacy, School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, Iran
  • Mohammad Hossein Ayati 4. Department of Traditional Medicine, School of Traditional Medicine, Tehran University of Medical Sciences, Tehran, Iran
Keywords: Insomnia; Sleep; Herbs; Plants


Insomnia is one of the most troubling sleep disorders and can be characterized by an inability to fall asleep and/or inadequate sleep duration and/or waking up multiple times during the night. Herbal medicine has been used to treat a range of sleep disorders for centuries. This study aimed to review medicinal plants investigated experimentally or clinically for sleep disorders, as well as their potential mechanisms of action and active components. Electronic databases and literature were systematically investigated to assess all in vitro and in vivo trials and clinical evidence of the efficacy and potential mechanisms of actions playing major roles in sleep induction or insomnia treatment. Among many herbal studies and trials on insomnia, some showed no significant difference between herbal remedies and placebos. While others showed improvements in sleep parameters (sleep latency, total sleep, non-rapid eye movement (NREM) and rapid eye movement (REM) sleep duration, delta activity in NREM sleep, wakefulness anxiety-associated insomnia). In this study, in vitro, animal, and clinical studies investigating a variety of herbal treatments for insomnia were systematically reviewed. The mechanisms of action of herbal medicines in treating insomnia are mainly related to gamma-aminobutyric acid (GABA)-synthesizing and GABA-metabolizing enzymes that influenced sleep outcomes. Overall, herbal remedies were not associated with more benefits than non-benzodiazepines, although side effects were less. The results suggest that herbs have some benefits in improving the quantity and quality of sleep and could be a promising alternative therapy. [GMJ.2019;8:e1085]


Chung VYS, Sharpe L, Glozier N, Hackett ML, Colagiuri B. A systematic review and meta-analysis of placebo versus no treatment for insomnia symptoms. Sleep Med RevSleep Medicine Reviews. 2017.

Pillai V, Roth T, Roehrs T, Moss K, Peterson EL, Drake CL. Effectiveness of benzodiazepine receptor agonists in the treatment of insomnia: An examination of response and remission rates. Sleep. 2016;40(2):zsw044.


Schweitzer PK, Feren SD. Pharmacological treatment of insomnia. Clinical handbook of insomnia: Springer; 2017. p. 97-132.

Sateia MJ, Buysse DJ, Krystal AD, Neubauer DN, Heald JL. Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: an American Academy of Sleep Medicine Clinical Practice Guideline. J Clin Sleep Med. 2017;13(2):307-49.

PMid:27998379 PMCid:PMC5263087

Akerele O. WHO guidelines for the assessment of herbal medicines. Fitoterapia. 1992;63:99-104.

Sarris J, Panossian A, Schweitzer I, Stough C, Scholey A. Herbal medicine for depression, anxiety and insomnia: a review of psychopharmacology and clinical evidence. Eur NeuropsychopharmacolEuropean neuropsychopharmacology. 2011;21(12):841-60.


Yeung W, Chung K, Poon M, editors. Acupuncture and Chinese Herbal Medicine for insomnia: a systematic review of effectiveness and TCM pattern differentiation. Hong Kong International Acupuncture Conference, HKIAC 2011; 2011.

Zick SM, Wright BD, Sen A, Arnedt JT. 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 Sep 22;11(1):78. PubMed PMID: 21939549. Pubmed Central PMCID: 3198755.

PMid:21939549 PMCid:PMC3198755

Lehrl S. Clinical efficacy of kava extract WS® 1490 in sleep disturbances associated with anxiety disorders: Results of a multicenter, randomized, placebo-controlled, double-blind clinical trial. J Affect DisordJournal of affective disorders. 2004;78(2):101-10.

Lillehei AS, Halcón LL, Savik K, Reis R. Effect of inhaled lavender and sleep hygiene on self-reported sleep issues: a randomized controlled trial. J Altern Complement MedThe Journal of Alternative and Complementary Medicine. 2015;21(7):430-8.

PMid:26133206 PMCid:PMC4505755

Lewith GT, Godfrey AD, Prescott P. A single-blinded, randomized pilot study evaluating the aroma of Lavandula augustifolia as a treatment for mild insomnia. J Altern Complement MedJournal of Alternative & Complementary Medicine. 2005;11(4):631-7.


Cases J, Ibarra A, Feuillere N, Roller M, Sukkar SG. Pilot trial of Melissa officinalis L. leaf extract in the treatment of volunteers suffering from mild-to-moderate anxiety disorders and sleep disturbances. Med J Nutrition MetabMediterranean journal of nutrition and metabolism. 2011;4(3):211-8.

PMid:22207903 PMCid:PMC3230760

Ngan A, Conduit R. A double-blind, placebo-controlled investigation of the effects of Passiflora incarnata (Passionflower) herbal tea on subjective sleep quality. Phytother ResPhytotherapy research. 2011;25(8):1153-9.


Lin Y, Wang XY, Ye R, Hu WH, Sun SC, Jiao HJ, et al. Efficacy and safety of Wuling capsule, a single herbal formula, in Chinese subjects with insomnia: A multicenter, randomized, double-blind, placebo-controlled trial. J Ethnopharmacol Journal of Ethnopharmacology. 2013;145(1):320-7.


Oxman AD, Flottorp S, Havelsrud K, Fretheim A, Odgaard-Jensen J, Austvoll-Dahlgren A, et al. A televised, web-based randomised trial of an herbal remedy (valerian) for insomnia. PLoS One. 2007;2(10):e1040.

