Clinical Takeaway
In this pilot trial of 20 adults with diagnosed insomnia disorder, a single oral dose of 10 mg THC combined with 200 mg CBD reduced total sleep time compared to placebo, suggesting that this cannabinoid combination did not improve objective sleep in the short term. High-density EEG allowed detailed measurement of sleep architecture, providing more rigorous data than subjective reports alone. These findings highlight that patient-reported improvement with cannabinoids may not align with measurable changes in actual sleep quality or duration.
#10 Acute Effects of Oral Cannabinoids on Sleep and High-Density EEG in Insomnia: A Pilot Randomised Controlled Trial.
Citation: Suraev Anastasia et al.. Acute Effects of Oral Cannabinoids on Sleep and High-Density EEG in Insomnia: A Pilot Randomised Controlled Trial.. Journal of sleep research. 2026. PMID: 40631525.
Design: 5 Journal: 0 N: 0 Recency: 3 Pop: 2 Human: 1 Risk: 0
Methodological Considerations:
- Self-reported outcomes — recall and social-desirability bias risk
Abstract: Cannabinoids, particularly Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD), have gained popularity as alternative sleep aids; however, their effects on sleep architecture and next-day function remain poorly understood. Here, in a pilot trial, we examined the effects of a single oral dose containing 10 mg THC and 200 mg CBD (THC/CBD) on objective sleep outcomes and next-day alertness using 256-channel high-density EEG in 20 patients with DSM-5 diagnosed insomnia disorder (16 female; mean (SD) age, 46.1 (8.6) years). We showed that THC/CBD decreased total sleep time (-24.5 min, p = 0.05, d = -0.5) with no change in wake after sleep onset (+10.7 min, p > 0.05) compared to placebo. THC/CBD also significantly decreased time spent in REM sleep (-33.9 min, p < 0.001, d = -1.5) and increased latency to REM sleep (+65.6 min, p = 0.008, d = 0.7). High-density EEG analysis revealed regional decreases in gamma activity during N2 sleep, and in delta activity during N3 sleep, and a regional increase in beta and alpha activity during REM sleep. While there was no observed change in next-day objective alertness, a small but significant increase in self-reported sleepiness was noted with THC/CBD (+0.42 points, p = 0.02, d = 0.22). No changes in subjective sleep quality, cognitive performance, or simulated driving performance were observed. These findings suggest that a single dose of cannabinoids, particularly THC, may acutely influence sleep, primarily by suppressing REM sleep, without noticeable next-day impairment (≥ 9 h post-treatment). Australian New Zealand Clinical Trial Registry (ACTRN12619000714189) https://www.anzctr.org.au/.
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