Does Chamomile Help You Sleep? Trials and the UK Wording

Pooled trials found that people taking chamomile rated their sleep better than controls (standardised mean difference -0.73), while the one placebo-controlled trial in diagnosed chronic insomnia, 34 adults taking 540 mg of extract a day for 28 days, found no significant change in time to fall asleep, time asleep, night-time waking or sleep quality.^1,2 Sixty people aged 60 and over who took 400 mg of extract a day for 28 days rated their sleep better than a control group,³ and 80 postnatal women who drank chamomile tea for two weeks reported fewer sleep complaints at two weeks but no difference at four.⁴ In Great Britain the chamomile claims submitted in 2008 were never assessed and remain on hold, so this page attaches no sleep wording to chamomile. Cup against capsule, the daisy-family allergy and the medicines to mention follow; the sleep supplements evidence page and the Wellgard ashwagandha guide set chamomile beside the other ingredients.

What did the chamomile sleep trials find?

The strictest trial is the smallest. In 2011, 34 adults aged 18 to 65 with primary insomnia of at least six months took 270 mg of a standardised chamomile extract twice a day, 540 mg in all, or placebo for 28 days. On every sleep-diary outcome, total sleep time, sleep efficiency, time to fall asleep, waking after sleep onset, sleep quality and number of awakenings, the groups did not differ significantly. The effect sizes were small to moderate and pointed both ways: time to fall asleep, night-time awakenings and daytime fatigue moderately favoured chamomile, while total sleep time moderately favoured placebo. Adverse events were the same in both groups.²

Two larger trials used softer designs. In 2017, 60 nursing-home residents in Iran, average age about 70, took 200 mg of chamomile extract twice a day or wheat-flour capsules for 28 days in a single-blind trial; the chamomile group's Pittsburgh Sleep Quality Index scores were significantly better after the course.³ In 2016, 80 Taiwanese women with poor sleep after childbirth drank chamomile tea for two weeks or had usual care with no placebo drink; at two weeks the tea group scored lower on physical-symptom sleep inefficiency and on a postnatal depression scale, and at four weeks the groups scored the same.⁴

Reviewing 12 randomised and quasi-randomised trials in 2019, reviewers found that pooled self-rated sleep quality was better on chamomile (standardised mean difference -0.73, 95% confidence interval -1.23 to -0.23), no significant change in insomnia severity in the single trial that measured it, and mild adverse events reported in three trials.¹ Read together: people taking chamomile tend to say they sleep better, the one diary-based insomnia trial could not confirm a change, and the positive trials lacked a placebo or a double blind.

What did the chamomile anxiety trials find?

The anxiety data are a little firmer than the sleep data. In the first controlled trial, 57 outpatients with mild to moderate generalised anxiety disorder took chamomile extract or placebo for eight weeks; Hamilton Anxiety Rating scores fell significantly more on chamomile (P = 0.047), one person in each group stopped for side effects, and the authors described the effect as modest.⁵ The 2019 pooled analysis put the generalised anxiety disorder difference at 1.43 points on the Hamilton scale at two weeks and 1.79 points at four, and found no effect on everyday state anxiety across three trials (standardised mean difference -0.15).¹ Those are findings in people with a diagnosed disorder, which is a matter for a GP and NHS talking therapies; no trial has compared chamomile with either.

How does chamomile work?

The flower's best-studied constituent is apigenin, a flavonoid that in laboratory work binds the same site on the GABA-A receptor as benzodiazepine medicines and produced calming effects in animals without sedation or muscle relaxation.⁶ That is the mechanism quoted on most chamomile pages, and a plausible one, but it comes from receptor assays and mice: no human study has shown that the apigenin in a cup of tea reaches the brain in amounts that matter, so the pooled trials report better self-rated sleep while the route in people is not yet established.

Chamomile tea or chamomile extract: how much is in a cup?

A tea bag holds 1 to 2 g of dried chamomile flower, steeped for a few minutes; most of the flavonoids are water-soluble, so a cup delivers some apigenin, but how much depends on the bag, the water temperature and the steeping time, and no trial has measured it. The capsule trials used 400 to 540 mg a day of a concentrated extract standardised to its apigenin content,^2,3 and the one tea trial reported cups rather than milligrams and compared tea with no drink at all.⁴ So a cup and a capsule cannot be converted into each other: the extract trials are the ones with placebo or control capsules, the tea trial the one that tested the drink people actually make. Chamomile tea is a herbal infusion with no caffeine, which matters because the NHS advises relaxing for at least an hour before bed and not drinking tea or coffee in the six hours before it.¹³

What may a UK label say about chamomile?

The Great Britain nutrition and health claims register lists the claims a food or supplement may make.¹⁰ Chamomile's proposed claims, submitted through the European botanical process in 2008, were never assessed: they sit among the several thousand botanical claims that remain "on hold", neither authorised nor rejected. That is a statement about the register's backlog, not a verdict on the trials above; the editorial position here is to report the trial numbers and attach no sleep, relaxation or calm wording to chamomile. In a blended product, the wording that may be used belongs to the nutrients that hold authorised claims: magnesium, for example, contributes to normal psychological function, to normal functioning of the nervous system and to the reduction of tiredness and fatigue, while the chamomile beside it carries no wording of its own.

