Valerian

Valerian Clinical Report Summary

Written Exclusively for MyNutritionStore.com by Rachel Parker

 

Published medical studies support the use of valerian as a safe, effective sleep aid. Research shows that valerian users have a higher quality of sleep, faster onset of sleep, with few side effects. Valerian has also been found to improve deep sleep in some studies, which may benefit health and memory. Dosages vary but many successful studies used 300-600 mg thirty minutes before bedtime for several weeks (1). Few side effects have been reported in clinical studies. And scientists are optimistic about valerian use in the overall population but caution that more research needs to be conducted to determine the safety of long term use (3).

 

Valerian Overview

 

Valerian is an herb native to Europe, Asia and North America.  The plant is primarily used in Europe as a botanical medicine to treat anxiety and sleeplessness. Historical usage of valerian goes back 2,000 years and has been used in many different cultures including Greek, Chinese and Indian (Ayurveda). The species of valerian used most in western preparations is Valeriana officinalis. The rhizome or root of the plant is believed to hold its medicinal properties. When ingested, researchers believe some of the root chemicals, valeric acid and valepotriates, interact with the brain neurotransmitter GABA or gamma aminobutyric acid. GABA inhibits excitement in the brain and valerian is believed to increase it's production and block re-absorption (1, 2).

 

Safe Use of Valerian

 

Valerian is well tolerated with little side effects, according to the results of numerous clinical studies (1, 2, 5, 7). Dosages of 300 to 900mg a day for up to 6 weeks are considered to be generally safe (1). More studies need to be conducted for longer use. Pregnant women are advised against taking valerian because it has not been well studied among this group.  

  
Clinical Studies and Valerian

 

Valerian has been the subject of more than 300 clinical research studies (3). Several of these studies were systematically reviewed by researchers at the University of California, San Francisco. In total, more than 1,000 patients were part of the data pool. Researchers found supportive evidence for the use of valerian and quantified the findings this way: Patients taking valerian had an 80% greater chance of reporting improve sleep compared with patients taking placebo (3). Other studies point out three key areas in which valerian improves sleep: it decreases sleep latency, increases Slow Wave Sleep and has a low risk of side effects (4, 5, 6, 7).

 
1. Sleep Latency and Valerian

 

Numerous studies have shown that use of valerian can reduce the period of sleep latency, or time it takes to fall asleep (2). The abstracts of two clinical research studies on valerian and sleep latency appear below. The first compares valerian to placebo (4). The second compares valerian to oxazepam, a mild tranquilizer in the benzodiazepine family (5).

 
Aqueous extract of valerian root (Valeriana officinalis L.) improves sleep quality in man. Leathwood et al.

The effect of an aqueous extract of valerian (Valeriana officinalis L.) root on subjectively rated sleep measures was studied on 128 people. Each person received 9 samples to test (3 containing placebo, 3 containing 400 mg valerian extract and 3 containing a proprietary over-the-counter valerian preparation). The samples, identified only by a code number, and presented in random order, were taken on non-consecutive nights. Valerian produced a significant decrease in subjectively evaluated sleep latency scores and a significant improvement in sleep quality: the latter was most notable among people who considered themselves poor or irregular sleepers, smokers, and people who thought they normally had long sleep latencies. Night awakenings, dream recall and somnolence the next morning were relatively unaffected by valerian. With the proprietary valerian-containing preparation, the only change was a significant increase in reports of feeling more sleepy than normal the next morning. Thus the questionnaire, simple to use and non-invasive, provides a sensitive means for detecting the effects of mild sedatives on different aspects of sleep in man. It also allows identification within the test population of the subgroups most affected (4).

 

Valerian versus oxazepam: efficacy and tolerability in non-organic and non-psychiatric insomniacs: a randomised, double-blind, clinical, comparative study. Dorn M.

