Cannabis Sleep Research

Recreational cannabis use and sleep in the general population: a systematic review and meta-analysis.

Mao, Fangxiang · 2025

Across 102 observational studies, current recreational cannabis use was associated with poorer sleep quality, both short and long sleep duration, more insomnia symptoms, and a later chronotype compared to non-use.

Expanding the Therapeutic Profile of Topical Cannabidiol in Temporomandibular Disorders: Effects on Sleep Quality and Migraine Disability in Patients with Bruxism-Associated Muscle Pain.

Walczyńska-Dragon, Karolina · 2025

Both 5% and 10% CBD gel groups showed statistically significant improvements in Pittsburgh Sleep Quality Index and Migraine Disability Assessment scores compared to placebo (p < threshold), with 10% CBD showing the strongest effects.

The Effects of Cannabis Access Laws on Sleep in the U.S.

Xu, Carol · 2025

Recreational cannabis laws reduced sleep by 5.37 minutes per night (99% CI: 0.91-9.83), primarily by delaying sleep onset by 7.14 minutes without changing wake times.

Childhood sleep is prospectively associated with adolescent alcohol and marijuana use.

Krishnan, Akshay S · 2024

At age 15, later bedtime (aOR 1.35) and shorter sleep at age 9 (aOR 1.19) were associated with greater odds of trying marijuana.

Prevalence of insomnia and use of sleep aids among adults in Canada.

Morin, Charles M · 2024

Among 4,037 Canadian adults, insomnia prevalence was 16.3%.

Evaluating possible 'next day' impairment in insomnia patients administered an oral medicinal cannabis product by night: a pilot randomized controlled trial.

Suraev, Anastasia · 2024

At 9+ hours after evening administration of 10mg THC/200mg CBD oil, there were no differences from placebo on 27 of 28 cognitive and psychomotor tests, including simulated driving performance.

Medicinal cannabis improves sleep in adults with insomnia: a randomised double-blind placebo-controlled crossover study.

Ried, Karin · 2023

60% of participants no longer classified as clinical insomniacs after 2 weeks of cannabis oil.

A Placebo-Controlled Trial of Cannabinoid Treatment for Disruptive Behavior in Children and Adolescents with Autism Spectrum Disorder: Effects on Sleep Parameters as Measured by the CSHQ.

Schnapp, Aviad · 2022

CBD-rich cannabinoid treatment (20:1 CBD:THC ratio) was not superior to placebo for sleep in 150 children and adolescents with autism, including bedtime resistance, sleep-onset delay, and sleep duration..

A double-blind, randomized, placebo-controlled, parallel group study of THC/CBD spray in peripheral neuropathic pain treatment.

Serpell, M · 2014

At the 30% pain reduction threshold (considered clinically meaningful), significantly more patients on THC/CBD spray achieved this target compared to placebo (p=0.034).

Multiple sclerosis and extract of cannabis: results of the MUSEC trial.

Zajicek, John Peter · 2012

The MUSEC trial randomized 279 MS patients across 22 UK centers to oral cannabis extract or placebo.

Randomized, controlled trial of cannabis-based medicine in central pain in multiple sclerosis.

Rog, David J · 2005

Sixty-six MS patients with central pain (59 with dysesthetic pain, 7 with painful spasms) participated in a 5-week randomized, double-blind, placebo-controlled trial of a THC:CBD oromucosal spray.

Demographics, methods of use, and perceived benefits among patients with cancer who use cannabis.

Behl, Deepti · 2026

24.7% of cancer patients used cannabis; primary reason was sleep (56.7%); associated with younger age, Stage 4 cancer (OR=3.28), and concurrent chemotherapy (OR=2.45); 68% smoked/vaped, 60% used edibles, 65%+ used multiple methods..

Cannabinol for Acute Treatment of Insomnia Disorder in a Randomized Placebo-Controlled Crossover Trial.

Lavender, Isobel G · 2026

300 mg CBN did not significantly change the primary outcome (WASO: -6.3 min, p=0.29) but improved subjective sleep quality (p=0.005), reduced sleep onset latency (p=0.004), increased N2 sleep (p=0.03), and reduced EEG arousal indices (p=0.02).

Smoke, sip, sleep, repeat: Investigating daily-level bidirectional relationships of separate and simultaneous use of alcohol and cannabis with sleep.

Moore, Annabelle · 2026

Compared to simultaneous use days, participants reported worse sleep quality and shorter sleep on alcohol-only days, earlier bedtime on cannabis-only days, and poorer sleep quality on no-use days.

Investigating the effectiveness and adverse events of medicinal cannabis for patients with muscle spasticity or spasms.

Nastatos, Xenia L · 2026

No physical functioning improvements for any group or product type.

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

Pakdee, Naruwat · 2026

In a randomized controlled trial, cannabis sativa oil reduced PSQI scores from 13.6 to 3.68 over four weeks, comparable to lorazepam (14.4 to 5.8) and a traditional Thai herbal remedy (12.3 to 6.6).

UK Medical Cannabis Registry: a case series analysing clinical outcomes of medicinal cannabis therapy for fibromyalgia.

Varadpande, Madhur · 2026

All patient-reported outcome measures improved significantly from baseline through 18 months of follow-up.

Canadian real-world evidence: observational 24-week outcomes for health care practitioner authorized cannabis.

Yang, Brian · 2026

Over 24 weeks, patients showed improvements in pain interference (-4.6 points), numeric pain rating (-1.19), anxiety (-2.24), depression (-2.79), and quality of life (-0.56).

Interactions between cannabis use and chronic pain on sleep architecture: Findings from in-home EEG recordings.

