Across six randomized trials with 1,077 patients, cannabinoids improved self-reported sleep quality compared to placebo, but the effect was driven by non-CBD cannabinoids; CBD-only therapies showed no significant benefit.
People using cannabis for sleep; clinicians advising on sleep aids; CBD product consumers
Non-CBD cannabinoids: SMD 0.82 (P = 0.005); CBD alone: SMD 0.13 (P = 0.61)
What the researchers found
Cannabinoids significantly improved sleep quality compared to placebo (SMD 0.53, P = 0.04), with stronger effects in people with insomnia or poor sleep (SMD 0.60, P = 0.02). Non-CBD cannabinoids showed greater efficacy (SMD 0.82, P = 0.005), while CBD-only therapies showed no significant effect (SMD 0.13, P = 0.61).
Why it matters
Many people use cannabis products, especially CBD, for sleep. This meta-analysis suggests CBD alone may not help, while THC-containing cannabinoids show meaningful benefit.
The numbers in context
Overall cannabinoids vs placebo: SMD 0.53 (95% CI 0.03-1.02, P = 0.04, I2 = 88%). Non-CBD: SMD 0.82 (P = 0.005). CBD-only: SMD 0.13 (P = 0.61). Insomnia subgroup: SMD 0.60 (P = 0.02).
How the study worked
Systematic review and meta-analysis of randomized controlled trials from MEDLINE, Embase, and Cochrane databases comparing cannabinoids vs placebo for sleep quality in adults.
What this study cannot tell us
Only six trials included. High heterogeneity (I2 = 88%). Different cannabinoid formulations, doses, and populations across studies. Subjective sleep measures only.
How to read the evidence
Meta-analysis of RCTs, the gold standard design, but limited by only six trials and high heterogeneity.
When this study was published
2025 meta-analysis of recent randomized trials
The bigger picture
The sleep supplement market is flooded with CBD products, but this evidence suggests CBD alone does not improve sleep in controlled trials. THC or mixed cannabinoid formulations appear to be the active ingredients for sleep.
Questions still open
- Why does CBD alone not improve sleep despite widespread consumer reports? What specific non-CBD cannabinoids are most effective? Do benefits persist long-term?
Common questions
Does CBD help with sleep?
What does SMD 0.53 mean?
Read the original research
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.
Sleep medicine reviews, 84, 102156
Citation
da Silva, Giovanna Hanike Santos; Barbosa, Eduardo Cerchi; de Lima, Fernanda Ribeiro; Barroso, Douglas Carneiro; Paez, Loyná Euá Flores E; Guimarães, Felipe Bandeira de Melo; Lança, Saulo Bernardo; de Faria, Stephanie Brito Ceolin; Petrucci, Arthur Bezerra Cavalcanti; Garbacka, Alicja; Walsh, Jennifer H. (2025). 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.. Sleep medicine reviews, 84, 102156. https://doi.org/10.1016/j.smrv.2025.102156
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