Ashwagandha for Sleep: What the Trials Actually Show

Most sleep supplement trends fall apart when you read the trials. Ashwagandha is different. It has randomized, placebo-controlled trials, at least two meta-analyses, and a consistent direction of effect. It also has a growing file of liver injury reports and a regulator in Australia that keeps updating its warning. This post grades both halves, and then answers the question we get a lot: why isn't it in Lunia Restore?

1. Where the sleep effect shows up

The best pooled evidence is a 2021 systematic review and meta-analysis of five randomized trials with 400 participants, all comparing ashwagandha extract with placebo in adults. It found a small but significant effect on overall sleep (standardized mean difference -0.59, 95% CI -0.75 to -0.42). The effect was more prominent in adults diagnosed with a sleep disorder, at doses of 600 mg a day or more, and in trials lasting eight weeks or longer.

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

A second meta-analysis in 2024 pooled five trials with 254 participants and reported improvements in sleep onset latency, total sleep time, sleep efficiency and Pittsburgh Sleep Quality Index scores, but not in time awake after sleep onset or total time in bed. Its authors called the results promising and asked for larger studies. The two reviews likely draw on overlapping trials, so treat them as one body of evidence seen twice rather than two independent confirmations.

Citation: Fatima K, Malik J, Muskan F, et al. Safety and efficacy of Withania somnifera for anxiety and insomnia: Systematic review and meta-analysis. Hum Psychopharmacol, 2024. PubMed: 39083548

2. How big the effect is, trial by trial

Two individual trials show what sits behind the pooled number. In a 10-week trial of 60 adults with diagnosed sleep problems, participants took 300 mg of root extract twice a day. Sleep onset latency was shorter than placebo at week 10 (p=0.019), and sleep efficiency rose from 75.6 to 83.5 percent on ashwagandha versus 75.1 to 79.7 percent on placebo. Note that placebo also improved. That is normal in sleep trials, and it is why the gap between groups matters more than the before-and-after number.

Citation: Langade D, Kanchi S, Salve J, Debnath K, Ambegaokar D. Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Insomnia and Anxiety: A Double-blind, Randomized, Placebo-controlled Study. Cureus, 2019. PubMed: 31728244

In a six-week trial of 150 healthy adults with non-restorative sleep, 120 mg a day of a standardized extract was associated with a 72 percent increase in self-reported sleep quality versus 29 percent on placebo (p<0.001), with significant gains versus placebo in actigraphy-measured sleep efficiency and total sleep time. This one is interesting because the dose is a fifth of the 600 mg a day that the pooled analysis flagged as stronger. Dose and duration subgroups from five trials are a thin basis for a rule, so the two findings do not line up neatly. That is what heterogeneity looks like.

Citation: Deshpande A, Irani N, Balkrishnan R, Benny IR. 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. PubMed: 32540634

Where does that leave us? An effect that most likely exists, that is probably modest, and that depends on the extract, the dose and the population in ways nobody has pinned down.

3. Who ran and funded the trials

Read the fine print before you trust a supplement literature. Both individual trials above tested branded, standardized root extracts, and both were run in India. In the 2019 trial, the authors thank the extract's manufacturer for supplying the product, and they declared no competing interests. That is a disclosure, not a red flag by itself. It does mean these papers cannot tell us how well the result carries over to generic or differently sourced extracts, which is what many store-shelf products use.

The thyroid trial discussed below also came from a single Indian center, and the case series on liver injury come from Iceland, the United States and India. A regional skew is not a flaw, but it limits how confidently the results carry over to a different population and a different product.

4. The liver question

This is the part of the ashwagandha story that has changed most in the last few years. The NIH's LiverTox database rates ashwagandha as a likely cause of clinically apparent liver injury (likelihood score B). Injury usually appears 2 to 12 weeks after starting, is usually cholestatic or mixed, and mostly resolves within 1 to 4 months of stopping. It also notes that commercial products can be mislabeled or adulterated, so cause is not always clear.