Brown, Tracy W · 2025

Cannabis use showed significant main effects on slow-wave sleep (deep sleep), total sleep time, sleep onset latency, and REM sleep.

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.

da Silva, Giovanna Hanike Santos · 2025

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).

UK medical cannabis registry: A clinical outcome analysis of medical cannabis therapy in chronic pain patients with and without co-morbid sleep impairment.

Datta, Ishita · 2025

Sleep-impaired patients showed improvements across all patient-reported outcomes at every follow-up.

Seeking relief or fueling the fire? Understanding the complex role of cannabis in PTSD, stress, and sleep dysregulation.

Davis, Jordan P · 2025

Day-to-day analysis showed elevated PTSD symptoms and poor sleep predicted greater stress the next day.

Daily associations between sleep quality, stress, and cannabis or alcohol use among veterans.

Davis, Jordan P · 2025

Within-day: higher cannabis use was associated with lower stress and better sleep quality that same night.

The differential effects of medicinal cannabis on mental health: A systematic review.

de Bode, Nora · 2025

High doses of CBD provided some acute relief in anxiety disorders.

Within-Person Bidirectional Relations Between Sleep Problems and Alcohol, Cannabis, and Co-Use Problems in a Representative U.S. Sample.

Drazdowski, Tess K · 2025

Individual-level alcohol and cannabis use problems were associated with lower likelihood of sleep problems in earlier waves but greater likelihood of sleep problems in later waves.

Profiles of polysubstance use among people reporting past 12-month sleep-motivated nonmedical use of prescription tranquilizers/sedatives.

Falise, Alyssa M · 2025

Two polysubstance profiles identified: marijuana/alcohol/tobacco (MAT, 68.3%) and MAT plus cocaine/hallucinogens/prescription drugs (31.7%).

Beyond the hype - who uses cannabidiol for self-medication - and why: a cross-sectional study in Germany.

Krowartz, Eva-Maria · 2025

37.9% used CBD for self-medication.

Chronic Disease Symptoms Self-Managed by Cannabis During the COVID-19 Pandemic: Results from the COVID-19 Cannabis Health Study.

O'Dell, Nicole · 2025

Of 1,466 cannabis users with chronic conditions, 90.9% reported using cannabis medicinally.

Mental Health, Substance Use, and Related Factors Associated with Recent Use of Cannabis for Sleep: A Co-Twin Control Study.

Panchal, Zoë · 2025

In co-twin control analyses that account for genetic and shared environmental factors, using cannabis for sleep remained significantly associated with more cannabis use problems, higher cannabis frequency, worse sleep quality, and more frequent use of alcohol and sleep medications.

Dynamic associations between cannabis use and sleep in adolescents and young adults during a cannabis intervention trial.

Parnes, Jamie E · 2025

During the first week of treatment, more cannabis use was associated with longer sleep for those with severe cannabis use disorder, but shorter sleep for those with mild CUD.

Cannabinoids for Anxiety and Sleep Disturbances: A Scoping Review.

Perez, Juan G · 2025

Of 29 studies meeting inclusion criteria, about 45% reported positive effects on both anxiety and sleep outcomes.

The effects of tetrahydrocannabinol and cannabidiol on sleep in cancer patients.

Reddy, Apoorva C · 2025

Among 1,962 cancer patients enrolled in the Minnesota Medical Cannabis Program (2015-2023), those in the highest CBD dose quintile showed sleep improvement of 1.87 points on a 0-10 scale, compared to approximately 1.5 points for lower quintiles.

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

Short, Megan M · 2025

Global sleep quality scores (PSQI) were significantly higher at baseline than at each follow-up point (p < 0.0001), with no significant differences among the 3-, 6-, 9-, and 12-month follow-ups, indicating early and sustained improvement.

Pre-trauma insomnia and posttraumatic alcohol and cannabis use in the AURORA observational cohort study of trauma survivors.

Short, Nicole A · 2025

Pre-trauma insomnia symptoms significantly predicted heavy cannabis use at 8 weeks post-trauma, even after controlling for pre-trauma substance use, demographics, and trauma severity.

Cannabis and sleep architecture: A systematic review and meta-analysis.

Velzeboer, Rob · 2025

Across 18 studies (9 in meta-analysis), cannabis administration did not consistently alter sleep duration, latency, wake time, efficiency, or sleep staging.

BETTER sleep: Sleep quality among adults living with type 1 diabetes in Canada.

Vézina-Im, Lydi-Anne · 2025

Cannabis use was independently associated with poor sleep quality (OR 1.578; 95% CI: 1.152–2.161) in adults with type 1 diabetes, alongside other correlates including being female, overweight/obesity, depression, fear of hypoglycemia, bedtime snacking, and low physical activity..

Cannabis Use in Central Disorders of Hypersomnolence in the Netherlands.

Vringer, Marieke · 2025

Lifetime cannabis use (42% vs 23%, p significant) and current use were both significantly higher among people with central disorders of hypersomnolence (CDH) compared to the Dutch general population.

A test of competing mediators linking trouble sleeping to cannabis use in adolescents and emerging adults.

Berey, Benjamin L · 2024

At the person level, trouble sleeping was associated with higher cannabis craving and negative affect (large effects, rs 0.34-0.48).

Longitudinal associations between insomnia, cannabis use and stress among US veterans.

Davis, Jordan P · 2024

Higher prior insomnia levels predicted greater increases in perceived stress.

Use and perceptions of Cannabidiol among individuals in treatment for opioid use disorder.

Kudrich, Christopher · 2024

CBD has become wildly popular, with claims ranging from anxiety relief to pain management.

