New Evidence Suggests Cannabis-Based Medicines Are Promising Treatment for Insomnia

A new systematic review and meta-analysis, published in the journal Sleep Medicine Reviews, suggests that cannabinoids could hold real promise for improving sleep quality, particularly ‘non-CBD formulations’. 

It comes as separate research from the UK highlights how insomnia patients receiving treatment with cannabis-based medicines reported better sleep quality, as well as a reduction in anxiety and depression. 

Around one in three people struggle with getting a good night’s sleep, with 10% of adults meeting the criteria for insomnia or a related sleep disorder.

Standard treatments, such as Cognitive Behavioural Therapy for Insomnia (CBTi) and prescription medications can be difficult to access and come with the risk of side-effects and dependence with long-term use. 

Researchers analysed data from six randomised controlled trials involving 1,077 participants, comparing the effects of cannabinoid therapies with placebo. 

Across the studies, cannabinoids were linked to a significant improvement in self-reported sleep quality. The effect was especially pronounced in people with diagnosed insomnia or poor sleep, where cannabinoids offered greater relief than placebo.

According to the researchers, non-CBD formulations, such as those containing THC or mixed cannabinoids, were associated with the strongest improvements in sleep, showing a medium-to-large effect size. 

By contrast, CBD-only therapies did not produce significant benefits, raising important questions about the popular perception of CBD as a sleep aid.

The analysis also found that improvements were consistent across different measures of sleep quality, however, the studies were highly variable, suggesting that further high-quality trials are needed to clarify dosing, formulations, and long-term safety.

“Cannabinoids, particularly non-CBD formulations, improve sleep quality, justifying further investigation as therapeutic options for insomnia or poor sleep,” the authors conclude.

‘The improvement in sleep quality appears to be driven by studies involving cannabinoid formulations which are not exclusively CBD.”

At the same time, researchers from Imperial College London and colleagues in the UK, analysed data from a set of 124 insomnia patients taking medical cannabis products after 18 months of treatment.

According to the findings, published in the journal PLOS Mental Health, patients reported improved sleep quality, as well as significant improvements in anxiety and depression, and reported less pain. 

About 9% of patients reported adverse effects such as fatigue, insomnia, or dry mouth, none of which were life-threatening. 

While the researchers agree that further randomised controlled trials are needed to demonstrate that the products are safe and effective, the findings suggest that cannabis-based medical products could improve sleep quality in insomnia patients.

Commenting on the findings, co-author Dr Simon Erridge, Research Director at Curaleaf Clinic, said: “Over an 18-month period, our study showed that treatment for insomnia with cannabis-based medicinal products was associated with sustained improvements in subjective sleep quality and anxiety symptoms. 

“These findings support the potential role of medical cannabis as a medical option where conventional treatments have proven ineffective, though further randomised trials are needed to confirm long-term efficacy.”

He adds: “Conducting this long-term study provided valuable real-world evidence on patient outcomes that go beyond what we typically see in short-term trials. It was particularly interesting to observe signs of potential tolerance over time, which highlights the importance of continued monitoring and individualised treatment plans.”