Chamomile (Matricaria chamomilla) is a herbal product that has become incredibly popular in the health & supplement industry as well as self-care, beauty and household products such as scented candles, pillow sprays and infused sleeping masks. Chamomile is specifically marketed as a sleep aid and a calming herb, most commonly used next to its twin, lavender.
The purpose of this article is to briefly review what we know about chamomile from research, what has been found and what hasn’t and how much of what we keep hearing has been demonstrated.
If you, the reader, are not very interested in reading about the individual studies or are short on time, I'd suggest you head to the final summary of the key findings towards the end of this article to save time :) If you are a more curious reader, please carry on as you would.
About Chamomile Chamomile is one of the oldest known medicinal and decorative herbs spread across the world. The name comes from the Greek “Kamai-Melon”, which translates roughly to ground apple due to its characteristic scent that vaguely resembles a fresh apple.
It had an important place in ancient and medieval medicine due to its pleasant smell and some early-discovered health benefits, mainly as a sedative for hysterical and psychotic people. Historically it would have also been combined with ginger in a hot drink to alleviate heartburn, flatulence or even infant colic.
Insomnia & Sleep Quality
One of the most common uses for chamomile is to improve sleep and many people claim that it does help them sleep. Several studies have investigated Chamomile’s usefulness in Insomnia and general sleep quality. Let’s break them apart.
Insomnia
Study 1 (Zick et al. 2011)
34 participants aged 18-65 suffering from medically diagnosed insomnia were randomly divided into two groups of 17 people. One group received a placebo, and the other group received a 540mg chamomile extract divided into two dosages of 270mg taken at different parts of the day. Researchers wanted to see if there would be any effect on insomnia, including quality of sleep, sleep onset latency, duration and overall quality, as well as on the daily fatigue score in those taking chamomile.
Results: In both groups, there was an improvement in insomnia. However, the results did not achieve statistical significance (meaning it is hard for us to be sure that improvements were due to chamomile and not something else). For example, simply knowing that participants were exposed to something that “might work” could produce a psychosomatic response, improving their sleep.
One of the expected effects of chronic insomnia is hopelessness (“nothing I try works”) and so having a new approach and being part of the research team, being surrounded by scientists and testing something that seems legit may have a robust psychosomatic response even if the substance itself (chamomile) might have nothing to do with it.
Based on this first study's results, it is impossible to conclude that Chamomile is helpful in insomnia. But, equally, it does not mean that it isn’t.
Study 2 (Chang & Chen, 2015)
(Unfortunately, everything I got on this study is from Abstract only, I was not able to obtain a full study so my understanding may be limited here)
80 Taiwanese post-natal (recently gave birth to a child) women who have been experiencing post-partum (after birth) sleep disturbance and depression were randomly divided into two equally large groups. The control group received a standard medical post-partum care, whereas the experimental group was told to drink chamomile tea every day for two weeks.
Results: Surprisingly, the group drinking chamomile tea improved sleep and felt less depressed. This effect, however, disappeared after 4 weeks, and both groups scored similarly on the test on week four after the study. This study, however, shows that drinking chamomile tea may produce a short-term improvement in mood and sleep. This effect could have also been fully psychosomatic since many of us are familiar with the smell & taste of chamomile and associate it with a calming effect. Secondly, I know that most of the readers of this blog are men in 18-36, so it may not be entirely relevant to you, the reader, that post-natal women had an improvement. It may certainly be a strategy worth considering especially considering the low investment in purchasing chamomile tea.
Sleep Quality
The topic of sleep quality (other than insomnia which is an extreme form of sleep deprivation) has been explored a little bit more. There was a large systematic review & meta-analysis (this type of study represents the highest form on the hierarchy of evidence because it pools together all available research on a particular topic within a specific set of time and creates a consensus based on the individual findings) done in 2019 (Hieu et al.).
In this study, they meta-analysed six studies (including the 3 above) exploring the topic of sleep quality and found that, overall, chamomile produced an improved sleep quality across the participants in dosages of 200-400 milligrams of chamomile extract.
What is worth noting is that most of these six studies was looking at older adults (over 70) where sleep problems are more common compared to young people and in one study, participants had a medically diagnosed chronic kidney disease. Only one of those included young male participants (Study 1, explored above) and one of them included younger female participants who recently gave birth (Study 2, explored above)
Conclusion on chamomile and sleep
In the elderly, chamomile appears to help improve sleep quality and insomnia.