Randomized controlled trial of zolpidem as a pharmacotherapy for cannabis use disorder.

Lee, Dustin C · 2024

Placebo participants but not zolpidem-XR participants showed significant sleep disturbance during week 1 of cannabis cessation.

Co-morbid cannabis use disorder and chronotype are associated with mood symptom onset in people with bipolar disorder.

Miranda, Alannah · 2024

Lower morningness (evening chronotype) and CUD were independently associated with earlier age of mood symptom onset in bipolar disorder.

Clinical outcome analysis of patients with multiple sclerosis - Analysis from the UK Medical Cannabis Registry.

Murphy, Matthew · 2024

At 6 months, significant improvements in MSQoL-54 subscales: cognitive function, mental health composite, physical health, role limitations, social and sexual function.

A Cross-Sectional Survey Study of Cannabis Use for Fibromyalgia Symptom Management.

Singla, Abhinav · 2024

Of 1,336 fibromyalgia patients, 49.5% (661) reported cannabis use since diagnosis.

The safety and efficacy of low oral doses of cannabidiol: An evaluation of the evidence.

Arnold, Jonathon C · 2023

Therapeutic benefits became clearly evident at doses of 300 mg or higher.

Assessing changes in sleep across four weeks among adolescents randomized to incentivized cannabis abstinence.

Baumer, Andreas M · 2023

In a randomized trial of 116 adolescents, those assigned to verified abstinence reported worse overall sleep quality than the monitoring group, but the disruption was specific to increased sleep latency during week one, which resolved by week two and remained at baseline through week four..

Multinational Association of Supportive Care in Cancer (MASCC) guidelines: cannabis for psychological symptoms including insomnia, anxiety, and depression.

De Feo, Giulia · 2023

From 829 articles screened, 2 systematic reviews and 15 RCTs met criteria.

Cannabis use for Sleep Disturbance Among Older Patients in a Geriatrics Clinic.

Kaufmann, Christopher N · 2023

Cannabis use among older adults is growing fast, and sleep is one of the top reasons cited.

Predictors of Pain Reduction Among Fibromyalgia Patients Using Medical Cannabis: A Long-Term Prospective Cohort Study.

Sotoodeh, Romina · 2023

Reductions in pain intensity among fibromyalgia patients using medical cannabis were partially mediated by concurrent improvements in sleep quality and reductions in anxiety and depression symptoms..

The beneficial effect of sleep on behavioral health problems in youth is disrupted by prenatal cannabis exposure: A causal random forest analysis of Adolescent Brain Cognitive Development data.

Spechler, Philip A · 2023

Sleep improvements reduced internalizing and externalizing problems in children overall, but prenatal cannabis exposure moderated this relationship, significantly diminishing the protective effect of sleep on internalizing symptoms..

A survey of medical cannabis use during perimenopause and postmenopause.

Dahlgren, M Kathryn · 2022

86.1% reported current cannabis use and 78.7% used it for menopause symptoms.

Changes in striatal dopamine release, sleep, and behavior during spontaneous Δ-9-tetrahydrocannabinol abstinence in male and female mice.

Kesner, Andrew J · 2022

THC withdrawal produced altered striatal dopamine release, sleep disturbances that mimic clinical observations (disrupted sleep architecture), and affect-related behavioral changes.

The Effects of Cannabinoids on Sleep.

Kolla, Bhanu Prakash · 2022

Cannabis products have minimal to no effects on sleep disorders and may have deleterious effects in some individuals.

Cannabis use as a moderator of cognitive behavioral therapy for insomnia.

Miller, Mary Beth · 2022

Among 56 young adult binge drinkers with insomnia, 46% used cannabis during the treatment phase.

Mood, sleep and pain comorbidity outcomes in cannabis dependent patients: Findings from a nabiximols versus placebo randomised controlled trial.

Montebello, Mark · 2022

Among participants with moderate-to-severe baseline scores, depression, anxiety, stress, and insomnia symptoms gradually decreased over 12 weeks of treatment.

Medical cannabis use in Canadians with multiple sclerosis.

Santarossa, Talia M · 2022

64.5% had tried medical cannabis, 52.3% were currently using it.

Assessment of Withdrawal, Mood, and Sleep Inventories After Monitored 3-Week Abstinence in Cannabis-Using Adolescents and Young Adults.

Sullivan, Ryan M · 2022

Cannabis-using participants (n=37) reported higher overall withdrawal, mood symptoms, and sleep problems than controls (n=42) during 3 weeks of verified abstinence.

A large Australian longitudinal cohort registry demonstrates sustained safety and efficacy of oral medicinal cannabis for at least two years.

Vickery, Alistair W · 2022

Statistically significant improvements sustained over 2+ years across all outcomes: clinical impression (+39-52%), pain interference and severity (22-26%), depression/anxiety/stress (24-28%), insomnia (35%), and physical/emotional functioning (34-37%).

Exploring the Relationship Between ADHD Symptoms and Daily Cannabis Consequences in Emerging Adulthood: The Role of Cannabis Motives.

Goldstein, Abby L · 2021

Higher past-6-month ADHD symptoms predicted more daily cannabis consequences overall.

The Effect of Medical Cannabis on Pain Level and Quality of Sleep among Rheumatology Clinic Outpatients.

Habib, George · 2021

Patients with neuropathic problems reported the largest pain reduction (83%) and sleep improvement (87%), while those with inflammatory conditions saw the smallest pain reduction (57%).

Effect of Cannabidiol on Interictal Epileptiform Activity and Sleep Architecture in Children with Intractable Epilepsy: A Prospective Open-Label Study.

