Hops
In short
Summary of findings for quick reference
Hops are best known as a brewing plant. In the Middle Ages, Hildegard of Bingen described their bitterness as helping drinks keep longer. The Bavarian statute of 1516 permitted barley, hops and water for beer. Medicinal use of the female cones for restlessness and sleep problems is traditional. The hop pillow and nineteenth-century North American Eclectic medicine belong to this later record.
Clinical trials mainly concern hops combined with valerian. Some found shorter sleep latency, while others found small or inconsistent differences from placebo. Franco and colleagues instead studied non-alcoholic beer in 17 nurses in 2012, without a placebo comparison. That study does not demonstrate a valerian-hops combination effect. Reliable evidence for treating sleep disorders with hops alone remains insufficient.
EMA distinguishes hops alone from specified valerian-hops products. Hops alone are used for mild stress and to aid sleep on the basis of long-standing use. EMA recognises well-established medicinal use for sleep disorders for precisely defined combination extracts, not every tea or mixed product. Symptoms persisting for more than two weeks while using hops alone require medical advice. People with hormone-sensitive conditions should seek advice before using concentrated preparations.
Clinical evidence ↔ Historical significanceWe display two separate evidence categories: clinical evidence from modern trials and historical significance from documented healing tradition. Both are valuable, but they answer different questions.Read more
In every encyclopedia entry we evaluate two distinct categories of evidence. Clinical evidence as used in trials meets a narrower but scientifically essential bar. At the same time, the hundreds of thousands of plant species worldwide have only partially been captured and tested in modern studies.
Alongside the trial picture our researchers compile a comprehensive overview of where and since when a plant has been used across different traditions of natural medicine. When a plant has been used as a medicinal plant in many cultures across many generations, that historical significance deserves to be visible too.
Our position: a truly informative overview emerges only when both categories sit side by side. We communicate transparently what counts as what.
Overview
Hops (Humulus lupulus) are a climbing perennial in the Cannabaceae family. They are native to central Europe among other regions and are cultivated worldwide for brewing. The cone-shaped female inflorescences bear yellow lupulin glands containing many of the bitter and aromatic substances. Medicinal preparations use the dried hop cones, not only the separated glands.
The European Medicines Agency (EMA) recognises hop strobiles as a traditional herbal medicine for mild symptoms of mental stress and to aid sleep. German Commission E also lists restlessness and sleep disturbances. Clinical trials mainly concern particular combinations with valerian; their results cannot be attributed to hops alone.
History
Hops have a long history in European brewing. In the twelfth century, Hildegard of Bingen described their bitterness as helping drinks keep longer. The Bavarian statute of 1516 named barley, hops and water as permitted beer ingredients. The later tradition of calming use is distinct: a long brewing history does not establish a sleep benefit.
A traditional household remedy is the hop pillow, filled with dried cones and placed near the head. King’s American Dispensatory described it as a popular sleep remedy in 1898, while also noting that hops often failed to induce sleep. Later EMA and German Commission E monographs address restlessness and sleep problems; the EMA indication for hops alone is explicitly based on long-standing use.
Mechanism
Hops contain several well-described groups of compounds. Humulone is an alpha bitter acid and lupulone a beta bitter acid. They matter for beer bitterness and preservation and are also studied in relation to calming effects. Xanthohumol is another compound investigated in the laboratory. In cell assays, 8-prenylnaringenin showed potent oestrogen-like activity; this does not establish the strength of hormonal effects of a particular hops preparation in humans.
How hops might influence sleep is not fully understood. Laboratory findings offer possible explanations but do not prove a benefit in humans. Better results with some valerian-hops products do not by themselves establish pharmacological synergy. Maroo and colleagues studied valerian, passionflower and hops together in 2013. Their trial does not isolate the contribution of each plant.
In 2012 Franco and colleagues studied 333 millilitres of non-alcoholic beer with supper in 17 nurses. After two weeks, measured sleep latency was shorter than during the preceding control phase without beer. There was no placebo, so the contribution of hops remains uncertain. In 2013 Maroo and colleagues compared a valerian, passionflower and hops formulation with zolpidem. Both groups reported improvements after two weeks. Without a placebo group or a hops-only arm, this does not establish an effect of hops alone.
Placebo-controlled trials also exist for particular valerian-hops extracts. Koetter and colleagues found shorter sleep latency with the combination in 2007. In a larger study by Morin and colleagues in 2005, differences were mostly small and laboratory sleep measurements showed no significant group differences. Overall, the findings are limited and preparation-specific. A combination effect cannot be attributed to hops alone, hops tea or a hop pillow.
