Clinical Takeaway
In this pilot RCT 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 outcomes in the short term. Clinicians should note that patient-reported improvement in sleep does not always align with measurable changes in sleep architecture, and next-day alertness effects remain an important consideration when recommending cannabinoids for insomnia.
#9 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 โ recall and social-desirability bias risk
Abstract: Cannabinoids, particularly ฮ9-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 10โmg THC and 200โmg 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 (-24.5โmin, pโ=โ0.05, dโ=โ-0.5) with no change in wake after sleep onset (+10.7 min, pโ>โ0.05) compared to placebo. THC/CBD also significantly decreased time spent in REM sleep (-33.9โmin, pโ<โ0.001, dโ=โ-1.5) and increased latency to REM sleep (+65.6โmin, pโ=โ0.008, dโ=โ0.7). 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, pโ=โ0.02, dโ=โ0.22). 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 (โฅโ9โh post-treatment). Australian New Zealand Clinical Trial Registry (ACTRN12619000714189) https://www.anzctr.org.au/.
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