The effects of ashwagandha (withania somnifera) on insomnia and sleep quality - a narrative review

Insomnia is one of the most common sleep disorders in modern society and represents a major public health concern due to its wide-ranging impact on physical health, mental well-being, and overall quality of life. Due to the escalating prevalence of sleep disorders and the potential side effects associated with conventional pharmacotherapy, there is a growing clinical and public interest in natural substances that can safely support the treatment of insomnia. The purpose of this review was to evaluate the current state of knowledge regarding the clinical and preclinical efficacy of Ashwagandha (Withania somnifera) in treating insomnia and sleep disturbances, while elucidating its underlying neurobiological mechanisms of action. A structured narrative literature review was conducted by searching major biomedical databases. The analyzed studies demonstrated that ashwagandha supplementation leads to statistically significant improvements in sleep metrics. In patients diagnosed with insomnia, researchers reported a shortened sleep onset latency (SOL), reduced waking after sleep onset (WASO), and increased total sleep time (TST). The majority of findings consistently underscore that Ashwagandha’s most profound impact on sleep architecture is driven by its interactions with the GABAergic pathway. Furthermore, supplementation correlated with a significant reduction in serum cortisol levels by a multi-pathway mechanism of action involving the hypothalamic-pituitary-adrenal (HPA) axis. The extracts were well-tolerated, with only mild and transient adverse effects reported. Ashwagandha represents an effective and safe therapeutic alternative for managing insomnia and enhancing sleep quality, particularly in individuals experiencing chronic stress.