Cannabinoids Produce Worse Sleep Outcomes in Small Pilot Study
A single dose of tetrahydrocannabinol/cannabidiol (THC/CBD) resulted in worse sleep for study participants with insomnia. Results from the small pilot study were published in the Journal of Sleep Research.
Cannabinoids have gained popularity as alternative sleep aids, but little research has been done regarding their effects on sleep. Insomnia, meanwhile, is one of the most common conditions reported for the use of medical cannabis.
The randomized, placebo-controlled, crossover design study included 20 people with confirmed insomnia according to DSM-5 criteria. Participants spent two 24-hour periods in an overnight sleep lab with at least 1 week in between visits. Patients were randomly allocated per visit to receive either a single oral dose containing 10 mg of THC and 200 mg of CBD or placebo, and were blinded to administration. Outcomes were measured using in-laboratory polysomnography and high-density electroencephalography (EEG).
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“This study is the first to use high-density EEG to explore the acute effects of oral THC/CBD on objective sleep outcomes in individuals with insomnia,” wrote Anastasia Suraev, PhD, MPsych, BSc, of the Center for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia, and coauthors. “A single oral dose significantly reduced total sleep time and REM sleep, without impairing next-day alertness.”
The single dose of medical-grade cannabis oil reduced total sleep time by almost 25 minutes (–24.5 min, p=0.05, d= –0.5), as well as reduced rapid eye movement (REM) sleep by around 34 minutes per person (–33.9 min, p<0.008, d=0.7). No changes were observed in next-day subjective measures of sleep quality, alertness, cognitive performance, or simulated driving performance. Participants reported a slight increase in sleepiness after THC/CBD use.
“High-density EEG analysis revealed frequency- and region-specific effects, suggesting that THC/CBD reduces cortical hyperarousal during lighter sleep stages while disrupting deeper and REM sleep stages,” concluded Suraev et al. “Further research with repeated dosing is needed to clarify the clinical significance of these findings and to evaluate the broader impact of cannabinoids on sleep macro- and micro-architecture, as well as insomnia symptoms.”
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