卡瓦胡椒 Kava × 失眠
結論：台灣市場資訊黑箱
卡瓦對失眠（原發性）證據明確偏向無效：方法學最強的單獨失眠 RCT（Jacobs 2005, n=391, 雙盲）在 ISI 上 kava 不優於安慰劑；唯一正面試驗（Lehrl 2004, WS 1490, n=61）研究的是『焦慮伴隨型睡眠障礙』，睡眠改善由抗焦慮作用混淆，且為產業資助、低品質。
U ⚫ U 未驗證 台灣法規禁言 ✨ low — community discussion mostly non-commercial
卡瓦對失眠（原發性）證據明確偏向無效：方法學最強的單獨失眠 RCT（Jacobs 2005, n=391, 雙盲）在 ISI 上 kava 不優於安慰劑；唯一正面試驗（Lehrl 2004, WS 1490, n=61）研究的是『焦慮伴隨型睡眠障礙』，睡眠改善由抗焦慮作用混淆，且為產業資助、低品質。
Examine 對 Sleep Quality 評 D（4 試驗/n=1261, No effect/Negligible），L5a/b/c/d 一致 not_addressed、L5e（AASM 2017）against。
獨立判讀為 D（反證據），與 kava×anxiety（有 A 級療效）截然不同——卡瓦非驗證安眠補給。
疊加肝毒性（LiverTox score A）與台灣食安法§15 禁用，本對為低效＋違法雙重負面。
⚖️
評分透明度
所有分數由 7 層證據引擎計算，過程公開可查原始分數 0.29
D
C
B
A
S
← 反證據 / 無效有效 / 強證據 →
最終評級
U · 台灣法規禁言
信心度
76%
證據方向大致一致
證據層級
E6
多篇較小型隨機對照試驗
▸查看完整決策路徑（audit trail）
- compute_raw_score — 加權公式: L2×0.30 + L3×0.25 + L5×0.25 + L11×0.10 + L1×0.10 = 0.294
- tier_from_score — 依分數區間映射至 tier letter
- apply_hec_rules — 無高階證據可裁決
- tier_strict_requirement_check — D 級條件未達 (需 E1-E3 negative；實際 E6)
- detect_disputes — 偵測到 0 個 hard + 0 個 soft dispute
- decide_status — 依 tier + dispute 結果決定 status
An internet-based randomized, placebo-controlled trial of kava and valerian for anxiety and insomnia
結論：Neither kava nor valerian relieved insomnia more than placebo; valerian vs placebo difference 0.4 points (95% CI -1.3 to +2.1), not significant.
前往 PubMed
Clinical efficacy of kava extract WS 1490 in sleep disturbances associated with anxiety disorders (multicenter RCT)
結論：Significant improvement in sleep quality (P=0.007) and recuperation (P=0.018) vs placebo, but population had anxiety-associated sleep disturbance — sleep effect confounded by anxiolysis, not standalone primary insomnia.
前往 PubMed
Kava and valerian in the treatment of stress-induced insomnia
結論：Small uncontrolled pilot reporting reduced stress-related insomnia with kava, but no placebo arm and sleep benefit tied to stress reduction; not standalone primary-insomnia evidence.
前往 PubMed
L4a US FDA
謹慎
Kava-containing products have been associated with liver-related injuries — including hepatitis, cirrhosis, and liver failure — in over 25 reports of adverse events in other countries. 來源↗
L4b EU EFSA
反對
The Medicines for Human Use (Kava-kava) (Prohibition) Order 2002... prohibits the sale, supply or importation of any medicinal product consisting of or containing Kava-kava. Following reports associating kava with cases of severe hepatotoxicity, Germany's BfArM revoked the marketing authorisations for kava-containing medicinal products in 2002. 來源↗
L4c UK NHS
反對
Subject to the provisions of this Order, no person shall sell, supply or import for the purpose of sale or supply any medicinal product that consists of or contains Kava-kava... 'Kava-kava' means any plant belonging to the species Piper methysticum. 來源↗
L4d TW TFDA / 衛福部
反對
台灣亦將卡瓦胡椒列為禁用之中藥成分(衛署中字)；卡瓦胡椒因具有潛在的嚴重肝毒性風險，目前在德國、瑞士、加拿大、英國等多國曾受到限制或禁止販售；美國 FDA 於 2002 年已發出消費者警告。 來源↗
L4e WHO
謹慎
Assessment of the risk of hepatotoxicity with kava products. [WHO, 2007] The objective of this assessment was to examine the safety of kava with a focus on the issue of hepatotoxicity, in view of reports of severe liver injury, including cases of liver failure requiring transplantation, associated with the consumption of kava-containing products. 來源↗
L5a NIH Office of Dietary Supplements
謹慎
Kava supplements may be helpful for anxiety, but they may need to be taken for several weeks to produce an effect. ... Various kava products have been linked to rare cases of liver injury, some of which have been serious or even fatal. 來源↗
L5b Mayo Clinic
謹慎
Kava has been linked to liver damage, including hepatitis and liver failure that in some cases required a liver transplant or led to death. Because of this risk, kava is not recommended. If you have liver problems or take medications that affect your liver, talk to your doctor before using kava. 來源↗
L5c Cleveland Clinic
謹慎
Kava may help with anxiety, but it comes with a serious caveat: It's been linked to liver damage. Because of that risk, it's not something we recommend reaching for, and you should talk to your doctor before taking it — especially if you have liver issues or take other medications. 來源↗
L5d Harvard Health
未表態
— 本適應症無對應資料
L5e Specialty Society (condition-mapped)
反對
The AASM 2017 Clinical Practice Guideline for the pharmacologic treatment of chronic insomnia in adults (Sateia et al.) evaluates specific agents (e.g., suvorexant, eszopiclone, zolpidem, doxepin, ramelteon) and notes 'we suggest that clinicians not use trazodone, tiagabine, diphenhydramine, melatonin, tryptophan, and valerian.' Kava is not among the agents the AASM recommends for chronic insom… 來源↗
PTT · Dcard · Mobile01 彙整自公開論壇討論，非統計抽樣，僅反映社群風向。
廣告 / 業配密度 低度
低中高
📍立場總覽
PTT/Dcard/Mobile01 幾乎無「卡瓦胡椒用於失眠」的在地實測討論；台灣禁止卡瓦作為食品／補充劑販售（肝毒性疑慮），社群幾無流通與心得。
💬社群實感
無共識（台灣社群幾無相關討論）
- 失眠認知行為治療（CBT-I）
- 睡眠衛生與刺激控制
查看 ClaimReview 結構化資料 (JSON-LD)
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