Taken together, the evidence suggests cannabis may provide short-term, subjective improvements, but tolerance, withdrawal effects, and inconsistent findings across studies highlight the need for further research. Their findings were generally neutral to slightly positive. Evidence in this area is still limited and inconsistent. Over time, the impact of cannabis on sleep often becomes neutral, and in some cases may worsen sleep quality.
Data were collected using the Strainprint app, which allows medicinal cannabis users to log conditions and symptoms, track cannabis use, and monitor symptom severity pre- and postcannabis use. When using cannabis products to help with sleep, people often use them before going to bed. Little research has been conducted on the best strain for sleep, though a small study found several preferred strains. Additionally, people who are pregnant or nursing should avoid using cannabis products that contain THC or CBD. This is due to differences in how individual cannabinoids, such as THC and CBD, affect the body.
Descriptive statistics for anxiety and sleep scores among adults using cannabidiol treatment Table 1 provides means and standard deviations for sleep and anxiety scores at baseline and during the follow-up period for adults taking CBD. Deidentified patient data were evaluated using descriptive statistics and plotted graphically for visual analysis and interpretation of trends. Side effects and tolerability of CBD treatment were assessed through spontaneous patient self-reports and were documented in case records.
Extensive research has been conducted regarding the effects of cannabis on the pulmonary system in both acute and long-term contexts. Based on retrospective analyses and molecular level suggestions, cannabis might adversely affect the cardiovascular system; however, these findings have not been confirmed by prospective clinical data. This study faced limitations because its variables were measured through self-reporting, which may introduce recall bias, and there was a significant lack of agreement between self-reported cannabis usage and biochemical validation (Jeffers et al., 2024). Consequently, these alterations may mediate the pathophysiology of CHS by disrupting stress and anxiety responses, thermoregulation, the transient receptor potential vanilloid system, and various neurotransmitter systems (DeVuono & Parker, 2020).
Another important consideration with regards to cannabis use in adolescents and young adults is its effect on cognition and intelligence. The entourage effect theory posits that the non-THC components within whole-flower cannabis influence the overall effects of cannabis. However, as concluded in a literature review exploring CBD and anxiety, evidence is mixed and limited (Lichenstein, 2022).
Respondents between the ages of 25 and 44 years were most likely to report a beneficial effect of marijuana on sleep (45%), while older adults responsible cannabis awareness in biker culture were less likely to report using marijuana. Results show that there are gender and age differences in both marijuana use and its perceived impact on sleep. In contrast, 19% of adults reported either no impact (11%) or that their sleep is worse when they use marijuana (8%), and 47% of respondents indicated that they don’t use marijuana. One-third (33%) of adults reported that their sleep is slightly or significantly better when they use marijuana.
Sleep has a well-documented role in the maintenance of cognitive function, thus there may be an interactive or additive effect of cannabis on cognition via its purported effect on sleep. This diurnal ECB expression pattern indicates that brain regions controlling cognitive function may be regulated in a circadian-like manner. The ECB system has become an emerging target of interest due to its purported role in both sleep regulation and cognition.
These findings support the hypothesis that CBD has more predictable sleep-promoting effects that may be moderated by stress, underlying health conditions, and concurrent medications. Studies have shown that low-to-moderate doses of CBD promote wakefulness in young adults and preclinical models 39, 40 and improve sleep in adults . This study also confirms that higher doses of CBD result in greater sleep improvement 36, 37, even though, unlike THC, CBD is not thought to alter sleep architecture . During their participation, 75% of cancer patients used enteral (oral) cannabis products, either alone or in combination with inhalation products. Approximately 40% qualified for the reduced program fee, which was used in this study as a proxy for patient financial status.
Methods
No competing interests are disclosed by the other authors. We discovered twenty-one recent studies related to cannabinoids and their effects on insomnia, subjective sleep impairment, obstructive sleep apnea, rapid eye movement sleep behavior disorder, and restless legs syndrome. There is no definitive evidence indicating whether CBD or THC is superior for alleviating insomnia symptoms. While cannabis may assist individuals with insomnia in falling asleep more easily, excessive or prolonged use could adversely affect their circadian rhythm, making it more challenging to both fall asleep and remain asleep. A significant number of individuals successfully manage their chronic pain and insomnia by using cannabis. For individuals suffering from conditions such as chronic pain, post-traumatic stress disorder (PTSD), and multiple sclerosis, cannabis may facilitate faster sleep onset, reduce awakenings during the night, and enhance overall sleep quality. With the evolving legal landscape, it is increasingly likely that healthcare providers will meet patients who report using cannabis products for sleep assistance.
The limited number of human studies exploring cannabis use’s effects on sleep and cognitive function restricts the convergence of findings, yet suggests a disconnect between cannabis’s impacts on cognition and sleep. The cohort of this study comprised 40 articles: 28 investigated cannabis’s effects on sleep, 4 assessed both sleep and chronic pain, 3 analyzed the impacts of cannabis on sleep and post-traumatic stress disorders, 3 focused solely on cannabis effects on obstructive sleep apnea, and 2 studies looked into cannabis for restless legs syndrome. This research took place within the Minnesota Medical Cannabis Program (MMCP), which permits patients with specific qualifying conditions to obtain cannabis products. These outcomes align with a cross-sectional survey of medical cannabis users, which indicated that inhalation is the predominant method of consumption. Data were obtained in a de-identified manner from Strainprint®, which operates a medical cannabis technology platform in Canada. The final sample included 991 Canadian medicinal cannabis users dealing with insomnia who utilized the app to track changes in their insomnia symptoms across 24,189 recorded sessions.
While an initial open-label trial indicated some improvements in the apnea-hypopnea index (AHI), substantial variability in response was observed. Concerning the survey, an online survey of 2,007 adults in the U.S. was commissioned by the American Academy of Sleep Medicine. According to the CDC, 3.7% of adults in the U.S. reported using marijuana or another cannabis product daily or most days over the past 30 days to aid in falling or staying asleep. Research investigating the effects of cannabis products on sleep has yielded inconsistent results.
Results from this large naturalistic sample of medicinal cannabis users who tracked their insomnia symptoms before and after cannabis use suggest significant improvements in insomnia symptoms, with no gender differences in perceived efficacy. Additionally, research into the effects of cannabis on sleep is often conducted with people who have other health problems. Three animal studies also evaluated the effects of cannabis on sleep-wake activity and cognition. In this systematic scoping review, we identified six human studies and six animal studies that included data on the effects of the sleep-wake cycle and the ECB system on cognitive function and behavior.