Valerian for night awakenings: what is known

There is currently no convincing evidence that valerian reduces the frequency of nighttime awakenings or helps people fall back to sleep more quickly after awakening. Nighttime awakenings are considered sleep-maintenance insomnia. The American Academy of Sleep Medicine specifically evaluated valerian for sleep-initiation and sleep-maintenance insomnia and recommended against its use due to insufficient evidence of efficacy. [1]

This doesn't mean valerian never helps anyone. Some small studies have reported improvements in some sleep parameters, and some people subjectively rate their sleep as more restful. However, research results are inconsistent, valerian preparations vary widely, and the most recent umbrella review from 2024 found insufficient evidence for valerian's effectiveness as a treatment for insomnia. [2]

There is particularly little compelling evidence for wake after sleep onset (WASO). In one randomized trial in older women, valerian did not reduce WASO after either a single dose or two weeks of treatment. The 2025 VA/DoD guideline also noted that the five valerian monotherapy trials included in the systematic review did not objectively assess WASO, total sleep duration, time to sleep, or sleep efficiency; subjective assessment results were mixed, and the quality of evidence was very low. [3]

Therefore, with regular awakenings in the middle of the night, the main question is usually not "how much valerian should I take?" but rather why my sleep is interrupted. Frequent awakenings can be a manifestation of chronic insomnia, but similar complaints arise with obstructive sleep apnea, restless legs syndrome, pain, alcohol use, certain medications, anxiety, sleep disturbances, and other conditions. [4]

What is considered a sleep maintenance problem?

Waking up in the middle of the night does not in itself indicate a disorder. Clinical insomnia is defined not by a single episode, but by repeated difficulties maintaining sleep or falling asleep, dissatisfaction with sleep, and consequences the following day despite adequate sleep. European guidelines classify the core manifestations of insomnia as difficulty initiating sleep, difficulty maintaining sleep, and waking up too early. [5]

Chronic insomnia is generally defined as a condition in which such symptoms occur at least three nights a week for at least three months and are accompanied by daytime sequelae. A specific number of awakenings or a strictly defined number of minutes of wakefulness at night are not required for the diagnosis: the overall clinical picture is decisive. [6]

For example, a person might wake up once or twice during the night, quickly fall back asleep, and feel fine in the morning—this situation is significantly different from waking up at 3 a.m., then staying awake for an hour several times a week and feeling very tired the next day.

A more objective measure used in research is wake after sleep onset (WASO). It measures the total time spent awake from the initial onset of sleep until the final awakening. This parameter is particularly important when studying the treatment of insomnia associated with sleep maintenance problems.

Does valerian reduce nighttime awakenings?

No reliable effect has been established.

Some older, small studies have shown positive results. A 2020 systematic review of herbal extracts noted that, in some trials, valerian reduced wakefulness after sleep onset. However, the same review included studies that found no changes in nocturnal awakenings or other sleep measures. This heterogeneity precludes the effect from being reproducible. [7]

A particularly informative randomized, double-blind, crossover study of 16 women with insomnia, with an average age of approximately 69 years, was conducted. Participants took 300 mg of concentrated valerian extract or placebo 30 minutes before bedtime for two weeks. Sleep was assessed using three methods: sleep diaries, actigraphy, and laboratory polysomnography. Valerian did not provide a significant advantage over placebo in terms of WASO, sleep onset time, sleep efficiency, or subjective sleep quality. [8]

Moreover, compared with baseline, WASO levels increased after two weeks of valerian in this small study. However, it is also impossible to conclude that valerian worsens nighttime sleep based on this result: the main comparison of valerian with placebo was not statistically significant, and the sample was very small. [9]

In the 2025 VA/DoD guideline, the working group separately reviewed a systematic review of valerian. Of 60 randomized trials, only five evaluated Valeriana officinalis monotherapy for insomnia over 2-4 weeks; together, they included 966 participants. Objective measures such as WASO were not assessed in these studies, and results for subjective sleep quality were inconsistent. [10]

This is more important than it seems: the claim that "valerian reduces night awakenings" is often found on individual product labels and advertising materials, but the level of clinical evidence is significantly weaker than this impression.

