Category Archives: Insomnia

Efficacy of cannabinoids for insomnia and sleep disturbance: A systematic review and meta-analysis of randomized controlled trials

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“Background: Insomnia is a common sleep disorder that presents with difficulty falling asleep or staying asleep. Standard hypnotics often lead to tolerance and dependency, prompting interest in cannabinoids as alternative sleep aids. This study evaluated the efficacy and safety of cannabinoids in improving sleep among adults with insomnia or poor sleep quality.

Methods: PubMed, EMBASE, Cochrane Library, Scopus, and Web of Science were searched from inception to January 2025 for randomized controlled trials (RCTs) comparing cannabinoids with placebo or melatonin. Primary outcomes were changes in Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI). Pooled mean differences (MD) or risk ratios (RR) with 95% confidence intervals (CI) were calculated using random-effects models.

Results: Ten RCTs involving 2134 participants were included. Cannabinoids significantly reduced insomnia severity (MD -3.73; 95% CI -5.04 to -2.42; p < 0.001) and improved sleep quality (MD -3.94; 95% CI -5.47 to -2.40; p < 0.001). Total sleep time increased by 33.99 min (95% CI 20.39 to 47.60), and sleep efficiency improved by 4.31% (95% CI 3.00 to 5.62). Sleep onset latency was modestly reduced (MD -12.0 min; 95% CI -22.6 to -1.4; p = 0.03). Adverse events, mostly mild dizziness and dry mouth, were more frequent with cannabinoids (RR 3.96; 95% CI 1.75 to 9.00), but no serious harms were observed.

Conclusion: Cannabinoids improve sleep quality and duration with acceptable safety, offering a potential alternative for managing insomnia. Larger, long-term trials are warranted to define optimal dosing and sustained efficacy.”

https://pubmed.ncbi.nlm.nih.gov/42574897

“Cannabinoids significantly improved insomnia symptoms and overall sleep quality compared with control treatments.”

“Participants receiving cannabinoids experienced longer sleep duration and better sleep efficiency.”

“Cannabinoid use was associated with faster sleep initiation and improved nighttime sleep continuity.”

https://www.sciencedirect.com/science/article/abs/pii/S1389945726004326?via%3Dihub

Δ9-Tetrahydrocannabinol Modulates Hippocampal Neurogenesis in Female Wistar Rats: Interaction with Estradiol

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“The endocannabinoid system (ECS) plays a key role in regulating neurogenesis and inflammatory processes in the brain.

The increasing prevalence of Cannabis use among women highlights the importance of understanding sex-specific effects of cannabinoids, particularly in the context of hormonal interactions.

This study aimed to investigate the effects of delta-9-tetrahydrocannabinol (THC) and estradiol benzoate (EB) on adult hippocampal neurogenesis (AHN) and inflammation in ovariectomized female Wistar rats.

Sixteen rats were allocated to four experimental groups receiving THC, EB, both treatments, and vehicle. Immunohistochemical analyses were conducted to evaluate markers of proliferation (Ki-67), neurogenesis (doublecortin and PSA-NCAM), cannabinoid receptor expression (CB1), and inflammation (COX-2 and TNF-α) in the hippocampal formation.

The administration of THC significantly increased Ki-67 immunoreactivity, suggesting enhanced cell proliferation. A trend toward increased doublecortin expression was observed, particularly in EB-treated animals. THC also modulated CB1 receptor expression, with significant increases in the dentate gyrus and hilus following combined THC and EB treatment. Furthermore, THC reduced inflammatory markers, with region-dependent decreases in COX-2 and TNF-α expression.

These findings indicate that THC influences markers associated with hippocampal cell proliferation, neurogenesis, cannabinoid signaling and inflammation in female rats, and that some of these effects depend on estradiol status.

The interaction between cannabinoids and gonadal hormones may represent an important mechanism underlying sex-specific neurobiological responses and suggests potential targets for therapeutic intervention in neuropsychiatric disorders.”

https://pubmed.ncbi.nlm.nih.gov/42570151

https://link.springer.com/article/10.1007/s11064-026-04857-w


Real-world quality of life and sleep outcomes in patients treated with THC- and CBD-rich Cannabis oil: a cross-sectional study

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“The endocannabinoid system plays an important role in the modulation of pain, mood, sleep, and subjective wellbeing. Despite the growing clinical use of medicinal Cannabis, real-world data simultaneously evaluating quality of life and sleep-related outcomes in heterogeneous clinical populations remain limited.