In young women who have recently given birth, drinking chamomile tea may, over the short term, improve sleep and mood
We don’t have enough data to confirm if chamomile is helpful for young men who experience insomnia
I think chamomile is worth experimenting with for those men who, alongside insomnia, also experience anxieties & depression, and in the next section, you will understand why
Anxieties & Depression
Six studies have explored the experimental use of chamomile extract in patients with anxieties or depression. Most of these have been conducted by the same group of researchers who were gradually testing more and more hypotheses with different degrees of response. Below is a summary of each, starting from the oldest.
Study 1 - Amsterdam, 2009
Aim: to explore the effect of Chamomile on Generalised Anxiety Disorder (GAD)
Design: 57 participants with diagnosed anxiety disorder were randomly assigned to 1100mg chamomile extract (28) or placebo (29) group.
Results: Significant reduction of anxiety symptoms in chamomile group compared to placebo across all measured scales
Adverse Effects: reduced heart rate in a few participants warrants caution for people who are already on medication designed to do this. A risk of bradycardia (very slow heart rate), albeit small, still exists.
Study 2 - Amsterdam, 2012
Aim: To investigate if chamomile can also be helpful for depression besides anxieties
Design: 57 depressed patients divided into chamomile (28) and placebo (29) groups for eight weeks. The experimental group took 220mg of chamomile extract the first week, and then doses were increased each week until they achieved 1100mg on the 5th week and carried on with 1100mg until the end of 8th week.
Results: chamomile produced statistically significant improvement in depressive symptoms. While some had more improvement and some less, everyone in the chamomile group improved slightly. Not just that, but the participants reported feeling less guilt on daily basis, better sleep and even improved libido.
Adverse Effects: In a few participants, their sleep has worsened, and they reported gastrointestinal discomfort.
Study 3 - Keefe,2016
Aim: To test if 1500mg chamomile extract is helpful for patients with anxieties and how well tolerated it would be
Design: 179 patients diagnosed with severe anxiety enrolled in a single-label open trial (open-label means that there was no blinding, no randomisation and no placebo, everybody received chamomile)1500 mg chamomile) for eight weeks.
Results: 104 out of 179 patients had an improvement in their anxieties. What was fascinating was that 24% of those 104 responded already at week 2 (positive response was classified as 50% anxiety improvement compared to baseline). People who responded significantly improved their overall quality of life, mood and subjective wellbeing. Yet despite having 42% of non-responders (did not get better taking chamomile), the fact that 58% did get better was an outcome that would be expected out of common psychiatric medication, often known to produce adverse effects when used long term.
Adverse Effects: mild adverse effects were experienced by about 21 study subjects, but none were classified as severe. Most common were drowsiness and dysgeusia (taste alteration and loss of appetite)
Mao,2016
Aim: To test if, following anxiety improvement, prolonged chamomile supplementation could cause anxiety relapse.
Design: This was a two-phase study.
Phase I – 179 participants diagnosed with moderate anxiety disorder were enrolled in a 12-week open-label trial (similar to above), and those of them classified as “responders” by the end of week 12, then proceeded to Phase II. Responder means improving anxiety by 50% or more compared to their initial anxiety scores (they used an anxiety scoring matrix called GAD-7 to make that comparison). 93 out of 179 passed Phase I (by getting >50% improvement on GAD-7) and were enrolled on Phase II
Phase II – the remaining 93 that passed Phase I were randomised into 1500mg/day chamomile group (n=46) and placebo group (n=47) for 26 weeks. Researchers wanted to know how many would relapse and how many would still be free from anxieties by the end of week 26
Results – By the end of the 26th week of Phase II, 15.2% in the chamomile group relapsed (anxiety got worse) compared to 25.2% relapsing in the placebo group.
Of the initial 46 patients in the chamomile group, 35 were no longer anxious by the end of week 26.
Of the initial 47 patients in the placebo group, 29 were no longer anxious by the end of the week
Because of this (both groups improved), the statistical significance of the result was low (it was hard to tell if chamomile had anything to do with the results because so many in the placebo also felt better)
All in all, those in the chamomile group had better psychological well-being by the end of week 26 and lower odds of relapsing.