OBJECTIVE: To show better improvement of sleep quality when treating non-organic insomniacs with extractum Valerianae radix siccum instead of oxazepam. DESIGN: Randomised, double blind, comparative study. SETTING: Out-patients of 8 general practitioners. PATIENTS: Non-organic and non-psychiatric insomniacs aged between 18 and 70 years were included into the trial. Persons with known hypersensitivity to valerian or benzodiazepines, other psychotropic drugs and various contraindications/limitations for benzodiazepines were excluded. INTERVENTION: 75 patients were randomly allocated either to the index group (2 x 300 mg extractum Valerianae radix siccum dragees LI 156) or control group (2 x 5 mg oxazepam dragees). The patients took study medication daily over a period of 28 days 30 min before going to bed. OUTCOMES: The factor sleep quality of the SF-B was defined as primary outcome. Secondary outcomes were other sleep characteristics of the SF-B, well-being (Bf-S) and anxiety (HAMA). Controls were performed before treatment as well as after 1, 2 and 4 weeks. Vital and laboratory parameters as well as unexpected events were assessed for safety and tolerability. STATISTICS: For all outcomes effect sizes between groups were calculated. For the main outcome criteria significance was tested by repeated-measures ANOVA considering all cases for which data of at least one follow-up existed (n = 70). RESULTS: Baseline characteristics were well balanced. 70% (54/75) of the patients were females, over 53% (40/75) reported insomnia for more than 1 year. Mean age was 52 +/- 12 years. In both groups sleep quality improved significantly (p <0.001), but no statistically significant difference could be found between groups (p = 0.70). Effect sizes between groups varied between 0.02 and 0.25. Five persons withdrew due to possibly adverse drug reactions (2 ( valerian, 3 ( oxazepam). No serious adverse events happened. CONCLUSIONS: The study showed no differences in the efficacy for valerian and oxazepam. Because of the more favourable adverse effect profile of valerian compared to oxazepam, this hypothesis should be analysed confirmatorily in an equivalence study.

 

2. Deep Sleep and Valerian

 

Valerian has also been shown to improve sleep by increasing Slow Wave Sleep, or deep sleep, throughout the night. Slow Wave Sleep (SWS) is part of the non-rapid-eye-movement sleep cycle. Emerging research shows that during SWS, the body produces human growth hormone, which helps processes memory. Some scientists believe a lack of SWS hampers the immune system and cognitive function. One clinical study's results are included in the following abstract (6):

Critical evaluation of the effect of valerian extract on sleep structure and sleep quality. Donath et al.

A carefully designed study assessed the short-term (single dose) and long-term (14 days with multiple dosage) effects of a valerian extract on both objective and subjective sleep parameters. The investigation was performed as a randomised, double-blind, placebo-controlled, cross-over study. Sixteen patients (4 male, 12 female) with previously established psychophysiological insomnia (ICSD-code 1.A.1.), and with a median age of 49 (range: 22 to 55), were included in the study. The main inclusion criteria were reported primary insomnia according to ICSD criteria, which was confirmed by polysomnographic recording, and the absence of acute diseases. During the study, the patients underwent 8 polysomnographic recordings: i.e., 2 recordings (baseline and study night) at each time point at which the short and long-term effects of placebo and valerian were tested. The target variable of the study was sleep efficiency. Other parameters describing objective sleep structure were the usual features of sleep-stage analysis, based on the rules of Rechtschaffen and Kales (1968), and the arousal index (scored according to ASDA criteria, 1992) as a sleep microstructure parameter. Subjective parameters such as sleep quality, morning feeling, daytime performance, subjectively perceived duration of sleep latency, and sleep period time were assessed by means of questionnaires. After a single dose of valerian, no effects on sleep structure and subjective sleep assessment were observed. After multiple-dose treatment, sleep efficiency showed a significant increase for both the placebo and the valerian condition in comparison with baseline polysomnography. We confirmed significant differences between valerian and placebo for parameters describing slow-wave sleep. In comparison with the placebo, slow-wave sleep latency was reduced after administration of valerian (21.3 vs. 13.5 min respectively, p<0.05). The SWS percentage of time in bed (TIB) was increased after long-term valerian treatment, in comparison to baseline (9.8 vs. 8.1% respectively, p<0.05). At the same time point, a tendency for shorter subjective sleep latency, as well as a higher correlation coefficient between subjective and objective sleep latencies, were observed under valerian treatment. Other improvements in sleep structure - such as an increase in REM percentage and a decrease in NREM1 percentage - took place simultaneously under placebo and valerian treatment. A remarkable finding of the study was the extremely low number of adverse events during the valerian treatment periods (3 vs. 18 in the placebo period). In conclusion, treatment with a herbal extract of radix valerianae demonstrated positive effects on sleep structure and sleep perception of insomnia patients, and can therefore be recommended for the treatment of patients with mild psychophysiological insomnia.