This study aimed to assess quality of life and sleep satisfaction in patients using medical Cannabis oil under supervised clinical follow-up. This cross-sectional observational study included patients treated with full-spectrum medical Cannabis oil rich in tetrahydrocannabinol (THC) and cannabidiol (CBD) in a real-world clinical setting.

Quality of life was assessed using the World Health Organization Quality of Life-BREF (WHOQOL-BREF), and sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). Sociodemographic, clinical, and treatment-related data were collected via an electronic questionnaire. Nonparametric analyses, Spearman correlation, and ordinal logistic regression models were performed. Seventy-one participants were included, predominantly female, with diverse clinical conditions.

Participants reported generally favorable perceptions regarding quality of life and sleep satisfaction, with median scores concentrated in the higher response categories. Positive correlations were observed between the psychological domains of quality of life and sleep satisfaction.

Higher Cannabis oil concentrations and longer treatment duration were associated with higher odds of better outcomes.

In a real-world clinical context, supervised use of full-spectrum medical Cannabis oil was associated with favorable patient-reported perceptions of quality of life and sleep, consistent with perceived effectiveness.

These findings highlight the need for longitudinal studies with pre-treatment baseline assessment.”

https://pubmed.ncbi.nlm.nih.gov/42558508

“Cannabis sativa L. [Cannabaceae] has a documented history of medicinal use spanning thousands of years across diverse cultural and geographic contexts, with traditional applications encompassing pain relief, mood modulation, sleep induction, and the management of inflammatory and neurological conditions.”

“The growing integration of Cannabis into contemporary clinical practice reflects both the long-standing ethnopharmacological tradition associated with this species and the expanding body of evidence supporting the pharmacological activity of its principal phytocannabinoid metabolites, tetrahydrocannabinol (THC) and cannabidiol (CBD).”

“In summary, the results suggest that, in supervised clinical practice, patients using full-spectrum THC and CBD rich oil reported favorable perceived quality of life and sleep satisfaction.”

https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2026.1862725/full


Cannabidiol corrects sleep deficits and reduces spontaneous seizures in Angelman syndrome model mice

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“The off-label use of cannabidiol (CBD) has outpaced investigation. We assessed the effects of CBD in Angelman syndrome model mice lacking the Ube3a gene and found that chronic injection of CBD increased rapid-eye movement sleep during the dark cycle, restored “Siesta”, improved sleep homeostasis, and reduced spontaneous seizures following flurothyl kindling.”

https://pubmed.ncbi.nlm.nih.gov/42265437

“Cannabidiol (CBD), a major non-psychoactive and non-psychotomimetic phytocannabinoid constituent of cannabis, is gaining attention for its medical benefits. The multitarget and complex pharmacological nature of CBD in the central nervous system makes it a unique candidate for treating a wide range of complex neurological and psychiatric conditions, including seizures and sleep deficits.”

“This study primarily suggests that CBD restores REM sleep deficits in AS model mice. One hypothesis is that this effect may be related to CBD’s ability to enhance acetylcholine signaling, a central regulator of REM sleep. CBD’s ability to reduce the frequency of SRS, beyond its effects on induced-seizure suppression, further strengthens the preclinical evidence supporting its potential for clinical translation.” 

https://www.nature.com/articles/s41386-026-02462-7

Integrative therapies for chronic insomnia: A randomized controlled trial of a traditional Thai Herbal Remedy and Cannabis sativa oil

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“Background: This study compared the efficacy and safety of integrative and conventional therapies for chronic insomnia.

Objective: To evaluate the effects of the Suk-Sai-Yat traditional Thai herbal remedy, Cannabis sativa oil (Deja formula) and lorazepam on sleep quality and quality of life in patients with chronic insomnia.

Methods: In a randomized controlled parallel-group trial, 60 adults with chronic insomnia received Suk-Sai-Yat, Cannabis sativa oil, or lorazepam for four weeks. Sleep quality was assessed using the Pittsburgh leep Quality Index (PSQI) and quality of life was evaluated using EQ-5D-5L and EQ-VAS. Safety was monitored throughout the study.

Results: After four weeks, PSQI scores significantly improved in all groups: Suk-Sai-Yat (12.3-6.6), Cannabis sativa oil (13.6-3.68) and lorazepam (14.4-5.8) (all p < 0.001), with no significant differences between groups. Quality-of-life scores improved significantly in the integrative therapy groups. Only mild adverse events were reported.

