Well-studied herb with solid evidence for anxiety and mixed results for sleep. Traditional European use is extensive, but modern research focuses on concentrated extracts rather than traditional tea preparations.
Traditions: European herbalism, German phytotherapy
Multiple traditions agree on use.
Approved monograph for dried flowering heads. Standard tea preparation: 3g flowers in 150mL boiling water, steep covered 5-10 minutes.
European Union Herbal Monograph based on 30+ years documented traditional use. Approved for minor gastro-intestinal complaints, relief of common cold symptoms, minor oral and throat inflammations, skin irritation and superficial wounds.
Included in WHO Monographs on Selected Medicinal Plants with specifications for essential oil, purity tests for microbes, pesticides, and heavy metals.
Anxiety evidence is strong with multiple RCTs showing meaningful symptom reduction. An 8-week trial with 179 adults with moderate-severe GAD found 58.1% met clinical response criteria on 1500 mg/day [1]. A meta-analysis of 10 trials found 9 of 10 studies concluded chamomile effective for anxiety [2]. Sleep evidence is weaker - one trial with 60 elderly adults found significant improvement [3], but a trial with 34 adults with chronic insomnia found only modest non-significant effects [4]. A meta-analysis found significant improvement in sleep quality (SMD -0.73) but no effect on sleep duration or efficiency [5]. Quality matters significantly - the research uses pharmaceutical-grade standardized extracts (1.2% apigenin), not traditional tea.
179 adults with moderate-severe GAD taking 1500 mg/day for 8 weeks: 58.1% met clinical response criteria, GAD-7 change β=-8.4 (95% CI -9.1 to -7.7). Treatment-emergent adverse events: 11.7%, none serious. Discontinuation: 15.6%.
10 clinical trials reviewed: 9 of 10 studies concluded chamomile effective in reducing anxiety. Authors note effective and less dangerous compared to pharmaceutical anxiety treatments.
60 elderly adults (60+): 200 mg twice daily (400 mg/day) for 28 days improved sleep quality vs controls (P<0.05).
34 adults with DSM-IV primary insomnia: 270 mg twice daily (540 mg/day) for 28 days showed no differences in sleep time, efficiency, latency, or quality (P>0.05). Modest non-significant advantage on daytime functioning.
10 trials, 772 participants: PSQI score reduction of 1.88 points (WMD -1.88, 95% CI -3.46 to -0.31, P<0.05). Improved sleep onset in 3 of 4 studies, improved awakenings in 2 of 3 studies. No effect on sleep duration or efficiency. No adverse events reported.
93 responders randomized after 12-week open-label phase: 26-week double-blind continuation showed relapse rate 15.2% (chamomile) vs 25.5% (placebo), hazard ratio 0.52 (95% CI 0.20-1.33, P=0.16) - non-significant trend favoring chamomile. Total duration 38 weeks.
Most robust evidence for GAD. Pharmaceutical-grade with HPLC fingerprinting confirming apigenin-7-glucoside and 7-methoxycoumarin. Standardized to 1.2% apigenin. Duration: 8-38 weeks in trials. Response rate: 58.1% clinical response at 8 weeks.
Significant sleep quality improvement in 60 elderly adults over 28 days. Lower dose than GAD protocols.
PMS: 100 mg 3x daily (300 mg/day) for 2 cycles showed 30-33% emotional symptom reduction. Menopausal symptoms: 400 mg/day (100 mg 4x daily) for 12 weeks reduced overall symptoms by 10.36 points.
German Commission E standard traditional preparation. Covering during steeping critical to retain volatile oils. Traditional method differs significantly from concentrated extracts used in clinical trials - not directly equivalent.
Used in trials for cyclic mastalgia (5 drops 3x daily for 2 months, significant pain reduction p=0.007) and hyperprolactinemia (5 mL syrup 2x daily for 4 weeks, significant prolactin reduction p<0.0001).
Oral mucositis: Applied topically 1-4x daily, effective in 4 of 6 RCTs with 492 patients total. Pediatric enuresis: Topical chamomile oil daily for 6 weeks in 80 children, significant reduction in enuresis frequency, no adverse events.