Who should be careful with chamomile?

Allergy. Chamomile belongs to the daisy family, Asteraceae, alongside ragweed, mugwort, chrysanthemums and marigolds, and people sensitised to those pollens can react to it. Published cases include anaphylaxis after chamomile tea in a person with mugwort pollen allergy.⁸ Anyone with hay fever to those plants treats a first cup with care; swelling of the lips or throat, wheeze or faintness after chamomile is an emergency, and the NHS allergy pages describe what to do.¹¹

Anticoagulant medicines. Chamomile contains coumarin-type compounds, and one published case describes a 70-year-old woman on an anticoagulant admitted with internal bleeding after using chamomile tea and lotion for a cold; no trial has tested the combination.⁹ Anyone on an anticoagulant tells the anticoagulant clinic or pharmacist before taking chamomile daily, and stops it before surgery as they would any herbal product.

Pregnancy and breastfeeding. The NHS says not all natural or herbal remedies are safe in pregnancy, advises against taking herbal remedies when trying to get pregnant, and asks women to tell their midwife, doctor or pharmacist about any they use.¹² The postnatal tea trial was in women after birth, not during pregnancy, and did not report on breastfeeding,⁴ so the question is a GP or midwife conversation rather than a label one.

Sedating medicines. Because apigenin acts at the benzodiazepine site in laboratory studies, anyone on sleeping tablets, sedating antihistamines or other sedating medicines mentions chamomile to the pharmacist. No clinical interaction has been documented, and the trials reported adverse events no different from placebo.^1,2

Frequently asked questions

Does chamomile tea make you sleepy straight away?

No trial has measured a single-cup effect. The tea trial ran for two weeks and found a difference at the end of it,⁴ and the extract trials ran for 28 days.^2,3

How much chamomile should you take for sleep?

The extract trials used 400 mg (two 200 mg capsules) and 540 mg (two 270 mg capsules) a day for four weeks.^2,3 The tea trial told women to drink chamomile tea daily for two weeks and did not standardise the strength.⁴ There is no established dose, because no dose-ranging trial exists.

Can you drink chamomile tea every night?

The trials ran two to four weeks with mild adverse events only.¹ The exceptions are the daisy-family allergy and anticoagulant medicines above; outside those, nightly use is a matter of taste.

Is chamomile better than melatonin or magnesium for sleep?

Melatonin, a prescription-only medicine in the UK, brought sleep about 7 minutes sooner and added about 8 minutes across 19 trials of 1,683 people;⁷ magnesium brought sleep onset about 17 minutes sooner in three small trials of older adults, low-quality evidence.¹⁴ Chamomile's trials report a moderate change in self-rated quality and no significant diary change in the one insomnia trial; the melatonin explainer and the magnesium sleep page have the detail.

Sources

1. Hieu TH et al. Therapeutic efficacy and safety of chamomile for state anxiety, generalized anxiety disorder, insomnia, and sleep quality: a systematic review and meta-analysis of randomized trials and quasi-randomized trials. Phytotherapy Research 2019. PubMed 31006899
2. Zick SM et al. Preliminary examination of the efficacy and safety of a standardized chamomile extract for chronic primary insomnia: a randomized placebo-controlled pilot study. BMC Complementary and Alternative Medicine 2011. PubMed 21939549
3. Adib-Hajbaghery M, Mousavi SN. The effects of chamomile extract on sleep quality among elderly people: a clinical trial. Complementary Therapies in Medicine 2017. PubMed 29154054
4. Chang SM, Chen CH. Effects of an intervention with drinking chamomile tea on sleep quality and depression in sleep disturbed postnatal women: a randomized controlled trial. Journal of Advanced Nursing 2016. PubMed 26483209
5. Amsterdam JD et al. A randomized, double-blind, placebo-controlled trial of oral Matricaria recutita (chamomile) extract therapy for generalized anxiety disorder. Journal of Clinical Psychopharmacology 2009. PubMed 19593179
6. Viola H et al. Apigenin, a component of Matricaria recutita flowers, is a central benzodiazepine receptors-ligand with anxiolytic effects. Planta Medica 1995. PubMed 7617761
7. Ferracioli-Oda E et al. Meta-analysis: melatonin for the treatment of primary sleep disorders. PLoS One 2013. PubMed 23691095
8. Nakagawa M et al. A case of anaphylactic reaction to chamomile tea in a patient with mugwort pollinosis. Allergology International 2019. PubMed 30952586
9. Segal R, Pilote L. Warfarin interaction with Matricaria chamomilla. CMAJ 2006. PubMed 16636327
10. Department of Health and Social Care. Great Britain nutrition and health claims (NHC) register. gov.uk
11. NHS. Allergies. nhs.uk/conditions/allergies
12. NHS. Medicines in pregnancy. nhs.uk/pregnancy/keeping-well/medicines
13. NHS. Insomnia. nhs.uk/conditions/insomnia
14. Mah J, Pitre T. Oral magnesium supplementation for insomnia in older adults: a systematic review and meta-analysis. BMC Complementary Medicine and Therapies 2021. PubMed 33865376