Citation: National Institute of Diabetes and Digestive and Kidney Diseases. LiverTox: Ashwagandha. NCBI Bookshelf, clinical and research information on drug-induced liver injury. NCBI Bookshelf: NBK548536

A 2020 case series of five patients from Iceland and the US Drug-Induced Liver Injury Network described jaundice after a latency of 2 to 12 weeks. Liver tests normalized within 1 to 5 months in four patients, one was lost to follow-up, and none developed liver failure. Chemical analysis confirmed ashwagandha in the supplements and found no other toxic compounds, though four patients were taking other supplements.

Citation: Björnsson HK, Björnsson ES, Avula B, et al. Ashwagandha-induced liver injury: A case series from Iceland and the US Drug-Induced Liver Injury Network. Liver Int, 2020. PubMed: 31991029

A 2023 case series from India reported eight patients with injury tied to single-ingredient ashwagandha products. Five had underlying chronic liver disease. Three of them presented with acute-on-chronic liver failure and all three died. In the rest, the injury was prolonged but self-limiting. The authors concluded that people with pre-existing liver disease are at particular risk.

Citation: Philips CA, Valsan A, Theruvath AH, et al. Ashwagandha-induced liver injury: A case series from India and literature review. Hepatol Commun, 2023. PubMed: 37756041

Put it in proportion. These are case reports and small series, which cannot tell you how often it happens. The regulators who have looked at the same data call the risk very rare. But a very rare risk of serious injury is worth knowing before you add a supplement to a nightly routine.

5. Thyroid, pregnancy and other flags

A 2018 pilot trial of 50 adults with mildly raised thyroid stimulating hormone (TSH) found that 600 mg a day for eight weeks shifted TSH, T3 and T4 levels versus placebo. The authors framed that as a benefit for that population. For everyone else it is a flag: if a supplement moves thyroid markers in people with a mildly raised TSH, anyone with a thyroid condition or on thyroid medication should check with a clinician first. It was a small single-center trial, so it raises the question rather than answering it.

Citation: Sharma AK, Basu I, Singh S. Efficacy and Safety of Ashwagandha Root Extract in Subclinical Hypothyroid Patients: A Double-Blind, Randomized Placebo-Controlled Trial. J Altern Complement Med, 2018. PubMed: 28829155

On pregnancy, Australia's regulator requires a pregnancy warning statement on the labels of certain ashwagandha preparations. Anyone who is pregnant or breastfeeding should talk to a clinician before using it, and so should anyone on prescription medication.

6. What regulators have said

The Australian Therapeutic Goods Administration published an update on 7 July 2026. It reported 11 possible liver injury cases in Australia, no fatalities or transplants there, at least four published international case reports of liver failure (one requiring a transplant), and the three fatalities from the Indian series. The TGA describes the risk as very rare, advises avoiding products with this herb in people with existing liver disorders, and says it will keep assessing whether regulatory action is needed.

The same update gives the other side. India's Ministry of Ayush published a 2024 safety dossier that found no evidence of intrinsic liver toxicity and suggested that reported cases may have other causes or, at most, rare idiosyncratic reactions. The TGA also notes that it is looking at whether the plant part matters (leaf versus root), and that the Netherlands pharmacovigilance center had logged 12 liver injury cases up to June 2025.

Citation: Therapeutic Goods Administration (Australia). Withania somnifera (Ashwagandha) and very rare risk of liver injury. Medicine Safety Update, 7 July 2026. TGA

So the fair reading: regulators are watching, not banning, in the jurisdiction we could verify, and the safety question is open rather than answered either way.

Where Lunia fits

If you want a research-backed grade for ashwagandha, here it is: a real but modest sleep signal from small, short trials of branded extracts, with open safety questions for people with liver or thyroid issues and for anyone pregnant. That is a respectable evidence base. It is also not a free pass for nightly, open-ended use.

Lunia Restore is built for open-ended nightly use. When we chose ingredients, ashwagandha's long-term safety and interaction record, including the liver and thyroid questions above, was a reason to leave it out. Restore uses magnesium bisglycinate (500 mg, which provides 90 mg of elemental magnesium), L-theanine (300 mg) and apigenin (50 mg), all listed on the label with no proprietary blends, and it is melatonin-free. There is no randomized trial on the finished Restore formula, and our evidence is at the ingredient level. Individual results may vary, and anyone on medication or with a health condition should check with a clinician before starting a supplement.