Klotz, Kerstin A · 2021

Interictal epileptiform discharge (IED) rate dropped significantly from 36.8 to 19.6 per minute after 3 months of CBD (p<0.0001).

Examining motivational pathways from adult attention-deficit/hyperactivity disorder symptoms to cannabis use: Results from a prospective study of veterans.

Stevens, Angela K · 2021

Sleep motives mediated the prospective relationship between ADHD symptoms and cannabis use frequency, while coping with negative affect was the only significant mediator of the ADHD-to-cannabis-problems pathway, controlling for demographics, other substance use, and psychopathology..

Cannabis: An Emerging Treatment for Common Symptoms in Older Adults.

Yang, Kevin H · 2021

15% of geriatric clinic patients used cannabis.

Cannabinol and Sleep: Separating Fact from Fiction

Corroon, Jamie · 2021

A systematic search of PubMed found zero randomized controlled trials of CBN for sleep.

Adding medical cannabis to standard analgesic treatment for fibromyalgia: a prospective observational study.

Giorgi, Valeria · 2020

Medical cannabis most consistently improved sleep quality (44% of patients) and overall fibromyalgia impact (33%).

Effects of Hemp Extract on Markers of Wellness, Stress Resilience, Recovery and Clinical Biomarkers of Safety in Overweight, But Otherwise Healthy Subjects.

Lopez, Hector L · 2020

Among 65 overweight but healthy adults, 60mg/day hemp extract (containing 15mg CBD) significantly improved HDL cholesterol (p=0.004, ES=0.75).

Medicinal cannabis for psychiatric disorders: a clinically-focused systematic review.

Sarris, Jerome · 2020

CBD showed tentative support for reducing social anxiety.

Cannabinoid therapies in the management of sleep disorders: A systematic review of preclinical and clinical studies.

Suraev, Anastasia S · 2020

Across 26 studies (14 preclinical, 12 clinical), evidence was insufficient for routine clinical use of cannabinoids for any sleep disorder due to limited research and moderate-to-high risk of bias.

Prenatal cannabis exposure and sleep outcomes in children 9-10 years of age in the adolescent brain cognitive development SM study.

Winiger, Evan A · 2020

Any prenatal cannabis exposure was associated with disorders of initiating and maintaining sleep, disorders of arousal, sleep-wake disorders, disorders of excessive somnolence, and a summed sleep disorder score (all p<0.03).

Impact of Medical Cannabis on Patient-Reported Symptoms for Patients With Cancer Enrolled in Minnesota's Medical Cannabis Program.

Anderson, Susan P · 2019

Significant reductions were found across all 8 symptoms (anxiety, appetite loss, depression, sleep disturbance, fatigue, nausea, pain, and vomiting) within 4 months of starting medical cannabis.

Use of Cannabis to Relieve Pain and Promote Sleep by Customers at an Adult Use Dispensary.

Bachhuber, Marcus · 2019

65% of adult-use customers used cannabis for pain relief, and 74% used it for sleep.

Using recreational cannabis to treat insomnia: Evidence from over-the-counter sleep aid sales in Colorado.

Doremus, Jacqueline M · 2019

Sleep aid market shares were growing before recreational cannabis availability, but the trend reversed with dispensary entry (-0.33 percentage points from a mean growth of 0.14).

Illegal cannabis use is common among Danes with multiple sclerosis.

Gustavsen, S · 2019

49% had tried cannabis, 21% were current users, and only 21% of current users had prescribed cannabis.

Use of medicinal cannabis and synthetic cannabinoids in post-traumatic stress disorder (PTSD): A systematic review

Orsolini, Laura · 2019

This systematic review gathered everything published through May 2019 on cannabis and synthetic cannabinoids for PTSD.

Reductions in cannabis use are associated with improvements in anxiety, depression, and sleep quality, but not quality of life.

Hser, Yih-Ing · 2017

This study tracked 302 adults with cannabis use disorder over 12 weeks of a medication trial, splitting them into those whose cannabis use decreased and those whose use increased. The cannabis reduction group (152 people) showed statistically significant improvements in anxiety, depression, and sleep quality compared to the cannabis increase group (150 people), even after controlling for demographics, treatment condition, and concurrent tobacco and alcohol use. However, reductions in cannabis use did not translate into improved overall quality of life.

Recreational stimulants, herbal, and spice cannabis: The core psychobiological processes that underlie their damaging effects.

Parrott, Andrew C · 2017

The review proposes that all recreational psychoactive drugs, including cannabis, cause harm through a shared core mechanism: acute mood gains followed by mood deficits on withdrawal, creating a cycle of psychobiological fluctuations. These mood swings are surface indicators of deeper disruptions.

Substitution of medical cannabis for pharmaceutical agents for pain, anxiety, and sleep.

Piper, Brian J · 2017

Among 1,513 New England dispensary members surveyed, the rates of medication reduction after starting medical cannabis varied significantly by drug class.

Attitudes to cannabis and patterns of use among Canadians with multiple sclerosis.

Banwell, Emma · 2016

Researchers surveyed 225 people with multiple sclerosis (MS) attending neurology and neuropsychiatry clinics in Canada about their cannabis use and attitudes. Overall attitudes were favorable: 54.3% approved of cannabis and 43.7% endorsed full legalization, while another 43.7% supported legalization for medical use only.

Cannabis withdrawal and sleep: A systematic review of human studies.

Gates, Peter · 2016

Sleep problems during cannabis withdrawal are among the most commonly reported symptoms and a major reason people relapse.

Effects of zolpidem alone and in combination with nabilone on cannabis withdrawal and a laboratory model of relapse in cannabis users.

