Does ashwagandha help with sleep disruption during perimenopause?

Ashwagandha may help improve sleep quality during perimenopause, and the biological reasoning is solid. As estrogen and progesterone fluctuate and gradually decline, your body's stress-response system loses some of its natural buffering. Cortisol, your main stress hormone, can stay elevated into the evening when it should be tapering off, making it harder to fall asleep and stay asleep. Ashwagandha is an adaptogen, meaning it works with your body to help regulate that cortisol rhythm rather than simply sedating you the way a sleep drug would.

The research on ashwagandha and sleep is more encouraging than for many supplements. A randomized controlled trial published in PLOS ONE (Langade et al., 2019) found that participants taking 300 mg of ashwagandha root extract twice daily for 10 weeks had significant improvements in sleep onset latency, total sleep time, sleep efficiency, and morning alertness compared to placebo. A 2021 double-blind study in adults with insomnia published in Medicine confirmed similar gains. The researchers believe much of the sleep benefit comes from a compound called triethylene glycol, found in ashwagandha leaves and root, which appears to have sleep-inducing properties independent of the withanolide compounds that drive most of ashwagandha's stress effects. A 2020 study specifically in women aged 40 to 60 with self-reported sleep problems found the KSM-66 extract improved sleep quality scores and reduced early morning awakening, which is a particularly common perimenopausal complaint. These studies are encouraging, though most are relatively short and not all populations studied were specifically perimenopausal. The research is promising but should be treated as supportive rather than definitive for your stage of life.

Perimenopause creates a particular kind of sleep disruption that differs from ordinary stress-driven insomnia. Night sweats and hot flashes fragment sleep architecture, cutting into deep and REM sleep. At the same time, declining progesterone, which has a calming effect similar to GABA in the brain, leaves many women feeling wired at bedtime even when they are exhausted. Cortisol dysregulation piles on top of this. Ashwagandha appears to address the cortisol piece specifically, by supporting the hypothalamic-pituitary-adrenal (HPA) axis and helping lower evening cortisol levels. It does not stop hot flashes directly, but some women report that reducing the overall stress load makes nighttime waking easier to fall back from.

Studies have most commonly used KSM-66 or Sensoril, two standardized ashwagandha root extracts. Doses in sleep-focused trials ranged from 300 mg once daily at bedtime to 300 mg twice daily. Taking it 30 to 60 minutes before bed may support sleep-specific goals, though some practitioners suggest a split dose, with one portion in the morning and one in the evening, to support daytime cortisol as well. Full-spectrum root extract is preferred over leaf-only formulas for most uses. Look for a product standardized to at least 5 percent withanolides and third-party tested for purity. Talk to your healthcare provider about the right dose for your situation.

Ashwagandha pairs well with magnesium glycinate for sleep, since magnesium supports GABA activity and muscle relaxation. Some women also add L-theanine for additional calm. Avoid taking ashwagandha alongside sedative medications, including benzodiazepines or prescription sleep aids, without medical guidance, as the combination could amplify drowsiness. It may also interact with thyroid medications, so if you take levothyroxine or similar drugs, check with your provider first. Ashwagandha belongs to the nightshade family, and people with nightshade sensitivities should use caution. Check with your provider if you take any prescription medications.

Give ashwagandha at least six to eight weeks before deciding whether it is working. Sleep improvements in clinical trials emerged gradually, with the biggest differences appearing at the 10-week mark. You may first notice a reduction in nighttime anxiety or an easier time falling back asleep after waking before you see a meaningful increase in total sleep time. Some women also report that their dreams become less vivid and anxious, which suggests a quieter stress response through the night. Ashwagandha is unlikely to eliminate night sweats or fully resolve perimenopausal sleep disruption on its own, but it can meaningfully take the edge off the cortisol-driven activation that makes broken sleep feel so depleting and hard to recover from the next day.

Some sleep problems during perimenopause need medical attention rather than supplementation. See your healthcare provider if you regularly stop breathing or gasp during sleep, which can signal sleep apnea that is underdiagnosed in women. Persistent insomnia lasting more than three months that affects daily functioning, mood, or work performance may benefit from cognitive behavioral therapy for insomnia (CBT-I), which has stronger evidence than any supplement. If night sweats are so severe they require changing your sheets, discuss hormone therapy or other options with your provider. Severe fatigue despite adequate sleep hours can also point to thyroid issues or anemia worth ruling out.

Tracking your sleep pattern alongside ashwagandha use helps you know whether it is genuinely making a difference. Note your bedtime, approximate time to fall asleep, number of wakings, and morning energy level each day. Even a simple 1-to-5 scale in your phone notes gives you useful data. The PeriPlan app lets you log symptoms like sleep quality and energy daily so you can see patterns across your cycle and spot whether your worst nights cluster around hormonal shifts. Find it at https://apps.apple.com/app/periplan/id6740066498.

This content is for informational purposes only and does not replace medical advice. Always consult your healthcare provider about your specific situation.