Learn more about Lunia Restore

Frequently Asked Questions

Does ashwagandha help you sleep?

In small randomized trials, ashwagandha root extract was associated with better sleep scores than placebo, and a 2021 pooled analysis of five trials supports a small to moderate effect. The trials are short and small, and both individual trials we reviewed were run in India, so the honest summary is promising but not settled.

How long does ashwagandha take to work for sleep?

The pooled analysis found stronger effects in trials lasting eight weeks or longer, while one trial in healthy adults reported changes at six weeks. Trial timelines ran from six to ten weeks, so a few nights of use is not what the research tested.

What dose of ashwagandha do the sleep trials use?

Doses in the trials above ranged from 120 mg a day to 600 mg a day of standardized root extract. The pooled analysis found larger effects at 600 mg a day or more. Extracts differ a lot between products, so a dose from one trial does not transfer cleanly to another label.

Is ashwagandha safe to take every night?

Most trial participants tolerated it well, but the authors of the 2021 pooled analysis said safety data are limited and more would be needed to judge long-term use. Liver injury has been reported in rare cases, and the Australian regulator calls the risk very rare. Anyone planning to take it long term should talk to a clinician.

Who should talk to a clinician before taking ashwagandha?

People with liver disease, people who are pregnant or breastfeeding, people with a thyroid condition or on thyroid medication, and anyone taking prescription medicines. The Australian regulator advises avoiding products with this herb in people with existing liver disorders.

Does ashwagandha work on sleep directly or through stress?

The trials cannot separate the two. The pooled analysis also found improvements in anxiety scores and mental alertness on waking, so some of the sleep effect may travel through lower stress. That is a plausible reading rather than a proven mechanism.

Why isn't ashwagandha in Lunia Restore?

Restore is built for open-ended nightly use, and ashwagandha's long-term safety and interaction record, including the liver and thyroid questions above, was a reason to leave it out. That is a formulation choice, not a verdict that ashwagandha is unsafe or ineffective.

The Bottom Line

Ashwagandha earns a B-minus. The sleep evidence is real and consistent in direction, but the trials are small, short and extract-specific, and the pooled results rest on a handful of studies. The safety picture matters more than most supplements because the liver reports are serious even if rare. If you are healthy, have no liver or thyroid issues, are not pregnant and want to try it for a few months, the research supports it as a reasonable thing to discuss with your clinician. If you want something for open-ended nightly use, the open safety questions are a fair reason to choose differently.

References

1. Cheah KL, Norhayati MN, Husniati Yaacob L, Abdul Rahman R. Effect of Ashwagandha (Withania somnifera) extract on sleep: A systematic review and meta-analysis. PLoS One, 2021.
2. Fatima K, Malik J, Muskan F, et al. Safety and efficacy of Withania somnifera for anxiety and insomnia: Systematic review and meta-analysis. Hum Psychopharmacol, 2024.
3. Langade D, Kanchi S, Salve J, Debnath K, Ambegaokar D. Efficacy and Safety of Ashwagandha (Withania somnifera) Root Extract in Insomnia and Anxiety: A Double-blind, Randomized, Placebo-controlled Study. Cureus, 2019.
4. Deshpande A, Irani N, Balkrishnan R, Benny IR. 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.
5. Sharma AK, Basu I, Singh S. Efficacy and Safety of Ashwagandha Root Extract in Subclinical Hypothyroid Patients: A Double-Blind, Randomized Placebo-Controlled Trial. J Altern Complement Med, 2018.
6. Björnsson HK, Björnsson ES, Avula B, et al. Ashwagandha-induced liver injury: A case series from Iceland and the US Drug-Induced Liver Injury Network. Liver Int, 2020.
7. Philips CA, Valsan A, Theruvath AH, et al. Ashwagandha-induced liver injury: A case series from India and literature review. Hepatol Commun, 2023.
8. National Institute of Diabetes and Digestive and Kidney Diseases. LiverTox: Ashwagandha. NCBI Bookshelf, clinical and research information on drug-induced liver injury.
9. Therapeutic Goods Administration (Australia). Withania somnifera (Ashwagandha) and very rare risk of liver injury. Medicine Safety Update, 7 July 2026.

These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.