Chinese herbal medicine was superior to placebo and benzodiazepine drugs and was superior to benzodiazepines and psychotherapy alone as an adjunct therapy in terms of subjective sleep quality and quantity and safety.
In this study, we systematically reviewed 79 RCTs investigating a variety of Chinese herbal medicine (CHM) treatments for participants with insomnia. We also performed meta-analyses to estimate the efficacy of CHM on subjective sleep quality assessed by validated instruments, patient-rated sleep parameters, clinician-reported severity, and PSG results, as well as to determine the safety of CHM.
Overall, this systematic review and meta-analysis showed that CHM was superior to placebo and benzodiazepine drugs (BZDs) when used as a monotherapy and was superior to BZDs and psychotherapy alone as an adjunct therapy in terms of subjective sleep quality and quantity and safety. CHM was not associated with more benefit than non-BZDs, although the risks were less. These results suggest that CHM could be a promising alternative therapy with a good benefit–risk ratio.