Conclusion: Suk-Sai-Yat and Cannabis sativa oil demonstrated comparable efficacy to lorazepam with favorable safety profiles, supporting their role as integrative, non-benzodiazepine options for chronic insomnia management.”

https://pubmed.ncbi.nlm.nih.gov/41623556

“Suk-Sai-Yat and Cannabis sativa oil significantly improved chronic insomnia symptoms.”

https://www.sciencedirect.com/science/article/pii/S2590142726000017?via%3Dihub

Changes in sleep quality during the 12 months following medical cannabis initiation

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“Background: Poor sleep quality is a commonly reported reason for medical cannabis (MC) use, yet evidence regarding its long-term impact on sleep remains limited. This study evaluated changes in subjective sleep quality over a 12-month period among adults initiating MC treatment in Pennsylvania and explored whether preferred route of administration and referring condition were associated with observed changes.

Methods: A total of 137 adults newly referred for MC in PA completed the Pittsburgh Sleep Quality Index (PSQI) at baseline and at 3, 6, 9, and 12 months. Linear mixed effects models assessed changes in PSQI global and subscale scores over time. Additional models evaluated whether preferred administration route (oral vs. other) and referring condition (chronic pain, anxiety, PTSD) were associated with differences in observed outcomes.

Results: Global sleep quality scores, where higher values indicate poorer sleep quality, were significantly higher at baseline than at each follow-up point (p < .0001), with no significant differences among follow-up assessments, suggesting early and sustained improvements in self-reported sleep quality. Improvements were observed across all PSQI subscales. No significant relationships were found between sleep quality scores and either administration route or referring condition.

Conclusions: These findings suggest that MC may be associated with improvements in subjective sleep quality, though its impact did not vary as a function of administration route or primary referring condition. Additional research using objective sleep measures and controlled designs is needed to clarify MC’s role in sleep quality.”

https://pubmed.ncbi.nlm.nih.gov/41422305

https://link.springer.com/article/10.1186/s42238-025-00376-7

Medicinal use of non-prescribed cannabis: a cross-sectional survey on patterns of use, motives for use, and treatment access in the Netherlands

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“Background: Despite the Netherlands having one of the world’s oldest medical cannabis programs, the majority of people who use cannabis for medicinal purposes continue to rely on non-prescribed sources. This study investigates patterns of use, motives for use, perceived effectiveness, and barriers to accessing prescribed cannabis among individuals self-medicating with non-prescribed cannabis.

Methods: A cross-sectional online survey was conducted between January and April 2023, using convenience sampling primarily via social media. Participants (N = 1059) were adults (18 years or older) residing in the Netherlands who self-reported current use of non-prescribed cannabis-based products to manage physical or mental health symptoms.

Results: Cannabis was used to manage a wide range of conditions, most commonly chronic pain, sleep disorders, depression, and ADHD/ADD, with three out of four participants reporting use for multiple conditions. Most participants obtained cannabis from coffeeshops, although one in four also reported home cultivation as a source. Participants typically smoked cannabis with tobacco, reported (near-)daily use for therapeutic purposes, and indicated a monthly expenditure of €100. The majority was not aware of the THC and CBD content of their products. Perceived effectiveness was rated as high, and more than half of those with a history of prescription medication use reported substituting cannabis for these medications. Only a minority of participants had ever used, or were currently using, prescribed cannabis. Commonly cited barriers included perceived lower quality, higher cost, and lower ease of access compared with non-prescribed cannabis.

Conclusions: The widespread use of non-prescribed cannabis for medicinal purposes in the Netherlands reflects both unmet health needs and barriers within the regulated medical cannabis system. Risky use practices – such as smoking cannabis with tobacco and using products without knowing their cannabinoid content – raise public health concerns. The findings highlight the need for harm reduction strategies and policies that better align medical cannabis regulation with patients’ real-world behaviours and care needs.”

https://pubmed.ncbi.nlm.nih.gov/41331499

https://link.springer.com/article/10.1186/s42238-025-00355-y

Cannabis Use in Central Disorders of Hypersomnolence in the Netherlands

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“Introduction: The endocannabinoid system plays a role in sleep-wake regulation. In clinical practice, people with central disorders of hypersomnolence (CDH) frequently report use of cannabis.

Methods: We compared lifetime and current use of cannabis of people with CDH to the Dutch general population. Additionally, we assessed cannabis use in relation to hypersomnolence symptoms.

Results: In total, 76 (out of 88) patients completed the online questionnaire. Lifetime cannabis use (42% vs. 23%, p < 0.001) and current use (18% vs. 4%, p < 0.001) were higher in people with CDH compared to the Dutch general population. For 57% of patients currently using cannabis, improvements of at least one CDH symptom were the motivation for use. Additionally, 79% of current cannabis users reported cannabis-related effects on a symptom, which were mostly positive (43%), some negative (7%), or mixed effects (29%). Patients that stopped using mostly started using cannabis before symptom onset and for recreational purposes. The most reported reasons to stop using were disadvantages of using or changes in the social environment.

