Valerian Root

• Sleep quality/insomnia: Research suggests valerian may modestly improve subjective sleep quality and reduce sleep onset latency, particularly after continuous use for 2–4 weeks; effects are small and study results are mixed (moderate evidence from multiple systematic reviews/meta-analyses with heterogeneity). • Anxiety and stress: Some studies show small reductions in mild anxiety or situational stress, but findings are inconsistent and generally weaker than for sleep (emerging-to-moderate evidence from small RCTs and reviews). • Menopause-related symptoms: Limited RCTs suggest valerian may reduce hot-flash frequency/intensity and improve associated sleep disturbance in peri/postmenopausal women (emerging evidence). • Restless legs syndrome (RLS): A small randomized trial reported improvement in RLS symptoms and sleep quality (emerging evidence). • Gastrointestinal spasm/functional discomfort: Traditionally used as an antispasmodic; modern clinical evidence is limited (traditional-to-emerging evidence).

Common (usually mild, often similar to placebo in trials): headache, dizziness/lightheadedness, gastrointestinal upset (nausea, abdominal discomfort), dry mouth, daytime drowsiness or “hangover,” vivid dreams. Dose-related: next-day sedation, impaired attention/reaction time—more likely with higher doses or co-use of other sedatives/alcohol. Less common/rare: pruritus or allergic reactions; paradoxical agitation; rare case reports of liver injury, often involving multi-herb products (causality uncertain). Safety notes: Avoid driving or operating machinery after dosing until individual response is known; sedation risk increases with alcohol, benzodiazepines, opioids, antihistamines, and hypnotics.

Commonly used ranges in studies (not prescriptive; optimal dose varies): • Standardized extract for insomnia: 300–600 mg of valerian root extract (often standardized to ~0.3–0.8% valerenic acids) taken 30–120 minutes before bedtime; some trials used single doses up to ~900 mg. • For anxiety/stress: 120–200 mg extract taken 2–3 times daily in small trials. • Traditional preparations: 2–3 g dried root as tea (steeped 10–15 minutes) or 2–4 mL tincture up to 3 times daily. • Onset: Some benefits appear after single doses, but several trials suggest more consistent effects after daily use for 2–4 weeks.

• Pregnancy and breastfeeding: Insufficient safety data—generally avoided. • Children: Limited data; avoid in very young children and use only with clinician guidance in older children/adolescents. • Liver disease or history of hepatotoxicity: Use cautiously or avoid; consider monitoring if prolonged use. • Concomitant use of CNS depressants (e.g., alcohol, benzodiazepines, opioids, sedative-hypnotics, first-generation antihistamines): Risk of excessive sedation/respiratory depression. • Sleep apnea or respiratory compromise: Use with caution due to sedative effects. • Surgery/anesthesia: Discontinue 1–2 weeks before elective procedures and inform the anesthesiologist, due to potential interactions with anesthetics and withdrawal-like symptoms reported anecdotally with abrupt cessation after heavy use.