Adverse Effects: no significant adverse effects were recorded. Some participants in the chamomile groups also experienced a reduction in the systolic blood pressure (the first number)
Amsterdam,2020
Aim: to test if chamomile is effective in anxious patients with and without comorbid depression and whether one group responds better than the other.
Design: 179 participants with primary anxiety disorder diagnosis enrolled on an 8-week open-label trial taking 500-1500mg chamomile. The dose was flexible, and participants could willingly oscillate between 500-1500 dosages (each capsule contained 500mg)
100 also had depression alongside anxieties
79 had only anxieties
Results – in this study, the majority of the results were not statistically significant (despite showing a trend toward improvement); however, one scale called Hamilton Depression Rating produced a statistically significant improvement that was more profound in people who experienced a comorbid depression alongside primary anxiety diagnosis compared to those who only experienced anxieties
Limitations of this study:
It is possible that the study was not large enough and not powered adequately to show meaningful statistical relationships in all the other markers. A more extensive study would indeed show something else.
A potential limitation was that the group with both anxieties and depression had a later average onset of the condition (25.1 years) compared to those who only suffered from anxieties (18.6 years). This means that in the second group, the people were likely to be first diagnosed with anxieties around the age of 18, whereas the other group were more likely to be diagnosed around 25. Now, this is just my speculation, but we know that long-term experience of a psychiatric condition produces specific macro and micro changes in the brain. The longer one suffers, the harder it is to treat this condition. So you can probably see why this would be a potential limitation. Imagine being treated for asthma that started developing five years ago vs if it began to developing 12 years ago.
And finally, one study (Ebrahimi, 2021) has shown that in the elderly, daily inhalation of chamomile oil (dropped on a cotton bud attached to the pillow overnight) improved self-perceived psychological well-being, so chamomile oil inhalation through a dehumidifier may also be worth as low-stakes experimentation for some people.
In summary, it appears, from the research available, that chamomile may be fairly effective for people who experience anxieties and do not want to go on medication. Daily doses up to 1500 mg were fairly well tolerated for up to 38 weeks and produced decent improvement in most patients. People taking chamomile, on average, reported feeling better, sleeping better and being more balanced.
Chamomile does not appear to be as effective for depression, perhaps because of different means of action, although in some of the above studies, even people experiencing depression had benefits. The primary use of chamomile should be aimed at anxiety disorders.
Who should be careful with taking supplemental Chamomile?
People already taking medication for anxieties or depression should be careful, and even though I haven’t found any direct case study of interaction, it is always to be cautious when taking herbs alongside psychiatric medicine.
People taking medication aimed at reducing heart rate, blood pressure or regulating heart irregularities should also be careful due to the known potential of chamomile to lower blood pressure and heart rate
People who may be intolerant to chamomile or have chamomile allergies in the family need to be careful too
Summary & Key Points
Chamomile is a traditional herb with a long-standing use for thousands of years across traditional medicines
Chamomile may be effective for young individuals who experience insomnia and other sleep problems; however at this stage, we have very little data to confirm that it works, so without more studies, we can’t be sure. It appears chamomile is more effective in the elderly in improving sleep than in healthier young individuals. Still, drinking chamomile tea before sleep may be a cheap way to test it for yourself.
For anxieties, taking 500-1500mg of chamomile extract has been shown to be fairly effective and well-tolerated for up to 36 weeks to improve subjective wellbeing and mood. Doses should be increased carefully, and people already on medication for heart health need to discuss this with their doctor first.
For depression, the effectiveness appears to be lower; however, for people not taking any psychiatric medication, doses up to 1500mg per day may produce some benefits in the mood.
Finally, for people who experience both anxieties & depression at the same time, the effectiveness of chamomile appears to be better than depression alone.
Some research also points out potentially useful chamomile oil inhalation for people suffering from stress and sleep problems.
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SOURCES
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Ebrahimi H, Mardani A, Basirinezhad MH, Hamidzadeh A, Eskandari F. The effects of Lavender and Chamomile essential oil inhalation aromatherapy on depression, anxiety and stress in older community-dwelling people: A randomized controlled trial. Explore (NY). 2022 May-Jun;18(3):272-278. doi: 10.1016/j.explore.2020.12.012. Epub 2021 Jan 9. PMID: 33454232.
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