Kava for Insomnia Relief

Weighing the Evidence and Possible Risks

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For help with sleep, some people with insomnia turn to an herb called kava (Piper methysticum). Most commonly used as a natural remedy for anxiety, kava is thought to promote sleep by producing a calming effect on the mind and body.

This article takes a closer look at health claims about kava and explores the potential benefits and risks of this popular herbal remedy.

Woman sleeping
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How Kava Works

Kava, also known as kava kava, is rich in kavalactones, chemicals that can have a sedative (sleep-inducing) effect. The scientific name of kava, Piper methysticum, even refers to this. "Piper" means "pepper" and "methystikos" means "intoxicating" in Greek.

Kavalactones are thought to promote sleep by reducing stress and anxiety. Scientists aren't sure exactly how this works, but one possibility is that kavalactones activate an enzyme known as p38 mitogen-activated protein kinase. This enzyme helps regulate the body's response to stress. By tempering this response, people may be better able to relax and sleep.

Kavalactones also appear to activate receptors in the brain called GABA receptors that regulate nerve signals in the brain. Kavalactones function similarly to benzodiazepine drugs like Xanax (alprazolam) by slowing down messages traveling between the body and brain. This helps induce a feeling of relaxation and drowsiness.

Recap

Kava contains compounds called kavalactones that are thought to act on enzymes and receptors in the brain that regulate anxiety and stress. By reducing anxiety, people may be better able to sleep.

Research on Kava and Sleep

Few scientific studies have examined kava's effectiveness as a sleep aid. Most were published before 2010 and had mixed results.

Evidence in Support of Kava

A 2005 animal study suggested that taking kava can help you fall asleep faster. Lab rats given an extract of kava took less time to fall asleep than untreated rats. What did not differ was the actual sleep time and the amount of REM sleep (dream-state sleep) each group of rats had.

A small study published in 2004 reported that kava improved sleep in people with chronic anxiety. Of the 61 people in the trial, those given a kava extract for four weeks reported better sleep and well-being than those given a placebo (sham drug).

A 2001 study reported similar improvements in people with stress-induced insomnia. Among the 24 adults given a daily 120-milligram dose of kava, most reported sleeping longer, falling asleep faster, and waking in a better mood. But there was no placebo (control) group in this study.

Evidence Against Kava

A 2005 study concluded that kava was not an effective treatment for insomnia. The trial, which involved 391 adults with anxiety and insomnia, explored whether kava or valerian (another popular herbal remedy) improved sleep any better than an inactive placebo. At the end of the 28-day trial, neither herb showed any improvements over the placebo.

A 2015 review of studies also reported that kava (and other herbal remedies like valerian and chamomile) did nothing to improve sleep in people with insomnia. Based on a review of 14 trials involving 1,602 participants, none of the herbal sleep aids fared any better in promoting sleep than an inactive placebo.

Recap

While several small studies have suggested that kava may help improve sleep in people with insomnia, a review of 14 clinical studies concluded that kava was no better in promoting sleep than an inactive placebo.

Possible Risks

There is no recommended dose of kava. As with all herbal remedies, kava carries potential risks. Common side effects include indigestion, headache, drowsiness, dizziness, and enlarged pupils.

There are also more serious concerns about kava. The National Institutes of Health currently advises against using it, because of a risk of liver damage. Even when taken for a short period of time at the advertised dose, kava can cause liver toxicity. The risk increases when kava is taken with alcohol or in people with pre-existing liver disease.

Early signs of liver problems include:

  • Stomach pain
  • Abdominal swelling
  • Extreme fatigue
  • Dark urine
  • Clay-color stools
  • Jaundice (yellowing of the eyes and skin)

Kava can also interfere with blood clotting and should be avoided if you take blood thinners like warfarin. Doing so may lead to easy bleeding or bruising. Kava should also be stopped a week before scheduled surgery or a dental procedure to avoid excessive bleeding.

Recap

The National Institutes of Health currently advises against the use of kava, citing concerns about liver damage.

Alternatives to Kava

Chronic stress can disturb sleep by stimulating the production of a stress hormone called cortisol. In people with chronic anxiety, cortisol levels are highest at bedtime. This is the time when cortisol levels should subside and another hormone called melatonin should increase to lull you to sleep. When cortisol levels are excessively high, the effects of melatonin are dampened.

Taking a melatonin supplement may help overcome this, but studies show that the benefits vary from one person to the next. Also, the effects of melatonin tend to wane the longer you use it.

One longer-term solution is mind-body therapies like yoga, meditation, and guided imagery. These have all been shown to relieve stress when performed regularly.

Exercise can help by stimulating the production of feel-good hormones called endorphins. Even a brisk walk before bedtime can help.

You can take steps to improve your sleep hygiene. Sleep hygiene is a term used to describe daily practices that create the ideal environment for sleep, including:

  • Keeping to a regular sleep schedule
  • Avoiding food, sugary drinks, and caffeine before bedtime
  • Turning off all electronics before bedtime
  • Creating a dark, cool environment in your bedroom

Recap

Alternatives to kava include melatonin supplements, exercise, and mind-body therapies like meditation and yoga. You can also improve your sleep by correcting your sleep habits (also known as sleep hygiene).

Summary

Kava (Piper methysticum) is a herb commonly used as a sleep aid. It may work by reducing anxiety and stress that contribute to insomnia. Kava contains compounds called kavalactones that work in the brain to regulate stress.

Studies are mixed as to whether kava actually helps with insomnia. In addition, there are risks associated with the use of kava, including reports that the herb can cause liver damage in some people.

There is no recommended dose of kava in any form.

A Word From Verywell

Due to the potential safety concerns, kava is not recommended for the treatment of insomnia or any other health condition. If you have trouble sleeping and are considering using kava, talk with your healthcare provider first to understand the benefits and risks. Your provider may be able to suggest other options.

In the end, it's important to remember that just because a remedy is "natural" doesn't mean that it is safe.

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