Because stress levels are associated with neuroendocrine function, ashwagandha may affect general mental and brain health by reducing stress.[1][2][3][4] In studies where ashwagandha improved subjective signs and symptoms of stress, factors such as anxiety, cognition, and sleep quality also improved, along with cortisol.[5][6][7][8][9] It should be noted that the efficacy of ashwagandha is more pronounced in people reporting both a negative health state and high stress levels.[10][11] Effectiveness for sleep has been mirrored in some human studies, where a significant increase in sleep quality (among other sleep related parameters such as improvements in sleep latency, sleep efficiency, sleep duration, alertness, and reduced sleep disturbance) occurred when ashwagandha (120–700 mg) was taken daily for periods ranging from 1 to 3 months.[12][13][14][15][16] It should be noted, however, that prior studies using higher doses of ashwagandha extract (750–2,000 mg, alone or combined with other herbs) did not result in further significant improvements in sleep.[17][18][19]