What the most recent review of research shows

A 2024 umbrella review compiled existing systematic reviews on valerian and insomnia. Its conclusion was quite clear: the evidence base does not support valerian as a reliable treatment for insomnia, and the studies are too heterogeneous and methodologically weak to predict a consistent effect. [11]

Another umbrella review of alternative insomnia treatments, published earlier, also found no significant improvement in sleep outcomes with valerian. The authors specifically noted that for many alternative treatments, subjective measures appear superior to objective ones, and the overall confidence in the evidence is low. [12]

Night awakenings as a separate outcome have been studied even less than overall sleep quality. Therefore, it's more accurate to say not "valerian helps with frequent awakenings," but rather "some studies suggest possible improvement, but there's no clinically convincing evidence."

What about the positive study in 2024?

There is a modern randomized study that looks much more optimistic than the overall picture.

In it, 80 adults with mild sleep complaints were assigned to either placebo or 200 mg of a standardized valerian extract containing 2% valerenic acids for eight weeks. 72 people completed the study. The extract group showed improvements in overall sleep quality, time to fall asleep, actual sleep duration, and sleep efficiency as measured by actigraphy; a subgroup also showed positive results in polysomnography. DOI: 10.1007/s12325-023-02708-6. [13]

But there's a crucial detail regarding nighttime awakenings: the Pittsburgh Sleep Quality Index subscale, which measures sleep disturbances, showed no statistically significant difference between valerian and placebo. The study was also not specifically designed to demonstrate a reduction in the number of awakenings or WASO. [14]

Furthermore, this study focused on young adults with mild symptoms and no significant comorbidities, and it examined a specific standardized commercial extract. The study and publication fee were funded by OmniActive Health Technologies, the product's developer. Funding alone does not invalidate the results, but it does reinforce the need for independent replication. [15]

Therefore, the study is interesting, but does not change the general conclusion of systematic reviews and clinical guidelines.

Why valerian can subjectively help even if awakenings do not decrease

Subjective sleep quality and objective sleep fragmentation are different indicators.

A person may wake up approximately the same number of times, but experience less anxiety after waking, more quickly disregard it, or perceive the night as more restful in the morning. In this case, the subjective assessment will improve even without a noticeable change in WASO.

This gap between self-perception and objective recording is well known in insomnia. VA/DoD guidelines explicitly note that people with chronic insomnia may report greater difficulty initiating and maintaining sleep than is indicated by actigraphy or polysomnography. This does not mean the complaints are "imaginary": the subjective perception of sleep is part of the disorder itself. [16]

This is why some people can quite sincerely say: “I sleep more soundly with valerian,” even if the number or duration of their nighttime awakenings has not objectively changed significantly.

Can I take valerian after waking up in the middle of the night?

There is no proven “woke up at night – take valerian and go back to sleep” scheme.

The European Monograph of Valerian recommends taking certain medications approximately 30-60 minutes before bedtime, sometimes with an earlier dose in the evening. The same monograph emphasizes the gradual onset of the intended effect and states that valerian is not suitable for acute intervention in sleep disorders. [17]

This is especially important when waking up, for example, at 3:00 AM. If a person takes another dose at this time, there are no high-quality studies showing that it will reliably shorten the period of wakefulness that same night.

Additionally, an additional nighttime dose may increase the likelihood of morning drowsiness, especially if there is little time left before rising or other sedatives are used concurrently.

Therefore, you should not try to turn valerian into an “emergency sleep aid” on your own, just because it is herbal.

Why do people wake up at night?

Frequent awakenings are a symptom with several possible mechanisms, and valerian does not affect all of them.

In chronic insomnia, awakening can be maintained by a state of hyperarousal: the person wakes up, notices the time, begins to count the remaining hours of sleep and becomes anxious, and attempts to force themselves to fall asleep further increase wakefulness. Stress and anxiety are known factors in the development and maintenance of insomnia. [18]

A similar complaint can occur with breathing disorders. With obstructive apnea, breathing repeatedly stops or is restricted during sleep, causing sleep fragmentation. Clues may include loud snoring, pauses in breathing noticed by others, awakenings short of breath, morning headaches, and severe daytime sleepiness. [19]

Restless legs syndrome can interfere not only with falling asleep but also with staying asleep after waking. It is characterized by discomfort in the legs while at rest, worsening in the evening or at night and temporarily alleviated by movement. [20]

