Cannabis for sleep and anxiety: Insomnia patients report better rest after 18 months

New research supports the sleep-promoting and anxiety-reducing properties of cannabis-based medical products, with insomnia patients in a new study reporting feeling better rested after 18 months of treatment. These findings contrast advice from the Sleep Foundation that cannabis consumption may, in fact, disrupt the overall quality of sleep, despite aiding in sedation.

The analysis involved 124 insomnia patients prescribed medical cannabis products. The researchers studied the patients’ own reports of their sleep quality, anxiety, depression, and changes in overall quality of life between one and 18 months of treatment.

The participants experienced “significant improvements” in anxiety or depression, as well as reporting less pain. Around 9% of the cohort reported adverse effects such as fatigue, insomnia, or dry mouth. However, none of the side effects were life-threatening.

“These findings support the potential role of medical cannabis as a medical option where conventional treatments have proven ineffective, though further randomized trials are needed to confirm long-term efficacy,” says co-author Dr. Simon Erridge, research director at Curaleaf Clinic.

“Conducting this long-term study provided valuable real-world evidence on patient outcomes that go beyond what we typically see in short-term trials. It was particularly interesting to observe signs of potential tolerance over time, which highlights the importance of continued monitoring and individualized treatment plans.”

Findings of the study are published in the journal PLOS Mental Health by the research team at Imperial College London, UK.

Alternatives to addictive sleep aids

Around one out of every three people experiences difficulty getting a good night’s rest, while 10% of adults meet the criteria for an insomnia disorder, the study authors highlight. They stress that cannabis treatments can often be challenging to obtain and that common pharmaceutical drugs prescribed for insomnia run the risk of dependence.

While randomized controlled trials will be needed to prove that cannabis-based medical products are safe and effective, the researchers suggest their findings offer a reliable basis that medical products may improve sleep quality in insomnia patients.

Although cannabis may help with falling asleep faster, the Sleep Foundation cautions that it may alter the time a person spends in different sleep stages. Short-term cannabis use appears to increase the time people spend in non-rapid eye movement sleep, which is the stage of rest that allows a person to wake up feeling refreshed.

However, the organization warns that THC (tetrahydrocannabinol) — the psychoactive compound in cannabis — decreases the amount of time spent in rapid eye movement (REM) sleep, which is the stage for dreaming, processing emotions, and cementing new memories.

“Decreasing REM sleep may have some benefits for people with PTSD, since nightmares are a common and disturbing symptom,” explains the Sleep Foundation. One study on women with PTSD found that those with more severe PTSD symptoms and poor sleep were more likely to use cannabis to help them cope.

Conversely, another study cited by the Sleep Foundation found that synthetic forms of cannabis significantly decreased nightmares, or stopped them completely, for people with PTSD. Some participants in this study also reported experiencing better overall sleep quality and fewer daytime flashbacks.

Natural alternatives

Innovation in the nutraceuticals space continuously offers natural alternatives to pharmaceutical sleep aids, particularly around cannabis CBD (cannabidiol). The non-psychoactive compound in cannabis and hemp is backed by growing evidence for its sleep and relaxation properties.

Following a rigorous safety evaluation earlier this week, Pureis’ lab-made Ultra Pure CBD recently entered the final stage of full authorization as a novel food in the UK. The company progressed to the public consultation phase of the licensing process, bringing it one step closer to full commercialization in Britain.

Nuritas recently launched PeptiSleep, a natural plant peptide ingredient derived from rice bran protein that supports all stages of sleep by reducing cortisol, the hormone responsible for stress and poor sleep. The company used AI to identify a peptide and match it to a receptor in the body to induce this effect, based on a library of over nine million plant peptides.

Melatonin-free sleep aids are also trending. A research paper highlighted that one handful of walnuts (40 g or about 1.5 oz) with dinner may help improve overall sleep quality. The paper also supports its effectiveness in reducing daytime sleepiness in healthy young adults.