Herrmann, Evan S · 2016

Eleven daily cannabis users completed three 8-day inpatient stays testing different medication conditions during monitored cannabis withdrawal. Both zolpidem alone and zolpidem plus nabilone improved sleep during withdrawal.

Endocannabinoid Signaling Regulates Sleep Stability.

Pava, Matthew J · 2016

Using multiple pharmacological tools, researchers mapped how the endocannabinoid system regulates sleep in mice.

The efficacy of nabilone, a synthetic cannabinoid, in the treatment of PTSD-associated nightmares: A preliminary randomized, double-blind, placebo-controlled cross-over design study.

Jetly, Rakesh · 2015

CAPS Recurring Dream scores: nabilone -3.6 (±2.4) vs placebo -1.0 (±2.1), p=0.03.

Sleep and substance use disorders: an update.

Conroy, Deirdre A · 2014

This review examined the bidirectional relationship between sleep disorders and substance use.

The effects of cannabinoid administration on sleep: a systematic review of human studies

Gates, Peter J. · 2014

Across 39 human studies that administered a cannabinoid and measured sleep quantitatively, results did not converge.

Cannabis withdrawal in chronic, frequent cannabis smokers during sustained abstinence within a closed residential environment.

Lee, Dayong · 2014

Twenty-nine chronic, frequent cannabis smokers were monitored during sustained abstinence on a closed research unit.

A human laboratory study investigating the effects of quetiapine on marijuana withdrawal and relapse in daily marijuana smokers.

Cooper, Ziva D · 2013

In a double-blind, within-subjects study, 14 heavy cannabis smokers (averaging 10 joints/day) completed two 15-day medication phases (quetiapine 200 mg/day vs.

Cannabidiol in humans-the quest for therapeutic targets.

Zhornitsky, Simon · 2012

The review identified 34 studies: 16 in healthy subjects and 18 in clinical populations covering MS, schizophrenia, bipolar mania, social anxiety, pain, cancer, Huntington's disease, insomnia, and epilepsy. Key findings included: high inhaled/IV doses of CBD were needed to block THC effects.

The Cannabis Withdrawal Scale development: patterns and predictors of cannabis withdrawal and distress.

Allsop, David J · 2011

Researchers developed and validated the Cannabis Withdrawal Scale using 49 dependent cannabis users who provided daily symptom scores during one baseline week and two weeks of abstinence. The scale demonstrated excellent psychometric properties: internal reliability (Cronbach's alpha = 0.91) and test-retest stability (average intra-class correlation = 0.95). Nightmares and strange dreams were the most statistically valid withdrawal indicator (Wald chi-squared = 105.6) but caused relatively little distress.

The effects of nabilone on sleep in fibromyalgia: results of a randomized controlled trial.

Ware, Mark A · 2010

Twenty-nine fibromyalgia patients with chronic insomnia completed a crossover trial comparing nabilone (0.5-1.0 mg at bedtime) to amitriptyline (10-20 mg at bedtime), each for two weeks with a two-week washout period. Nabilone was significantly superior to amitriptyline on the Insomnia Severity Index (difference = 3.2 points, 95% CI: 1.2-5.3).

Effect of illicit recreational drugs upon sleep: cocaine, ecstasy and marijuana.

Schierenbeck, Thomas · 2008

This review compared the sleep effects of three illicit drugs. Cannabis: Acute use facilitated sleep onset and increased Stage 4 (deep) sleep while reducing REM sleep.

Effect of Delta-9-tetrahydrocannabinol and cannabidiol on nocturnal sleep and early-morning behavior in young adults.

Nicholson, Anthony N · 2004

In 8 healthy volunteers given sublingual cannabis extracts before sleep, 15 mg THC alone had no effect on nocturnal sleep architecture but produced next-day sedation, impaired memory, and reduced sleep latency (indicating increased sleepiness).

Delta-9-Tetrahydrocannabinol (THC) Before Bedtime: Feasibility and Mechanistic Pilot Study on Sleep and Cardiac Autonomic Activity.

Gonzalez, Joshua E · 2026

Acute THC before bedtime increased sleep latency and slow-wave sleep while markedly reducing heart rate variability across time- and frequency-domain measures during sleep, indicating reduced cardiac parasympathetic activity — and regular cannabis users showed shorter total sleep time and greater disruption at home..

The effects of cannabidiol on sleep disturbances within a sample of high trait worriers: A double-blind, randomized placebo controlled trial.

Gournay, L Riley · 2026

300 mg CBD decreased sleep disturbances significantly more than 50 mg CBD (B=-0.39, t=-2.59, p<0.05, d=0.08) but not significantly more than placebo (B=-0.32, t=-2.09, p=0.10, d=0.07), with no effects on sedation or cognitive impairment..

Daily web survey data collection of time-varying cannabis use motives and contexts, with implications for adaptive interventions: A pilot study.

Ma, Yongchao · 2026

Four types of weekly motive transitions were identified, with shifts toward sleep-aid and cannabis-availability-dominated motives predicting higher subsequent use frequency.

A qualitative study on cannabis use for harm reduction and pain among veterans enrolled in an SUD treatment program.

Pleasant, Traben · 2026

Through interviews with 33 veterans receiving care in a VA substance use disorder treatment program, researchers documented how veterans with chronic pain viewed and used cannabis alongside their addiction treatment. Most participants had a primary diagnosis of alcohol use disorder (70%), followed by opioid use disorder (18%) and stimulant use disorder (12%).

Acute Effects of Oral Cannabinoids on Sleep and High-Density EEG in Insomnia: A Pilot Randomised Controlled Trial.