Chamomile has clearer research than most herbs - and the picture that emerges is nuanced. It genuinely helps anxiety. It sort of helps sleep. And it’s surprisingly useful for certain women’s health issues.
For Anxiety - This Is Chamomile’s Strength
In a trial of 179 adults with moderate-to-severe generalized anxiety, 58% met clinical response criteria after 8 weeks on chamomile extract [1]. That’s not a small effect. A 2024 systematic review found 9 out of 10 trials concluded chamomile works for anxiety, with the authors specifically noting it’s “effective and less dangerous compared to pharmaceutical anxiety treatments” [2].
What does “clinical response” mean in practice? Your anxiety doesn’t disappear, but stressful situations stop spiraling. The constant background hum of worry quiets. You can handle things that would have sent you into a tailspin before.
The long-term data is encouraging too - one trial followed people for 38 weeks without serious adverse events [6]. You can keep taking this if it works for you.
For Sleep - Honest About the Limits
Here’s where you need realistic expectations. Chamomile helps some aspects of sleep but not others.
In elderly adults, 400 mg daily improved sleep quality over 28 days [3]. A meta-analysis of 10 trials found you’re likely to fall asleep faster and wake up less often during the night [5]. That’s real.
But total sleep time? The research doesn’t show improvement there [5]. You won’t suddenly sleep 8 hours instead of 6. You’ll still sleep the same amount, but the sleep you get may feel better. If that’s enough for you, chamomile might help. If you need more hours, look elsewhere.
For Women’s Health - Underrated
This is where chamomile surprised researchers. For PMS emotional symptoms specifically (irritability, mood swings, tension), 300 mg daily for two cycles reduced symptoms by 30-33% - actually outperforming mefenamic acid for the emotional component [11]. It didn’t help physical symptoms, but for the emotional rollercoaster, it worked.
For menopausal symptoms, 400 mg daily for 12 weeks reduced hot flashes, mood issues, joint discomfort, and urinary symptoms across the board [10]. Two women out of 80 had to stop due to side effects (mouth sores, skin spots), but most tolerated it fine.
Chamomile has been used in European medicine for so long that regulatory bodies across the continent have formal monographs on it. The German Commission E, European Medicines Agency, and WHO all recognize its traditional uses - and interestingly, those traditional uses line up reasonably well with what modern trials confirm.
Traditional applications centered on digestive complaints (bloating, spasms), calming effects, sleep support, and skin irritations. The standard preparation was tea - a heaped tablespoon of dried flowers steeped covered in hot water for 5-10 minutes. The covering matters because it keeps the volatile oils from escaping.
One important distinction: The clinical trials showing 58% response rates for anxiety used concentrated extracts standardized to 1.2% apigenin at doses of 1500 mg daily [1]. Traditional chamomile tea is nowhere near that concentration. The tea is fine for general relaxation and mild digestive complaints - it has centuries of safe use behind it. But if you’re trying to match the anxiety trial results, you’ll need the standardized extracts, not grandma’s bedtime tea.
What you’re trying to address determines your protocol. The anxiety evidence is strongest, sleep is modest, and women’s health uses are specific to certain symptoms.
Take 1500 mg daily of standardized extract (500 mg capsules, three times a day). This is the dose that achieved 58% clinical response in the main anxiety trial [1]. You need pharmaceutical-grade extract standardized to 1.2% apigenin - not the random chamomile supplement from the grocery store.
Give it 8 weeks before deciding if it works. Some people notice shifts by week 2-4, but the full assessment window is 8 weeks [9]. If you’re responding, the research shows you can safely continue for at least 38 weeks [6].
Take 400 mg daily, split into 200 mg twice a day. This helped elderly adults fall asleep faster and wake up less often [3].
Be realistic about what you’re looking for. Chamomile may help the quality of your sleep - falling asleep faster, fewer 3am awakenings. It probably won’t add hours. If you’re tracking sleep duration expecting to go from 5 hours to 7, you’ll be disappointed [5]. If you’re tracking “did I toss and turn less?” you might see improvement.