Evidence
| Outcome | Class | Grade | Effect | Studies | Refs |
|---|---|---|---|---|---|
| Sleep quality (hops + valerian combination)Specific valerian-hops extracts have been tested against placebo. Koetter et al. 2007 found shorter sleep latency. Morin et al. 2005 found mostly small or inconsistent differences, with no significant group differences in laboratory sleep measurements. This does not establish an effect of hops alone.Adults with mild sleep difficulties | EmergingEmerging research. Early small trials suggest an effect but await replication. | CEvidence quality grade C. Mixed or limited evidence. Small trials, signals, or traditional use under an EMA HMPC traditional-use monograph. This is an evidence rating, not a product endorsement. | Mixed findings | [3][4][7] | |
| Sleep quality (hops monotherapy)Reliable trials establishing hops alone as a treatment for sleep disorders are lacking. Franco et al. 2012 studied non-alcoholic beer, not an isolated hops extract, and had no placebo group. EMA bases its sleep-aid indication on long-standing use.Adults with mild sleep difficulties | TraditionalTraditional use. Long-standing folk practice or EMA HMPC traditional-use monograph. | DEvidence quality grade D. Preliminary signal. A single small trial, pilot result, or laboratory or animal model. Clinical relevance unclear. This is an evidence rating, not a product endorsement. | Efficacy insufficiently established | [6][1] | |
| Nervous restlessness (traditional use)Hops are traditionally used for restlessness, an indication also listed by Commission E. This does not establish a measured treatment effect. The hop pillow is a traditional remedy without a reliable clinical efficacy finding.Adults with mild restlessness or tension | TraditionalTraditional use. Long-standing folk practice or EMA HMPC traditional-use monograph. | DEvidence quality grade D. Preliminary signal. A single small trial, pilot result, or laboratory or animal model. Clinical relevance unclear. This is an evidence rating, not a product endorsement. | Traditional use | [6] | |
| Mild symptoms of mental stress (traditional use)EMA lists relief of mild stress symptoms as a traditional use. This classification rests on long-standing use rather than sufficient reliable clinical trials establishing efficacy.Adults with mild stress | TraditionalTraditional use. Long-standing folk practice or EMA HMPC traditional-use monograph. | DEvidence quality grade D. Preliminary signal. A single small trial, pilot result, or laboratory or animal model. Clinical relevance unclear. This is an evidence rating, not a product endorsement. | Traditional use | [6] |
Usage
Forms and preparation
For a bedtime tea, pour 150 to 200 millilitres of boiling water over 0.5 to 1 gram of dried, comminuted hop cones. Cover, steep for ten to fifteen minutes and strain, following the medicinal tea’s preparation instructions where provided. The infusion is markedly bitter; a little honey can soften the taste. EMA specifies taking it 30 to 60 minutes before bedtime. A hop pillow is filled with dried cones, sometimes with lavender, and placed near the head. Its filling can be renewed as the scent fades. It is a traditional household remedy without an established sleep benefit. Clinical studies mainly concern particular orally administered valerian-hops extracts.
Dosage
The following EMA doses apply from age twelve: for mild stress, 0.5 gram of comminuted hop cones per infusion up to four times daily; to aid sleep, 0.5 to 1 gram, in 150 to 200 millilitres of boiling water, 30 to 60 minutes before bedtime. Follow the individual leaflet for extracts and valerian combinations; milligram amounts of different extracts are not directly interchangeable. If symptoms persist for more than two weeks while using hops alone, or worsen, consult your doctor. Combination medicines have their own leaflet instructions. There is no medically established dose for a hop pillow, and it does not replace assessment of persistent sleep problems.
Safety
Look-alikes
FAQs
How does a Hopfenkissen actually work?
A hop pillow contains dried cones, sometimes mixed with lavender, and is placed near the head to release an aromatic scent. It is a long-standing household sleep remedy, but a reliable benefit has not been established clinically. The filling can be renewed as its scent fades.
Should I combine hops with valerian?
Specific valerian-hops extracts have been studied together and have their own EMA monograph. Some trials found improvements; others found only small differences from placebo. These findings apply to the tested preparations, not automatically to homemade tea mixtures. A pharmacist or doctor can advise whether a combination medicine is suitable. The efficacy of hops alone for sleep disorders is less well established.
Is hops hormonally active?
Yes, at least in laboratory experiments: 8-prenylnaringenin can act like oestrogen. Its relevance to a particular hops preparation depends in part on content and absorption. If you have a hormone-sensitive condition or receive hormone therapy, seek advice before using concentrated preparations. Laboratory findings alone cannot quantify an individual’s risk.
Can I take hops if I do not tolerate beer?
That depends on what causes the reaction. Beer contains possible triggers besides hops, so beer intolerance establishes neither a hops allergy nor the safety of hops preparations. Have unexplained or allergic reactions assessed before trying a preparation. With a known hops allergy, avoid hops in tea or pillows as well.
7 sources.
- Lourdes Franco; Cristina Sánchez; Rafael Bravo; Ana B. Rodríguez; Carmen Barriga; Eulalia Romero; Javier Cubero. The sedative effect of non-alcoholic beer in healthy female nurses. 2012. doi:10.1371/journal.pone.0037290
- Niteeka Maroo; Avijit Hazra; Tapas Das. Efficacy and safety of a polyherbal sedative-hypnotic formulation NSF-3 in primary insomnia in comparison to zolpidem: a randomized controlled trial. 2013. doi:10.4103/0253-7613.106432
- U. Koetter; E. Schrader; R. Käufeler; A. Brattström. A randomized, double blind, placebo-controlled, prospective clinical study to demonstrate clinical efficacy of a fixed valerian hops extract combination (Ze 91019) in patients suffering from non-organic sleep disorder. 2007. doi:10.1002/ptr.2167
- Charles M. Morin; Uwe Koetter; Célyne Bastien; J. Catesby Ware; Virgil Wooten. Valerian-hops combination and diphenhydramine for treating insomnia: a randomized placebo-controlled clinical trial. 2005. doi:10.1093/sleep/28.11.1465
- S. R. Milligan; J. C. Kalita; A. Heyerick; H. Rong; L. De Cooman; D. De Keukeleire. Identification of a potent phytoestrogen in hops (Humulus lupulus L.) and beer. 1999. doi:10.1210/jcem.84.6.5887
- European Medicines Agency, Committee on Herbal Medicinal Products (HMPC). Community herbal monograph on Humulus lupulus L., flos, Revision 1. 2014. Source
- European Medicines Agency, Committee on Herbal Medicinal Products (HMPC). European Union herbal monograph on Valeriana officinalis L., radix and Humulus lupulus L., flos, Revision 1. 2019. Source
Legal notice: The depiction of historical significance and traditional use is context within our encyclopedia and not a health claim for any product, not a treatment promise, and not a substitute for medical advice. What may be stated on product labels, product pages, or in advertising is governed by the applicable legal requirements.