Conclusion: This study provides a rationale for future research on the potential benefits of cannabis in CDH.”

https://pubmed.ncbi.nlm.nih.gov/41321442

https://karger.com/mca/article/8/1/181/935204/Cannabis-Use-in-Central-Disorders-of

Full Spectrum Cannabis Oil for the treatment of chronic pain and sleep dysfunction in myofascial temporomandibular disorder: a case report

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“Medicinal cannabis has been the subject of extensive research, with recent studies demonstrating its potential in managing chronic pain and enhancing quality of life.

This case report examines the use of medicinal cannabis in a patient treated at the School of Dentistry of Araçatuba (FOA-UNESP). The patient, a 28-year-old female with no comorbidities, presented with chronic muscular TMD and reported poor sleep quality. Full-spectrum cannabis oil (1:1 ratio of THC to CBD), was prescribed for a period of 60 days, with a maximum dosage of 10 drops per day. Pain intensity was measured using the Visual Analog Scale (VAS), while sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Evaluations were conducted at three intervals: baseline, day 30, and day 60. To ensure patient safety, pre- and post-treatment blood tests were performed, and dosage adjustments were made every three days under the supervision of the study’s medical team.

The results revealed significant improvements in pain management, with the patient’s orofacial pain score decreasing from 7 to 3 on the NRS. Additionally, sleep quality improved, as reflected by a lower PSQI score (global sleep quality at level 6 at the end), indicating more restorative sleep. Throughout the treatment period, the patient experienced mild side effects, including drowsiness and gastrointestinal discomfort, which were effectively managed through dosage modifications.

In conclusion, full-spectrum cannabis oil shows promise as a therapeutic strategy for managing orofacial pain and improving sleep quality, providing significant relief in conditions where other interventions are ineffective or poorly tolerated. Further research is warranted to better understand the therapeutic mechanisms and potential side effects of medicinal cannabis in the management of chronic pain and related conditions.”

https://pubmed.ncbi.nlm.nih.gov/41092177/

“In conclusion, the use of Full Spectrum Cannabis Oil in this case was associated with a clinically meaningful reduction in chronic orofacial pain and improvement in sleep quality, with no adverse effects or laboratory abnormalities observed during the treatment period. These outcomes suggest that individualized cannabinoid-based therapy may be a safe and effective approach for selected patients with temporomandibular disorders and comorbid sleep disturbances.”

https://www.scielo.br/j/bjb/a/bK69ZBYPSB4dJ9yqcFxSzcf/?lang=en

Effectiveness of cannabinoids on subjective sleep quality in people with and without insomnia or poor sleep: A systematic review and meta-analysis of randomised studies

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“Study objectives: This systematic review and meta-analysis assessed the efficacy of cannabinoids compared to placebo for improving sleep quality.

Methods: Searches were conducted in MEDLINE, Embase, and Cochrane databases for randomised controlled trials comparing cannabinoids vs. placebo for improving sleep quality in adults with or without insomnia or poor sleep. The primary outcome was self-reported sleep quality (PROMIS, PSQI, LSEQ, Sleep Diary). Secondary outcomes included actigraphy parameters, anxiety (GAD-7, STAI-T), well-being (WHO-5 index), and insomnia severity (ISI). Additional analyses focused on sleep quality in (1) participants with insomnia or poor sleep, and (2) cannabidiol (CBD) vs. non-CBD interventions. Statistical analysis was performed using RevMan 5.4.1, with p < 0.05 considered significant.

Results: Six trials (1077 patients) were included. Cannabinoids significantly improved sleep quality compared to placebo [SMD 0.53; 95 % CI 0.03-1.02; p = 0.04; I2 = 88 %], particularly in those with insomnia or poor sleep [SMD 0.60; 95 % CI 0.09-1.11; p = 0.02; I2 = 89 %]. Non-CBD cannabinoids demonstrated greater efficacy [SMD 0.82; 95 % CI 0.24-1.40; p = 0.005], whereas CBD-only therapies showed no significant effect [SMD 0.13; 95 % CI -0.38-0.65; p = 0.61].

Conclusion: Cannabinoids, particularly non-CBD formulations, improve sleep quality, justifying further investigation as therapeutic options for insomnia or poor sleep.”

https://pubmed.ncbi.nlm.nih.gov/40929927/

https://www.sciencedirect.com/science/article/abs/pii/S1087079225001091?via%3Dihub