Take 300 mg daily (100 mg three times a day) for at least two menstrual cycles. The trial found 30-33% reduction in irritability, mood swings, and tension [11]. Physical symptoms didn’t change - this is specifically for the emotional component.
Take 400 mg daily (100 mg four times a day) for 12 weeks. The trial found improvements across hot flashes, mood, joint discomfort, and urinary symptoms [10].
Steep a heaped tablespoon (~3g) of dried flowers in 2/3 cup boiling water for 5-10 minutes, covered. The cover matters - it traps the volatile oils.
This is fine for general relaxation and mild digestive issues. But don’t expect tea to match the trial results for anxiety or sleep. The extracts are far more concentrated.
Week 1: Too early to judge. Just establish your baseline. Weeks 2-4: Early responders might notice something subtle. Weeks 4-8: This is the real assessment window. If nothing by week 8, you’re probably a non-responder. Beyond 8 weeks: If it’s working, keep going. Long-term safety data is reassuring [6].
Get a baseline before you start. A week of honest self-assessment gives you something real to compare against.
For anxiety: Pick a few situations that typically trigger you. Rate your anxiety 0-10 in those situations. How often do you have anxiety episodes? When stress hits, can you regulate or does it spiral?
For sleep: How long does it take you to fall asleep? How many times do you wake up at night? Rate your overall sleep quality 0-10. Don’t obsess over total sleep duration - the research doesn’t show chamomile changes that [5].
For PMS: Rate your emotional symptoms (irritability, mood swings, tension) in the days before your period. Track through 2-3 full cycles to see if there’s a pattern.
For menopause: Rate hot flashes, night sweats, mood, joint discomfort, urinary symptoms separately. Track for the full 12 weeks.
For anxiety: Stressful situations still happen, but they don’t send you spiraling. The background worry quiets. You can handle things that would have overwhelmed you before.
For sleep: You’re falling asleep faster. You’re waking up less at 2am. You don’t necessarily sleep longer, but the sleep feels better.
For women’s health: Emotional symptoms before your period are noticeably less intense. Menopausal symptoms across all domains have eased.
Chamomile is generally very well tolerated - the meta-analysis found only mild adverse events in 3 out of 12 trials [9]. The main things to watch: mouth sores, skin spots, itching (2 out of 80 women in one trial [10]). If you have any allergic reaction signs - rash, swelling, breathing difficulty - stop immediately. This is especially important if you have any ragweed allergies (same plant family).
You have mild-to-moderate generalized anxiety and want something gentler than pharmaceuticals. The systematic review specifically noted chamomile is “effective and less dangerous compared to pharmaceutical anxiety treatments” [2]. You’re an older adult whose sleep quality has declined (falling asleep takes forever, you wake up constantly). You have PMS emotional symptoms - the irritability and mood swings, not the cramps. You’re dealing with menopausal symptoms across the board.
What people who respond report: “Work stress doesn’t send me into a tailspin anymore.” “I fall asleep in 20 minutes instead of an hour.” “My PMS mood swings are way less intense.”
You have severe anxiety or insomnia that needs immediate intervention - this takes weeks to work. You want more total sleep time - chamomile helps quality, not duration [5]. You expect dramatic overnight changes - this is subtle and cumulative. You’re not willing to use pharmaceutical-grade extracts - the tea won’t match the trial results.
You’re allergic to ragweed, chrysanthemums, marigolds, echinacea, or anything else in the Asteraceae family. Same plant family means potential cross-reaction.
Pregnancy note: The EMA doesn’t list pregnancy as a contraindication, but the data is thin. For nursing, LactMed considers it generally compatible when taken orally [21]. Chamomile tea has even been safely used in infants for colic and diarrhea.
The trials that showed 58% anxiety response [1] and significant sleep quality improvement [3] used pharmaceutical-grade extracts standardized to 1.2% apigenin with HPLC fingerprinting. What you grab off a drugstore shelf might not be anywhere close.
LactMed actually warns about this: “differences often found between labeled and actual ingredients/amounts in dietary supplements” [21]. The supplement industry has a quality control problem, and chamomile isn’t exempt.