Sleep fragmentation can also be maintained by alcohol, caffeine, and nicotine, an irregular schedule, noise and light, pain, certain medications, and comorbidities. European guidelines therefore recommend assessing not only sleep itself, but also medical history, medications, mental state, substance use, routine, and possible signs of other sleep disorders. [21]

Nighttime awakenings: when valerian is unlikely to solve the problem

Situation	What could be behind the awakenings?	What is more important than valerian?
You wake up and can't fall back asleep for a long time, thinking about sleep and looking at the clock	Sleep maintenance insomnia	Insomnia assessment and cognitive behavioral therapy
Loud snoring, pauses in breathing, choking	Possible sleep apnea	Sleep-disordered breathing testing
My legs are pulling, I want to move them	Possible restless legs syndrome	Evaluation of symptoms and causes of the syndrome
Awakens pain	Somatic disease or chronic pain	Controlling the cause of pain
Waking up after drinking alcohol	Alcohol-related sleep fragmentation	Changes in evening drinking
You frequently get up to urinate.	Nocturia or other medical condition	Finding the cause of nighttime urination
You wake up very early and can't fall back asleep.	Insomnia, circadian drift, or other condition	Analysis of the regimen and clinical picture

This table is not intended for self-diagnosis, but rather to help understand why the same symptom may require different actions. A clinical examination for insomnia begins with a detailed sleep history and a search for associated causes. [22]

What to do if you wake up at night and can't fall asleep

In chronic insomnia, it is more reasonable to change the response to nighttime wakefulness rather than add another sedative.

One component of cognitive behavioral therapy for insomnia is stimulus control. Its principle is to avoid forming a strong association between "bed = place where I spend hours awake and worrying." Therefore, the person is encouraged to lie down when drowsiness sets in, use the bed primarily for sleeping, and get out of bed if wakefulness persists, returning to sleep after drowsiness sets in. [23]

It's important not to turn this into a rigid rule: "If you haven't fallen asleep in exactly 20 minutes, get up." With insomnia, constantly watching the clock can itself perpetuate arousal. The goal of this technique is to reduce prolonged, anxious wakefulness in bed, not to force a person to measure every minute.

Multicomponent cognitive behavioral therapy for insomnia has a strong recommendation from the American Academy of Sleep Medicine, and the 2023 European Guidelines consider it first-line treatment for chronic insomnia in adults of any age, including those with comorbidities.[24]

The World Sleep Society also strongly recommends multi-component cognitive behavioral therapy for chronic insomnia. Sleep hygiene alone, without other components of therapy, does not receive such a recommendation. [25]

Why simply “calming down harder” doesn’t always help

Nocturnal sleep maintenance insomnia often becomes self-perpetuating.

The first awakening may be related to stress, noise, or illness. Then the person begins to anticipate it: "I'll wake up again at three o'clock." After awakening, they check the clock, estimate how much time remains until morning, try to force themselves to fall asleep, and gradually become increasingly agitated.

In this scenario, the problem is no longer limited to insufficient sedation. This is why evidence-based treatment for chronic insomnia targets the mechanisms that maintain wakefulness, rather than simply pharmacologically enhancing sleepiness. [26]

Valerian may theoretically reduce subjective tension in some people, but there is limited research showing that it disrupts this cycle and consistently reduces nighttime wakefulness.

What do current clinical guidelines say about valerian?

The 2023 European guidelines explicitly state that herbal remedies are not recommended for the treatment of insomnia due to insufficient evidence. Cognitive behavioral therapy remains the first-line treatment. [27]

The American Academy of Sleep Medicine, in its guidelines for pharmacological treatment, specifically recommended against using valerian for problems with falling asleep or sleep-maintenance insomnia, that is, difficulty maintaining sleep. [28]

The 2025 VA/DoD guidelines updated their assessment of herbal and dietary supplements. For valerian, the quality of evidence was rated as very low, and the working group came to a weak recommendation against its use for chronic insomnia. Reasons cited included mixed results, imprecise studies, adverse effects, and the risk that supplement use would delay more effective therapy. [29]

At the same time, there is a European regulatory monograph (EMA) recognizing certain valerian root preparations for the relief of sleep disorders or as traditional sleep aids. This is not a direct contradiction: the EMA evaluates specific herbal medicinal products and their history of use, while clinical guidelines address a different issue: whether there is sufficient evidence to recommend the remedy for patients with insomnia. [30]

If valerian does help subjectively

If a person uses a registered valerian preparation, tolerates it well, and actually notices improvement, the mere fact that the evidence base is weak does not mean that there cannot be an individual effect.

