What is the efficacy of cannabis for insomnia (sleep disorder)?

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Last updated: April 7, 2025View editorial policy

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From the Guidelines

Cannabis can be effective for sleep, but research is limited, and it should be used under the guidance of a healthcare provider, especially when considering other medications or health conditions. For sleep issues, indica strains with higher CBD content and lower THC (around 5-10mg THC) are generally recommended, taken 1-2 hours before bedtime 1. Products like tinctures, oils, or edibles provide longer-lasting effects compared to smoking or vaping. Start with a low dose (2.5-5mg THC) and increase gradually if needed. CBD-dominant products (with ratios like 2:1 or 3:1 CBD:THC) may provide sleep benefits with fewer psychoactive effects. Specific strains often recommended include Granddaddy Purple, Northern Lights, and Purple Kush. Cannabis works by interacting with the endocannabinoid system, with THC potentially reducing sleep latency while CBD may help with anxiety that interferes with sleep. However, regular cannabis use can lead to tolerance, withdrawal symptoms affecting sleep when stopping, and may suppress REM sleep. It's best used occasionally rather than nightly, and should be discussed with a healthcare provider, especially if you take other medications 1.

Some key points to consider:

  • The American College of Physicians guideline recommends cognitive behavioral therapy for insomnia (CBT-I) as the first-line treatment for chronic insomnia disorder 1.
  • Pharmacologic therapy, including benzodiazepines, nonbenzodiazepine hypnotics, and melatonin receptor agonists, may be effective for short-term treatment of insomnia, but the evidence is limited, and the risks of adverse effects, such as cognitive and behavioral changes, should be carefully considered 1.
  • Complementary and alternative approaches, including acupuncture and Chinese herbal medicine, have also been used to treat insomnia, but the evidence is limited, and more research is needed to determine their effectiveness 1.

Overall, while cannabis may be effective for sleep, it is essential to weigh the potential benefits against the potential risks and to discuss its use with a healthcare provider, especially when considering other medications or health conditions.

From the Research

Data for Use with Cannabis for Sleeping

There are no research papers provided that directly discuss the use of cannabis for sleeping. The available studies focus on other treatments for insomnia, such as zolpidem, eszopiclone, and cognitive behavioral therapy.

Alternative Treatments for Insomnia

  • Zolpidem: a hypnotic drug used to treat insomnia, with potential side effects including increased risk of falls, hip fractures, and complex behaviors such as sleepwalking and hallucinations 2
  • Eszopiclone: a hypnotic drug used to treat insomnia, with moderate effects on sleep onset and maintenance, and potential side effects including unpleasant taste, dry mouth, somnolence, and dizziness 3
  • Cognitive Behavioral Therapy (CBT): a non-pharmacological approach to treating insomnia, which has been shown to be effective in improving sleep quality and reducing symptoms of insomnia 4, 5

Considerations for Treatment

  • The treatment of insomnia should involve a multi-disciplinary approach, focusing on implementing behavioral interventions, improving sleep hygiene, managing psychological stressors, hypnotic treatment, and pharmacological therapy 2
  • The choice of treatment should be made on a case-by-case basis, considering both the physical and psychiatric risks posed to the patient with insomnia 2
  • Certain patient subgroups, such as the elderly and those with cognitive and motor impairments, may require increased caution when using pharmacological treatments for insomnia 3

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Zolpidem: Efficacy and Side Effects for Insomnia.

Health psychology research, 2021

Research

Eszopiclone for insomnia.

The Cochrane database of systematic reviews, 2018

Research

Making sleep easier: pharmacological interventions for insomnia.

Expert opinion on pharmacotherapy, 2018

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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