Is bedtime use of kratom (Mitragyna speciosa) a sleep aid or disruptor? Examining its daily effects and individual differences

Kratom (Mitragyna speciosa) is a psychoactive botanical native to Southeast Asia increasingly used in the United States for various self-reported benefits, including sleep improvement. However, empirical evidence concerning kratom's effects on sleep is limited. Here, we examined the association between bedtime kratom use and self-reported sleep outcomes in naturalistic settings across consecutive days, while also exploring sex and chronic pain status as potential moderators. A secondary analysis was conducted using the data from a 15-day ecological momentary assessment study of 357 U.S. adults who reported regularly using kratom. Participants made daily reports of their bedtime kratom use and rated their sleep duration and quality. Linear mixed-effects models assessed associations between bedtime kratom use and sleep outcomes, with sex and chronic pain status as moderators, controlling for age. Bedtime kratom use occurred on 23.4% of days and was associated with modest increases in sleep duration (13 min) and perceived quality (5.93-point increase on a 0-100 scale). Female respondents reported greater improvements in sleep quality (but not duration) than male respondents. Participants with chronic pain reported greater improvements in sleep duration and quality compared to those without chronic pain. Bedtime kratom use is associated with modest sleep duration and quality improvements, particularly in adults with chronic pain, and better sleep quality in female respondents. These findings among experienced kratom consumers suggest the need for human laboratory studies in kratom-naïve participants to determine causality and underlying mechanisms, which could help inform clinical guidance and policy as kratom use continues to rise. (PsycInfo Database Record (c) 2025 APA, all rights reserved).