3. Side Effects and Valerian

 

In study after study, researchers are continually impressed by the lack of adverse reactions found with valerian use (1, 2, 3). This is of significant importance because many current sleep medications cause several side effects. Commonly prescribed drugs to improve sleep like benzodiazepines are linked to serious side effects like dizziness, car accidents and memory impairment. Some drugs may also be habit forming (2). Evidence of valerian's tolerability is illustrated in the abstract of the following clinical study (7):

The influence of valerian treatment on "reaction time, alertness and concentration" in volunteers. Kuhlman J et al.

A randomised, controlled, double-blind trial was performed on 102 male and female volunteers to determine whether reaction time, alertness and concentration might be impaired by treatment with a native valerian root extract (VRE). The effect was first examined the morning after a single evening dose of VRE (600 mg LI 156) vs. flunitrazepam (FNZ) (1 mg) and placebo (PL) (trial section A), and then after two weeks of evening administration of VRE (600 mg LI 156) vs. PL (trial section B). 99 volunteers were analysed in section A and 91 in section B. The primary criterion was the median of reaction time (MRT) measured with the Vienna Determination Test. Secondary criteria were cognitrones (alertness test), tracking test (two-handed co-ordination), sleep quality (VIS-A, Vis-M), further VDT parameters, and safety criteria. The single administration of LI 156 did not impair the reaction abilities, concentration and co-ordination. After 14 days of treatment, the equivalence of VRE and PL was proven by confirmative analysis concerning the improvement of MRT (p = 0.4481). Evaluation of the secondary criteria were consistent with the results of the primary criterion. It is concluded that neither single nor repeated evening administrations of 600 mg of VRE have a relevant negative impact on reaction time, alertness and concentration the morning after intake.

Valerian References

 

1. Hadley S, Petry J. Valerian (Complementary and Alternative Medicine). Am Fam Physician. 2003; 67(i8): 1755.
2. 2.Wheatley D: Medicinal plants for insomnia: a review of their pharmacology, efficacy and tolerability. Jour of Psychopharm. 2005; 19 (4): 414-421.
3. 3.Bent S, Padula A, Moore D, Patterson M, Mehling W: Valerian for sleep: a systematic reiew and meta-analysis. Am J of Med. 2006; 119(12): 1005-10124.
4. Leathwood PD, Chauffard F, Heck E, Munoz-Box R: Aqueous extract of valerian root (Valeriana offcinalis L.) improves sleep quality in man. Pharmacol Biochem Behav. 1982; 17:65-71.
5. Dorn M: Valerian versus oxazepam: efficacy and tolerability in nonorganic and nonpsychiatric insomniacs: a randomized, double-blind, clinical comparative study [in German]. Forschende Komplementarmedizin und Klassische Naturheilkunde. 2000; 7: 79-84.
6. Donath F, Quispe Bravo S, Diefenbach K, Fietz I, Roots I: Critical evaluation of the administration of valerian extract on sleep structure and sleep quality. Pharmacopsychiatry. 2000; 33(2): 47-53.
7. Kuhlmann J, Berger W, Podzuweit H, Schmidt U: The influence of valerian treatment on "reaction time, alertness and concentration" in volunteers. Pharmacopsychiatry. 1999; 32(6): 235-241.