But it's helpful to determine in advance what constitutes improvement. For example: are awakenings occurring less frequently, is the time it takes to fall back to sleep shortened, is overall nighttime wakefulness reduced, is one's morning well-being improved, and is daytime sluggishness occurring?

Sleep can be assessed using a sleep diary over a period of 1–2 weeks. The European Guidelines recommend sleep diaries when assessing insomnia and indicate a period of 7–14 days as useful for structuring sleep information. [31]

In a diary, it's enough to record your bedtime, approximate time you fell asleep, the number of noticeable awakenings, the approximate duration of each, your final awakening, and your morning state. Such a diary isn't a full-fledged diagnostic test, but it helps distinguish between sustained improvement and a general impression of "feeling calmer."

If there is no improvement after a reasonable period of regular use, increasing the amount of valerian just for the sake of night awakenings has no convincing evidence base.

Should you use a smartwatch to measure nighttime awakenings?

Consumer watches can be useful for observing trends, but should not become a tool for constant self-checking.

The clinical diagnosis of chronic insomnia does not usually require polysomnography or actigraphy. European guidelines base the diagnosis primarily on history and self-report; actigraphy is used primarily in isolated diagnostic situations, and polysomnography is used when another sleep disorder is suspected or in resistant insomnia. [32]

Therefore, several short awakenings marked by hours do not in themselves prove illness and are not a reason to start taking valerian.

A more important clinical question is whether awakenings interfere with falling back to sleep and whether daytime performance suffers because of them.

When to look for the cause of night awakenings

If awakenings occur several times a week over a period of months and are accompanied by daytime fatigue, decreased concentration, irritability, or sleep dissatisfaction, this picture corresponds to the key elements of chronic insomnia and deserves evaluation. [33]

Particular attention is required if loud snoring, pauses in breathing, or awakenings with choking are observed at night. These signs are characteristic of possible obstructive sleep apnea, which is not treated with valerian. The NHLBI recommends discussing these symptoms with a doctor; a sleep study may be necessary for diagnosis. [34]

If awakening is accompanied by a strong urge to move the legs and unpleasant sensations that are relieved by movement and intensify in the evening, restless legs syndrome should be considered. [35]

New nocturnal awakenings after starting or changing medications, severe pain, shortness of breath, or a noticeable increase in nocturnal urination are also reasons to reconsider the underlying cause. In such cases, addressing the underlying cause makes more sense than gradually adding sedatives. [36]

Valerian safety

Short-term use of valerian is generally well tolerated by most adults, but it is not completely free of side effects.

The NCCIH lists headache, stomach discomfort, a feeling of lethargy, agitation, anxiety, and vivid dreams. The safety of long-term use has not been adequately studied. [37]

Valerian should not be combined with alcohol or other sedatives without medical approval, as their effects may additive. This is especially important for someone who wakes up at night and decides to take an additional dose after taking a sleeping pill or sedative the night before. [38]

After chronic use, symptoms have been described following abrupt discontinuation, so the habit of taking the drug every night for months should not be considered automatically safe. [39]

What is often misunderstood

"If a drug is indicated for frequent nighttime awakenings, then it's proven by research." Not necessarily. The indication for a specific product and the evidence base for an entire class are two different things. The American Academy of Sleep Medicine does not recommend valerian specifically for sleep-maintenance insomnia due to its lack of effectiveness. [40]

"If valerian helps you fall asleep at night, it necessarily prevents awakenings." No. Sleep onset and sleep maintenance are different endpoints, and data on WASO and night awakenings are particularly limited.

