How Effective Are Cannabis-Based Treatments for Insomnia?

Is cannabis an effective remedy for insomnia? Who can really benefit from its use, and is it right for you or your patients? This article provides a nuanced exploration of cannabis as a treatment for various types of insomnia, from fibromyalgia to anxiety-related disturbances. Discover through evidence-backed research how cannabis impacts sleep quality across different conditions and demographics.

Causes, Impact, and Prevalence of Insomnia

Up to 30% of people experience insomnia, which is a sleep disorder that makes it hard to fall asleep or stay asleep. Insomnia is prevalent among 10% to 30% of adults, and its occurrence tends to rise with age and the presence of other health conditions.¹

Insomnia can profoundly affect:¹ 

• Daily life
• Energy levels
• Focus
• Mood 
• Overall physical health

The far-reaching effects of insomnia—impairing everything from daily energy levels to mental health—are driving an increasing number of sufferers to explore alternative treatments, including medicinal cannabis. Reports indicate that about 25% of recreational cannabis users find it beneficial for relaxation and sleep, highlighting its potential as a sleep aid. This burgeoning interest has spurred deeper investigations into cannabis as a potential therapeutic agent.²

The Potential of Cannabis in Insomnia Management

Cannabis has long been discussed for its sedative properties, but how effective is it really in treating insomnia? In this section, we investigate how this versatile plant is used to combat sleepless nights across three distinct groups: those suffering from insomnia only, those dealing with fibromyalgia, and people grappling with anxiety and depression.

Efficacy of Medicinal Cannabis Oil in Insomnia Patients

A clinical trial led by Reid et al. explored the effects of Entoura-10:15 medicinal cannabis oil, which contains both THC and CBD, on adults suffering from insomnia. Over a period of two weeks, participants used the oil daily, with doses increasing from 0.2 to 1.5 ml. Their sleep was compared to a placebo group, with assessments including midnight melatonin levels, responses to insomnia-related questionnaires, and Fitbit sleep tracking.¹

Results showed significant improvements for those using cannabis oil. Notably, their melatonin levels increased by 30%, indicating better sleep initiation and depth, unlike the placebo group, which saw a 20% decrease (Fig. 1).

Moreover, the Insomnia Severity Index questionnaire revealed that symptoms like difficulty falling asleep, waking at night, and overall sleep duration improved markedly. Participants also reported feeling more satisfied with their sleep and daily functioning.¹

In terms of sleep quality, tracked using a Fitbit, the active group enjoyed about 30 minutes more sleep per night than before the trial. In particular, the light sleep stage extended by an average of 21 minutes per night, significantly more than the placebo group’s negligible increase (Fig. 2).¹

What about side effects? While 83% of participants reported mild side effects such as dry mouth, nausea, and vertigo, these were generally brief and non-serious.¹

Overall, the Entoura-10:15 oil was well-tolerated and notably effective, with 60% of the active group no longer meeting the criteria for clinical insomnia after the two-week period.¹

Efficacy of Medicinal Cannabis Oil for Fibromyalgia-Related Insomnia

The effectiveness of cannabis-based treatments for insomnia related to fibromyalgia was demonstrated in a study comparing nabilone, a synthetic THC compound, to amitriptyline, an antidepressant commonly used to treat sleep disorders. In this well-controlled trial, patients took each medication for two weeks with a break in between.³ 

Both medications significantly improved sleep. However, nabilone (0.5–1.0 mg) was consistently more effective than amitriptyline (10 –20 mg) throughout the study. By the end, patients using nabilone reported lower insomnia scores, meaning they experienced fewer sleep disturbances compared to those using amitriptyline (Fig. 3).³ 

Not only did nabilone help patients sleep better, but it also made them feel more rested upon waking. Given its effectiveness and good tolerance by patients, Nabilone holds promise as an alternative treatment for those suffering from Fibromyalgia-related insomnia.³

Efficacy of Cannabis for Mental Health-Related Insomnia

Disruptions in sleep patterns are often linked to mood and anxiety disorders, with insomnia being a frequent issue. To better understand how cannabis is used for managing insomnia in individuals suffering from depression, anxiety, or both, a comprehensive study was conducted using data from the Strainprint® app. This app allows users to track their symptoms and cannabis use.²

The study found that people of all ages and genders found cannabis helpful for insomnia, regardless of the form in which it was consumed. Dried cannabis flowers and oral oils were particularly popular and effective. Notably, individuals with depression responded better to indica-dominant and sativa-dominant strains compared to CBD-dominant strains, which were less effective for them.²

For those with anxiety and combined depression and anxiety, all types of cannabis strains were beneficial, with no particular strain standing out. Moreover, when people with both conditions used cannabis, they noticed improvements across all forms of products, with oils being slightly more effective than other forms.²

This research suggests that while all cannabis strains generally help improve sleep for individuals with mood and anxiety disorders, those with depression may experience less benefit from CBD-dominant products. This might indicate that CBD’s effects differ based on the underlying condition, possibly due to its anxiety-reducing properties, which can in turn influence sleep quality.²

The takeaway? People with depression, anxiety, and combined conditions who use cannabis for insomnia consistently report improvements in their sleep, showing that cannabis can be an effective part of managing these complex disorders.²

Overcoming Insomnia with Cannabis-Based Therapies

The evidence collected from various studies highlights the potential utility of cannabis in managing insomnia. Clinical trials, such as those involving the synthetic THC compound Nabilone and the Entoura-10:15 cannabis oil demonstrate measurable improvements in sleep parameters among individuals with conditions ranging from fibromyalgia to generalized insomnia.^1,3 

Moreover, observational data from apps like Strainprint® confirm that a broad spectrum of users, including those with mood and anxiety disorders, report significant benefits from cannabis use. While these findings are promising, they also call for a cautious approach to fully understand the differential impacts across diverse patient profiles.² 

For a more comprehensive exploration of how cannabis might affect other sleep disorders, consider reading the detailed analysis in “The Latest News on The Relationship of Cannabis and Sleep“.

References

1. Ried K, Tamanna T, Matthews S, Sali A. Medicinal cannabis improves sleep in adults with insomnia: a randomised double‐blind placebo‐controlled crossover study. Journal of sleep research. 2023 Jun;32(3):e13793.
2. Kuhathasan N, Minuzzi L, MacKillop J, Frey BN. An investigation of cannabis use for insomnia in depression and anxiety in a naturalistic sample. BMC psychiatry. 2022 Apr 28;22(1):303.
3. Ware MA, Fitzcharles MA, Joseph L, Shir Y. The effects of nabilone on sleep in fibromyalgia: results of a randomized controlled trial. Anesthesia & Analgesia. 2010 Feb 1;110(2):604-10.