What to look for:
A concerning note about tea: Some loose-leaf chamomile teas from health food stores have been found to contain Clostridium botulinum spores [21]. This is particularly concerning for infant use. If you’re giving chamomile to a baby (it’s traditionally used for colic), stick to tested, reputable sources.
Avoid products with: no standardization info, “proprietary blends” hiding actual amounts, or claims that sound too good (“cures insomnia,” “eliminates anxiety”).
Chamomile has real evidence behind it - rigorous trials with meaningful sample sizes, not just “promising preliminary results.” The picture is nuanced, though.
Where chamomile delivers: Anxiety is the clearest win - 58% clinical response rate, with 9 out of 10 trials concluding it works [1][2]. A 2024 systematic review specifically noted it’s “effective and less dangerous” than pharmaceutical anxiety treatments [2]. Sleep quality (not duration) improves for some people, especially older adults [3][5]. PMS emotional symptoms and menopausal symptoms both respond well in the research [10][11].
Where you need realistic expectations: About 42% of people with GAD didn’t respond in the main trial [1]. Sleep duration doesn’t change - only sleep quality. Effects take weeks to assess, not days. The traditional tea is pleasant but won’t match trial results - you need standardized extracts.
If you decide to try it: Use pharmaceutical-grade extract standardized to 1.2% apigenin. For anxiety: 1500 mg/day split into three doses, 8-week trial minimum. For sleep: 400 mg/day, split into two doses, 4-week trial. For PMS/menopause: 300-400 mg/day, track through 2-3 cycles. If you’re not noticing anything by 8 weeks, you’re probably a non-responder - move on.
Don’t bother if: You’re allergic to ragweed or related plants. You need immediate relief. You won’t commit to standardized products. You’re expecting dramatic changes rather than subtle, cumulative improvement.
The safety profile is genuinely reassuring - 38 weeks studied without serious adverse events [6], and most trials show adverse events at or below placebo levels [9]. Just make sure you’re not allergic to the Asteraceae plant family, and you’re using quality products.
Duration: 28 days minimum for sleep effects (most sleep trials). 8 weeks for anxiety (clinical response evident, though some improvement seen earlier). Up to 38 weeks studied for GAD without serious adverse events. Women's health: 2 cycles for PMS, 12 weeks for menopausal symptoms. Start within first 2-4 weeks of trying to assess if you're responding.
What to notice:
You're tracking: did anxiety feel more manageable in daily situations? Can you notice falling asleep faster, even if total sleep time hasn't changed? For women's health, track specific symptom severity through 2-3 cycles to detect patterns. The research shows quality improvements (how you feel) more than duration improvements (objective measures). Meta-analysis of anxiety and sleep studies reported only mild adverse events in 3 of 12 RCTs with favorable overall safety profile. What you won't see: immediate overnight changes - effects build over weeks. If no noticeable benefit by 4 weeks, you're likely a non-responder for that indication.
Generally considered: safe
Contraindications:
Pregnancy/Nursing: EMA monograph does not list pregnancy as explicit contraindication, though more research needed. LactMed Database (2021): safely and effectively used in infants for colic and diarrhea. Risk of contact dermatitis with topical nipple applications (2 case reports with Kamillosan ointment). Generally compatible with breastfeeding when used orally.
Long-term safety up to 38 weeks in trials without serious adverse events. GAD trial with 179 adults: 11.7% treatment-emergent adverse events, 15.6% discontinuation, zero serious adverse events. Menopausal trial: 2 of 80 participants experienced mouth sores, skin spots, itching leading to discontinuation. Most trials show similar or lower adverse event rates vs placebo. Quality control critical: loose-leaf chamomile teas from health food stores can contain Clostridium botulinum spores (particular concern for infant use). LactMed warns differences often found between labeled and actual ingredients/amounts in dietary supplements. Allergic reactions more common with topical preparations (especially on moist internal surfaces) than oral. Theoretical additive sedative effects with CNS depressants. Coumarin content (~0.1%) theoretically relevant for anticoagulant interactions though clinical significance unclear. Comparative safety: described as 'effective and less dangerous compared to pharmaceutical anxiety treatments' in 2024 systematic review.