Efficacy of cannabinoids for insomnia and sleep disturbance: A systematic review and meta-analysis of randomized controlled trials
Abstract
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…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 2,134 participants or records.
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