Ashwagandha supplementation: a support for sleep and recovery?

Sleep quality is critical to recovery for all athletes. Women tend to be more prone to anxiety and NRS than men. In highly active endurance female athletes, this can seriously impair health and performance. Ashwagandha (Withania somnifera) is a well-known botanical and adaptogen that has been used in Ayurvedic medicine in India for thousands of years for stress, anxiety, and non-restorative sleep (NRS) management. NRS can include: late sleep onset, waking up multiple times during the night, difficulties falling back to sleep, and overall translates into poor sleep quality. Adaptogens are plants and mushrooms that help our body respond to stress, anxiety, and fatigue. Their action allows our body to return to balance (homeostasis).

The most active part of the plant is the root, which is the one commonly used in most supplements. There are a few active compounds in the plant, which have been identified as responsible for their potential benefits. Some of the bioactive compounds identified as responsible are Withanolides (amongst them Withaferin and Withanolide-A), but other compounds, such as some oligosaccharides, could also play a role. The mechanism of action is still under study, as it could result from regulation of the Hypothalamic-Pituitary Axis, and of the stress hormones cortisol and epinephrine. Another effect on sleep quality could be a positive influence on GABAergic and serotonin activities. 

However, the herbal composition (% withanolides), dosage, and part of the plant used show a broad diversity amongst available products on the market. The most researched and proven efficient supplements (root extract) on anxiety reduction and sleep quality improvement include 5-10% withanolides, and the dosage can vary from 350 to 800 mg daily. It is best to start with a lower dosage at first. 

It has to be noted that ashwagandha has both the potential to induce relaxation and reduce sleep onset time, as well as having an anti-fatigue effect (which is why it is recommended to be taken in the morning).

Clinical trials on humans related to ashwagandha effect on stress-related disorders, such as anxiety and insomnia, present different dosages of supplementation and durations. There is also a need to conduct further studies on larger populations from different cultures (most of the trials have been conducted in India). However, in the scientific literature, there is a long history of ashwagandha use as an herbal supplement to reduce stress and improve sleep.

The herb is generally safe in both adults and children, with only mild to moderate adverse effects reported during some trials. Having said that, the literature recommends that care should be taken when ashwagandha is used alongside certain medications, and advises taking breaks between supplementation periods.

Cheah, K.L., Norhayati. M.N., Yaacob, L.H. and Rahman, R.A. 2021. Effect of Ashwagandha (Withania somnifera) extract on sleep: A systematic review and meta-analysis. Plos One. https://doi.org/10.1371/journal.pone.0257843

Deshpande, A., Irani, N., Balkrishnan, R. and  Benny, I.R. 2020. A randomized, double blind, placebo-controlled study to evaluate the effects of ashwagandha (Withania somnifera) extract on sleep quality in healthy adults. Sleep Medicine. https://doi.org/10.1016/j.sleep.2020.03.012

Elgar, K. 2021. Ashwagandha: A Review of Clinical Use and Efficacy. Nutritional Medicine Journal. https://www.nmi.health/ashwagandha-a-review-of-clinical-use-and-efficacy/

Gopukumar, K., Thanawala, S., Somepalli, V., Rao, S.T.S., Thamatam, V.B. and Chauhan, S. 2021. Efficacy and Safety of Ashwagandha Root Extract on Cognitive Functions in Healthy, Stressed Adults: A Randomized, Double-Blind, Placebo-Controlled Study. Evidence-Based Complementary and Alternative Medicine.  https://doi.org/10.1155/2021/8254344

Langade, D., Thakare, V., Kanchi, S. and Kelgane, S. 2021. Clinical evaluation of the pharmacological impact of ashwagandha root extract on sleep in healthy volunteers and insomnia patients: A double-blind, randomized, parallel-group, placebo-controlled study. Journal of Ethnopharmacology. Volume 264. [online]. Available at:  https://doi.org/10.1016/j.jep.2020.113276

Lopresti, A.L. and Smith, S.J. 2021. Ashwagandha (Withania somnifera) for the treatment and enhancement of mental and physical conditions: A systematic review of human trials. Journal of Herbal Medicine. https://doi.org/10.1016/j.hermed.2021.100434