Suraev, Anastasia · 2026

In a pilot randomized controlled trial with 20 patients diagnosed with insomnia disorder (16 female, mean age 46), a single oral dose of 10 mg THC and 200 mg CBD was compared to placebo using 256-channel high-density EEG — the most detailed sleep measurement technology available. The results contradicted the widespread perception that cannabis aids sleep.

Pilot Randomized Trial of Medical Cannabis to Reduce Symptom Burden in Patients With Newly Diagnosed Advanced Pancreatic Cancer (CanPan).

Zylla, Dylan · 2026

The trial met all prespecified feasibility benchmarks: 74% enrollment (goal 20%), 81% compliance (goal 60%), and 75% outcome completion (goal 50%).

UK Medical Cannabis Registry: A clinical outcomes analysis for insomnia.

Aggarwal, Arushika · 2025

Sleep quality scores (SQS) improved from 2.66 at baseline to 5.67 at one month (P<0.001) and remained significantly improved at 18 months (3.81, P<0.001), though improvements diminished over time.

Understanding Cannabis Use After Spinal Cord Injury: A Canadian Survey Study.

Allison, David J · 2025

Of 80 Canadian adults with spinal cord injury, 42.5% reported cannabis use post-injury and 37.5% were current users, exceeding the general Canadian population rate of 25%.

Predictors of Replacing Alcohol With Cannabis Among Adult Women.

Attonito, Jennifer · 2025

Younger women (<56) were significantly more likely to substitute THC for alcohol (14.0% vs 7.8%) and reported higher rates of sleep problems, stress, and scores on AUDIT, PTSD, GAD, and PHQ instruments.

Understanding cannabis use and car crashes: Insights from a randomized trial using a driving simulator on THC blood levels and subjective measures of sleepiness and performance.

Cardozo, Bibiana · 2025

In this double-blind crossover RCT (randomized controlled trial where each person receives each condition), inhaled THC increased driving simulator collisions, with the clearest increase observed 4 hours after 10 mg and 30 mg THC.

Characterizing Cannabidiol Use in a Breast Cancer Population.

Fleege, Nicole M G · 2025

Of 141 breast cancer patients surveyed, 68 (48.2%) reported prior or current CBD use.

Effectiveness of a Cannabinoids Supplement on Sleep and Mood in Adults With Subthreshold Insomnia: A Randomized Double-Blind Placebo-Controlled Crossover Pilot Trial.

Hausenblas, Heather · 2025

In a double-blind crossover trial of 20 adults with subthreshold insomnia, a multi-cannabinoid oral supplement (3 mg THC, 6 mg CBN, 10 mg CBD, plus terpenes) significantly improved sleep quality/efficiency, insomnia symptoms, and health-related quality of life compared to placebo after 10 days.

Dispensing Medical Advice: San Francisco Bay Area Budtender Recommendations for Pain and Sleep Relief.

Hoang, Christine · 2025

Across 35 Bay Area dispensaries, budtenders showed strong consensus: 77% recommended topicals for pain and 60% recommended edibles for sleep.

Clinical and psychosocial changes in adults with opioid use disorder and chronic pain using medical cannabis: a brief report.

Lent, Michelle R · 2025

Over three months, participants taking a 1:1 THC:CBD capsule alongside buprenorphine/naloxone reported significant decreases in pain severity, improved sleep quality, and better quality of life across seven of eight domains.

Motivation and experiences of individuals with opioid use disorder and chronic pain using medical cannabis for 12 months.

Lent, Michelle R · 2025

Across 10 interviews, participants consistently described four benefits from 12 months of medical cannabis: reduced pain levels, improved emotional regulation and mood, better sleep quality and duration, and reduced cravings for illicit drugs.

Inflammatory state moderates response to cannabis on negative affect and sleep quality in individuals with anxiety.

Lisano, Jonathon K · 2025

While cannabis use did not change cytokine concentrations over four weeks, baseline inflammation moderated outcomes.

Same-Day Sedative and Night-Time Sleep Effects Following Combined Cannabinoid Formulations: A Randomised-Controlled Trial.

Narayan, Andrea J · 2025

Subjective sleepiness increased from 40 to 265 minutes post-dosing across all conditions (including placebo), but neither the 1:1 THC:CBD nor the 1:16 THC:CBD oil produced greater sleepiness than placebo.

Long-term cannabinoid therapy can ameliorate chronic sleep deprivation-induced behavioral and neuroinflammatory changes in mice.

Niazi, Nasar Ullah Khan · 2025

Chronic sleep deprivation caused memory impairment, depression-like behavior, microglial activation, and elevated pro-inflammatory cytokines in mice.

Clinicians' Perspectives on Cannabis Use and Cannabis Treatment in Clients Undertaking Opioid Dependence Treatment.

Parvaresh, Laila · 2025

Clinicians estimated 56.1% of OTP clients had used cannabis in the past month and 44.9% had cannabis dependence, but only 15.3% identified their cannabis use as problematic and 10.7% sought treatment.

Assessing patient perceptions of off-label cannabidiol use for insomnia through sentiment analysis.

Pereira, Gabriel Rodrigues Coutinho · 2025

From 74,562 unique tweets, 25,005 were classified as relevant to CBD for insomnia.

Sleep, Alcohol and Cannabis Use in College Students With and Without Attention-Deficit/Hyperactivity Disorder.

Marsh, Nicholas P · 2024

Among college drinkers, those with ADHD (n=51) reported significantly worse sleep quality and more alcohol-related negative consequences than those without ADHD (n=50).