"Woke up in the night – can take another dose?" There are no reliable studies for this rescue regimen. A European monograph describes taking it before bedtime and emphasizes the gradual nature of the expected effect. [41]

"Any awakening during the night is insomnia." No. The disorder becomes clinically significant in the context of difficulty falling asleep again, sleep dissatisfaction, and daytime consequences. For the chronic form, the frequency and duration of symptoms are also taken into account. [42]

"If I wake up frequently, I just need a stronger sleep aid." Frequent awakenings can be associated with sleep apnea, restless legs syndrome, and other causes, so increasing sedation doesn't always solve the underlying problem. [43]

Key points from experts

Christopher L. Drake, PhD, is a sleep medicine specialist, director of Sleep Research at Henry Ford Health, and professor of medicine at Michigan State University College of Human Medicine. Henry Ford Health's official profile lists his certification by the American Board of Sleep Medicine and his many years of work in clinical research on insomnia. [44]

Drake co-authored a 2024 umbrella review of valerian. The research team concluded that existing reviews do not provide sufficient empirical support for valerian as a treatment for insomnia and that higher-quality randomized trials are needed. This is particularly important for the topic of night awakenings, as the evidence on sleep maintenance is even less clear-cut than the evidence on subjective sleep quality in general. [45]

Dieter Riemann is Professor Emeritus at the University Hospital of Freiburg; his main research areas include insomnia, sleep psychophysiology, and cognitive behavioral therapy. His university profile lists over 450 peer-reviewed publications and long-term research in the field of sleep. [46]

Riemann is the first author of the 2023 European insomnia guidelines. The working group recommends cognitive behavioral therapy as first-line treatment for chronic insomnia and does not recommend herbal remedies due to insufficient evidence.[47]

Frequently Asked Questions

Does valerian help you stay awake at night?

This has not been convincingly proven. Individual studies have shown positive results, but the overall evidence base is contradictory, and current clinical guidelines do not consider valerian a proven treatment for sleep maintenance disorders. [48]

Does valerian reduce the number of night awakenings?

No reliable reduction in the number of awakenings has been demonstrated. In one well-controlled study in older women, there was no significant difference compared with placebo. [49]

Does it help you fall back asleep faster?

There is a lack of specific, high-quality research to support the reduction in time to fall back to sleep after waking up at night.

Is it possible to drink valerian at three in the morning?

There is no proven regimen for such use. Valerian is not considered a rapid remedy for acute sleep disorder correction, and an additional nighttime dose may increase morning sleepiness. [50]

If I wake up every night at the same time, will valerian help?

Not necessarily. A recurring wake-up time may be related to sleep patterns, circadian mechanisms, habit, insomnia, or another factor. It's more helpful to first consider your overall sleep pattern.

How many weeks does it take to know if valerian is working?

The European monograph for certain medicinal products describes a gradual development of the expected effect and a course of treatment lasting several weeks. However, this does not mean that treatment should be continued in the absence of any noticeable result or that any product has the same effect. [51]

What is more important to count - the number of awakenings or the minutes of wakefulness?

Both parameters are important for insomnia, but the most informative is how long a person remains awake after initially falling asleep and how this impacts their daytime performance. In research, this indicator is called WASO.

Should I have a polysomnography if I wake up frequently?

Not for everyone. In common chronic insomnia, the diagnosis is primarily clinical. Polysomnography is particularly useful when sleep apnea, periodic limb movements, or another sleep disorder is suspected, or when insomnia remains treatment-resistant. [52]

Can frequent awakenings due to snoring be treated with valerian?

There is no reason. If loud snoring, pauses in breathing, or awakenings with suffocation are present, obstructive sleep apnea must first be ruled out. [53]

What if the reason is anxiety?

While anxiety can indeed maintain nighttime wakefulness, valerian lacks sufficient evidence as a treatment for chronic insomnia. For persistent problems, methods that directly address the underlying mechanisms of insomnia are preferable. [54]

Can valerian itself worsen sleep?

Some people may experience agitation, anxiety, or vivid dreams, so subjectively sleep may indeed become worse. [55]

Main

Valerian has not been convincingly proven to be effective against frequent nocturnal awakenings. Some studies have found improvements in certain sleep parameters, but high-quality trials yield conflicting results, and modern systematic reviews and clinical guidelines do not support it as a reliable treatment for sleep-maintenance insomnia. [56]

A particularly weak piece of evidence is the objective time after sleep onset, WASO. In a small randomized trial, valerian did not reduce WASO, and the updated VA/DoD guidelines note that most of the valerian studies reviewed did not measure this objective measure at all. [57]

Therefore, when recurring nighttime awakenings occur, it is more useful to determine the underlying mechanism—chronic insomnia, sleep apnea, restless legs syndrome, pain, medications, alcohol, or other factors. For chronic insomnia, the most proven initial treatment remains cognitive behavioral therapy for insomnia. [58]