PMid:17940604 PMCid:PMC2002515

Coxeter P, Schluter P, Eastwood H, Nikles C, Glasziou P. Valerian does not appear to reduce symptoms for patients with chronic insomnia in general practice using a series of randomised n-of-1 trials. Complement Ther MedComplementary therapies in medicine. 2003;11(4):215-22.

Donath F, Quispe S, Diefenbach K, Maurer A, Fietze I, Roots I. Critical evaluation of the effect of valerian extract on sleep structure and sleep quality. Pharmacopsychiatry. 2000;33(02):47-53.


Diaper A, Hindmarch I. A double-blind, placebo-controlled investigation of the effects of two doses of a valerian preparation on the sleep, cognitive and psychomotor function of sleep-disturbed older adults. Phytother ResPhytotherapy Research. 2004;18(10):831-6.


Herrera-Arellano A, Luna-Villegas G, Cuevas-Uriostegui ML, Alvarez L, Vargas-Pineda G, Zamilpa-Alvarez A, et al. Polysomnographic evaluation of the hypnotic effect of Valeriana edulis standardized extract in patients suffering from insomnia. Planta MedPlanta medica. 2001;67(8):695-9.


Shinomiya K, Inoue T, Utsu Y, Tokunaga S, Masuoka T, Ohmori A, et al. Effects of kava-kava extract on the sleep-wake cycle in sleep-disturbed rats. Psychopharmacology. 2005;180(3):564-9.


Shinomiya K, Inoue T, Utsu Y, Tokunaga S, Masuoka T, Ohmori A, et al. Hypnotic activities of chamomile and passiflora extracts in sleep-disturbed rats. Biol Pharm BullBiological and Pharmaceutical Bulletin. 2005;28(5):808-10.


Shinomiya K, Fujimura K, Kim Y, Kamei C. Effects of valerian extract on the sleep-wake cycle in sleep-disturbed rats. Acta Med OkayamaActa Med Okayama. 2005;59(3):89-92.


Cui X-Y, Cui S-Y, Zhang J, Wang Z-J, Yu B, Sheng Z-F, et al. Extract of Ganoderma lucidum prolongs sleep time in rats. J EthnopharmacolJournal of ethnopharmacology. 2012;139(3):796-800.


Kumar A, Singh A. Protective effect of St. John's wort (Hypericum perforatum) extract on 72-hour sleep deprivation-induced anxiety-like behavior and oxidative damage in mice. Planta MedPlanta medica. 2007;73(13):1358-64.


Rakhshandeh H, Sadeghnia HR, Ghorbani A. Sleep-prolonging effect of Coriandrum sativum hydro-alcoholic extract in mice. Nat Prod ResNatural product research. 2012;26(22):2095-8.

Lee C-I, Kim C-S, Han J-Y, Oh E-H, Oh K-W, Eun J-S. Repeated Administration of Korea Red Ginseng Extract Increases Non-Rapid Eye Movement Sleep via GABA A ergic Systems. J Ginseng ResJournal of ginseng research. 2012;36(4):403-10.

PMid:23717143 PMCid:PMC3659601

Ma Y, Kim YB, Nam SY, CHEONG JH, Park SH, Kim HJ, et al. Effects of red ginseng extract on sleep architecture and electroencephalogram power spectra in rats. Sleep Biol RhythmsSleep and Biological Rhythms. 2009;7(2):78-83.

Tokunaga S, Takeda Y, Niimoto T, Nishida N, Kubo T, Ohno T, et al. Effect of valerian extract preparation (BIM) on the sleep-wake cycle in rats. Biol Pharm BullBiological and Pharmaceutical Bulletin. 2007;30(2):363-6.


Qiu M-H, Qu W-M, Xu X-H, Yan M-M, Urade Y, Huang Z-L. D 1/D 2 receptor-targeting L-stepholidine, an active ingredient of the Chinese herb Stephonia, induces non-rapid eye movement sleep in mice. Pharmacol Biochem BehavPharmacology Biochemistry and Behavior. 2009;94(1):16-23.


Dimpfel W, Suter A. Sleep improving effects of a single dose administration of a valerian/hops fluid extract. A double blind, randomized, placebo-controlled sleep-EEG study in a parallel design using the electrohypnogram. Z PhytotherZeitschrift für Phytotherapie. 2008;29(S 1):P06.

Koetter U, Schrader E, Käufeler R, Brattström A. A randomized, double blind, placebo-controlled, prospective clinical study to demonstrate clinical efficacy of a fixed valerian hops extract combination (Ze 91019) in patients suffering from non-organic sleep disorder. Phytother ResPhytotherapy research. 2007;21(9):847-51.


Hemmeter U, Thum A, Giesler M, Haag A, Wartenberg-Demand A, McGregor G, et al., P. 2. c. 011 Effects of a phytopharmacal triple combination of St. John's wort, valerian and passion flower on sleep EEG, cognitive performance and mood: a double-blind randomised cross-over study in healthy volunteers. Eur NeuropsychopharmacolEuropean Neuropsychopharmacology. 2006;16:S318.

Ross SM. Sleep disorders: a single dose administration of valerian/hops fluid extract (dormeasan) is found to be effective in improving sleep. Holist Nurs PractHolistic nursing practice. 2009;23(4):253-6.


Wheatley D. Kava and Valerian in the treatment of stress-induced insomnia. Phytother ResPhytotherapy Research. 2001;15(6):549-51.


How to Cite
Feizi, F., Namazi, N., Rahimi, R., & Ayati, M. H. (2019). Medicinal Plants for Management of Insomnia: A Systematic Review of Animal and Human Studies. Galen Medical Journal, 8, e1085.
Review Article