Examining the effect of cannabis cues on cannabis demand in sleep, driving, and typical drug-use contexts.

Miller, Brandon P · 2024

Cannabis picture cues increased self-reported craving (p=.044) but did not significantly alter demand on purchase tasks.

Sleep disturbance after cessation of cannabis administration in mice.

Asano, Takashi · 2023

During cannabinoid administration, there was no difference in sleep/wake patterns between treated and control mice.

Perceived Effectiveness of Medical Cannabis Among Adults with Chronic Pain: Findings from Interview Data in a Three-Month Pilot Study.

McMahon, Alexandra N · 2023

Patient experience data is often overlooked in cannabis research, where the focus tends to be on controlled trials.

CBD lengthens sleep but shortens ripples and leads to intact simple but worse cumulative memory.

Samanta, Anumita · 2023

CBD extended the sleep period but changed properties of rest and non-REM sleep oscillations (delta, spindle, ripples).

The Place of Cannabinoids in the Treatment of Gynecological Pain.

Sinclair, Justin · 2023

Cannabis has a long history of use for menstrual and reproductive pain, predating modern medicine by centuries.

Clinical outcome analysis of patients with autism spectrum disorder: analysis from the UK Medical Cannabis Registry.

Erridge, Simon · 2022

Among 74 ASD patients (mean age 32.7), significant improvements were seen in general quality of life (EQ-5D-5L), sleep quality (SQS), and anxiety (GAD-7) at 1 and 3 months.

Assessing cognitive behavioral therapy for insomnia in individuals with cannabis use disorder utilizing actigraphy and serum biomarkers: A pilot study.

Geagea, Luna · 2022

After four CBT for insomnia sessions, mean ISI scores dropped from moderately severe to not clinically significant, sustained at 3 and 6 months.

Is There a Place for Medicinal Cannabis in Treating Patients with Sleep Disorders? What We Know so Far.

Maddison, Kathleen J · 2022

Cannabis is one of the top reasons people cite for using medicinal cannabis, but when you look at the actual clinical trial evidence for specific sleep disorders, the cupboard is surprisingly bare. For insomnia — the most common reason people use cannabis for sleep — the authors found only a handful of clinical studies, and most were small, short-term, and used different cannabis preparations.

Insomnia treatment: a new multitasking natural compound based on melatonin and cannabis extracts.

Palmieri, G · 2022

PSQI (sleep quality) and HAM-A (anxiety) scores showed significant improvements.

Survey of Patients Employing Cannabigerol-Predominant Cannabis Preparations: Perceived Medical Effects, Adverse Events, and Withdrawal Symptoms.

Russo, Ethan B · 2022

Most common conditions treated: anxiety (51.2%), chronic pain (40.9%), depression (33.1%), insomnia (30.7%).

An initial analysis of the UK Medical Cannabis Registry: Outcomes analysis of first 129 patients.

Erridge, Simon · 2021

Among 129 patients (most common indication: chronic pain, 37.2%), statistically significant improvements were seen at 1 and 3 months in GAD-7 (anxiety), sleep quality, EQ-5D-5L pain and discomfort, anxiety and depression subscales, and overall quality of life indices.

The effect of daily aerobic cycling exercise on sleep quality during inpatient cannabis withdrawal: A randomised controlled trial.

McCartney, Danielle · 2021

The cycling group showed improved sleep duration (P = 0.008) and sleep efficiency (P = 0.023) from baseline to treatment, while the stretching control group saw increased sleep onset latency.

Effects of Cannabis Consumption on Sleep.

Mondino, Alejandra · 2021

This review focused specifically on whole-plant cannabis consumption — smoked, oral, or vaporized — rather than isolated cannabinoids.

Safety and efficacy of low-dose medical cannabis oils in multiple sclerosis.

S, Gustavsen · 2021

Pain decreased from median NRS 7 to 4 (p=0.01), spasticity from 6 to 2.5 (p=0.01), and sleep disturbances from 7 to 3 (p<0.001).

Health Outcomes among Adults Initiating Medical Cannabis for Chronic Pain: A 3-month Prospective Study Incorporating Ecological Momentary Assessment (EMA).

Wang, Yan · 2021

Real-time EMA data (2,535 random + 705 daily assessments) showed significant reductions in momentary pain intensity after starting medical cannabis.

The Effectiveness of Cannabinoids in the Treatment of Posttraumatic Stress Disorder (PTSD): A Systematic Review.

Hindocha, C · 2020

Every study had medium to high risk of bias and was of low quality.

Exposure to the cannabinoid agonist WIN 55, 212-2 in adolescent rats causes sleep alterations that persist until adulthood.

Macías-Triana, Lorena · 2020

Adolescent rats exposed to WIN 55,212-2 (a cannabinoid agonist) for 14 days during adolescence (postnatal days 30-44) showed significant sleep disturbances when tested as adults (postnatal day 80): decreased wakefulness and enhanced REM sleep.

Cannabidiol and Sports Performance: a Narrative Review of Relevant Evidence and Recommendations for Future Research.

McCartney, Danielle · 2020

Preclinical studies show CBD has anti-inflammatory, neuroprotective, and analgesic properties potentially beneficial for athletes.

Acute effect of vaporized Cannabis on sleep and electrocortical activity.

Mondino, Alejandra · 2019

A single vaporized dose of Cannabis with THC 11.5% (and negligible other cannabinoids) was linked to a short-lived increase in NREM sleep (non-REM sleep, a deeper non-dream sleep stage), but only at the 200 mg dose and only during the first hour of the light phase.

The Consumption of Cannabis by Fibromyalgia Patients in Israel.

