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Meta-Analysis
. 2020 Jan-Dec:25:2515690X20967323.
doi: 10.1177/2515690X20967323.

Valerian Root in Treating Sleep Problems and Associated Disorders-A Systematic Review and Meta-Analysis

Noriko Shinjyo  1   2 , Guy Waddell  3 , Julia Green  4
Affiliations
Meta-Analysis

Valerian Root in Treating Sleep Problems and Associated Disorders-A Systematic Review and Meta-Analysis

Noriko Shinjyo et al. J Evid Based Integr Med. 2020 Jan-Dec.

Abstract

Sleep problems are widely prevalent and associated with various comorbidities including anxiety. Valerian (Valeriana officinalis L.) is a popular herbal medicine used as a sleep aid, however the outcomes of previous clinical studies are inconsistent. This study was conducted to update and re-evaluate the available data in order to understand the reason behind the inconsistent outcomes and to provide a broader view of the use of valerian for associated disorders. PubMed, ScienceDirect, and Cochrane Library were searched to retrieve publications relevant to the effectiveness of valerian as a treatment of sleep problems and associated disorders. A total of 60 studies (n=6,894) were included in this review, and meta-analyses were performed to evaluate the effectiveness to improve subjective sleep quality (10 studies, n=1,065) and to reduce anxiety (8 studies, n=535). Results suggested that inconsistent outcomes were possibly due to the variable quality of herbal extracts and that more reliable effects could be expected from the whole root/rhizome. In addition, therapeutic benefits could be optimized when it was combined with appropriate herbal partners. There were no severe adverse events associated with valerian intake in subjects aged between 7 and 80 years. In conclusion, valerian could be a safe and effective herb to promote sleep and prevent associated disorders. However, due to the presence of multiple active constituents and relatively unstable nature of some of the active constituents, it may be necessary to revise the quality control processes, including standardization methods and shelf life.

Keywords: anxiety; herbal medicine; insomnia; sleep; systematic review; valeriana officinalis.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
PRISMA flowchart.
Figure 2.
Figure 2.
Sleep quality improvement by repeated administration of V. officinalis. Ten studies were included in meta-analysis. Positive values indicate enhanced sleep quality. (A) Forest plot for sleep quality improvement. Effect sizes (Hedges’ g) for 10 studies (blue circles) and combined effect size (green circle) are shown. Black horizontal bars indicate 95% CI. (B) Funnel plot. Included data points are presented as filled blue circles and imputed data are shown as open orange circles.
Figure 3.
Figure 3.
Subgroup analysis for V. officinalis whole root and extract as a sleep aid. Subgroup analysis was performed with 4 studies (1 ∼ 4) using the whole root/rhizome and 6 studies (5 ∼ 10) using extracts. Effect sizes for each group are shown as red circles. Black horizontal bars indicate 95% CI.
Figure 4.
Figure 4.
V. officinalis for anxiety. Eight studies were included in meta-analysis. Positive values indicate either reduced anxiety or enhanced calmness. (A) Forest plot for anxiety reduction. Effect sizes (Hedges’ g) for each study (blue circles) and combined effect size (green circle) are shown. (B) Funnel plot. Included data points are presented as filled blue circles. (C) Subgroup analysis for V. officinalis whole root (1 and 2) and extracts (3 ∼ 8).
Figure 5.
Figure 5.
Valerian’s active constituents and potential therapeutic benefits.
Figure 6.
Figure 6.
V. officinalis and herbal partners. Frequently used herbal partners and potential uses supported by evidence are shown with number of studies and total number of subjects (n).
See this image and copyright information in PMC

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