Habib, George · 2018

Researchers surveyed 383 fibromyalgia patients through Israeli Facebook support groups. Of respondents, 84% reported consuming cannabis, but only 44% had a medical cannabis license.

Medical Cannabis for the Treatment of Fibromyalgia.

Habib, George · 2018

Researchers collected data from registries at two Israeli hospitals on fibromyalgia patients treated with medical cannabis. Of 30 identified patients, 26 were included.

Cannabis Use in Individuals With Spinal Cord Injury or Moderate to Severe Traumatic Brain Injury in Colorado.

Hawley, Lenore A · 2018

Researchers surveyed 116 Colorado adults who had sustained spinal cord injury (SCI) or moderate to severe traumatic brain injury (TBI), combining focus group data with a telephone survey. 70% reported cannabis use before their injury (67% SCI, 74% TBI) and 48% reported use after their injury (53% SCI, 45% TBI). Reasons for use differed between groups.

Mother of Berries, ACDC, or Chocolope: Examination of the Strains Used by Medical Cannabis Patients in New England.

Piper, Brian J · 2018

Researchers conducted two studies to understand cannabis strain preferences among medical patients. Study I catalogued strains from the online database Leafly.com, finding 1,987 strains listed.

Cannabis, Cannabinoids, and Sleep: a Review of the Literature.

Babson, Kimberly A · 2017

This review pulled together what was known about cannabis and sleep through 2017, and the picture was split down the middle by compound.

Medical Cannabis in Parkinson Disease: Real-Life Patients' Experience.

Balash, Yacov · 2017

Forty-seven Parkinson's patients (40 men, median Hoehn & Yahr stage III) who had used medical cannabis for at least 3 months reported their symptom changes via structured telephone interviews. The largest effect sizes for improvement were: falls (r=0.89), pain relief (r=0.73), depression (r=0.64), tremor (r=0.64), muscle stiffness (r=0.62), and sleep (r=0.60).

Cannabis use patterns and motives: A comparison of younger, middle-aged, and older medical cannabis dispensary patients.

Haug, Nancy A · 2017

This dispensary-based study compared 217 medical cannabis patients across three age groups: younger (18-30), middle-aged (31-50), and older (51-72). All age groups used cannabis at similar frequencies over the past month.

The Endocannabinoid System Modulating Levels of Consciousness, Emotions and Likely Dream Contents.

Murillo-Rodriguez, Eric · 2017

This review proposed a novel hypothesis: that the endocannabinoid system influences dream activity. The reasoning builds on established evidence that the endocannabinoid system modulates multiple processes integral to dreaming: consciousness, learning and memory, attention, pain perception, emotions, and the sleep-wake cycle itself.

Role of N-Arachidonoyl-Serotonin (AA-5-HT) in Sleep-Wake Cycle Architecture, Sleep Homeostasis, and Neurotransmitters Regulation.

Murillo-Rodríguez, Eric · 2017

This study demonstrated that AA-5-HT, a dual FAAH inhibitor and TRPV1 blocker, is a potent sleep modulator in rats. When injected during the dark (active) period, AA-5-HT decreased wakefulness and increased both slow wave sleep and REM sleep in a dose-dependent manner.

Marijuana and other cannabinoids as a treatment for posttraumatic stress disorder: A literature review

Steenkamp, Maria M. · 2017

The biological case for cannabis helping PTSD was compelling.

The impact of perceived sleep quality and sleep efficiency/duration on cannabis use during a self-guided quit attempt.

Babson, Kimberly A · 2013

Researchers followed 102 cannabis-dependent military veterans for 6 months after a self-guided quit attempt.

Marijuana use is associated with inattention in men and sleep quality in women with Attention-Deficit/Hyperactivity Disorder: a preliminary study.

Ly, Christine · 2013

Fifty-six men and 20 women with ADHD (ages 18-45) were assessed for marijuana use, ADHD symptoms, and sleep quality.

Characterizing smoking topography of cannabis in heavy users.

McClure, Erin A · 2012

Twenty heavy cannabis users had their smoking behavior objectively measured during periods of ad libitum use in an inpatient study.

Cannabis use in patients with fibromyalgia: effect on symptoms relief and health-related quality of life.

Fiz, Jimena · 2011

Researchers compared 28 fibromyalgia patients who used cannabis to 28 matched non-users.

Sleep disturbance and the effects of extended-release zolpidem during cannabis withdrawal.

Vandrey, Ryan · 2011

When participants stopped cannabis for three nights and took placebo at bedtime, objective sleep quality dropped.

Functional consequences of marijuana use in adolescents

Jacobus, Joanna · 2009

Across the studies reviewed, adolescents who used marijuana heavily tended to score lower on attention, learning, and processing speed.

Sleep disturbance in heavy marijuana users

Bolla, Karen I. · 2008

Across two consecutive lab nights immediately after stopping, heavy users slept less and spent less time in slow wave sleep than matched drug-free controls.

Experience with the synthetic cannabinoid nabilone in chronic noncancer pain.

Berlach, David M · 2006

This report described clinical experience with off-label nabilone (a synthetic cannabinoid approved only for chemotherapy nausea) for chronic non-cancer pain at a Canadian pain clinic from 1999 onward. Twenty adult patients with chronic non-cancer pain were followed for an average of 1.5 years.

An α-hemoglobin-derived peptide (m)VD-hemopressin (α) promotes NREM sleep via the CB1 cannabinoid receptor.

Xie, Jun-Fan · 2023

The hemoglobin-derived peptide (m)VD-HPalpha promoted non-rapid eye movement (NREM) sleep when administered to mice.