Study register · detailMeta-Analyse · Sleep Disorders · 2025
Effectiveness of cannabinoids on subjective sleep quality in people with and without insomnia or poor sleep: A systematic review and meta-analysis of randomised studies.
da Silva et al.·Sleep medicine reviewsImpact 7.2
Clear benefitGRADEHigh3 citations
Samplek = 6 Studien n = 1.077 Pat.
Durationunclear
ControlPlacebo
EndpointSelf-reported sleep quality
Blindingdoppelblind
DesignMeta-Analyse
”Key finding
Cannabinoids significantly improved sleep quality versus placebo (SMD 0,53; p=0,04), especially in patients with insomnia or poor sleep (SMD 0,60; p=0,02); non-CBD cannabinoids showed greater efficacy than CBD-only therapies.
Summary
Systematic review and meta-analysis across k=6 RCTs (n=1.077 patients) on cannabinoids vs. placebo for sleep quality. Cannabinoids significantly improved subjective sleep quality (SMD=0,53; 95% CI 0,03–1,02; p=0,04; I²=88%), especially in insomnia/poor sleep (SMD=0,60; 95% CI 0,09–1,11; p=0,02; I²=89%). Non-CBD cannabinoids showed higher efficacy (SMD=0,82; 95% CI 0,24–1,40; p=0,005), while pure CBD therapy had no significant effect (SMD=0,13; 95% CI −0,38 to 0,65; p=0,61).
P
PopulationAdults with or without insomnia/poor sleep, pooled n=1077
I
InterventionCannabinoids (various, including CBD and non-CBD formulations)
C
ControlPlacebo
O
OutcomeCannabinoids significantly improved sleep quality vs. placebo (SMD 0,53; 95% CI 0,03–1,02; p=0,04; I²=88%); stronger in insomnia/poor sleep (SMD 0,60; p=0,02); non-CBD cannabinoids effective (SMD 0,82; p=0,005), CBD-only without significant effect (SMD 0,13; p=0,61)
Confidence in the evidence
Very lowLowModerateHigh
High
The highest of four GRADE levels, the effect estimate is very reliable.
Quality profile
Sample size★★★★★
BlindingDouble-blind
Effect sizeClear benefit
Citations / year★★★★★
Authors
da Silva GHS, Barbosa EC, de Lima FR, Barroso DC, Paez LEFE, Guimaraes FBM, Lanca SB, de Faria SBC, Petrucci ABC, Garbacka A
Study Objectives: This systematic review and meta-analysis assessed the efficacy of cannabinoids compared to placebo for improving sleep quality.
Methods: Searches were conducted in MEDLINE, Embase, and Cochrane databases for randomised controlled trials comparing cannabinoids vs. placebo for improving sleep quality in adults with or without insomnia or poor sleep. The primary outcome was self-reported sleep quality (PROMIS, PSQI, LSEQ, Sleep Diary). Secondary outcomes included actigraphy parameters, anxiety (GAD-7, STAI-T), well-being (WHO-5 index), and insomnia severity (ISI). Additional analyses focused on sleep quality in (1) participants with insomnia or poor sleep, and (2) cannabidiol (CBD) vs. non-CBD interventions. Statistical analysis was performed using RevMan 5.4.1, with p < 0.05 considered significant.
Results: Six trials (1077 patients) were included. Cannabinoids significantly improved sleep quality compared to placebo [SMD 0.53; 95 % CI 0.03-1.02; p = 0.04; I2 = 88 %], particularly in those with insomnia or poor sleep [SMD 0.60; 95 % CI 0.09-1.11; p = 0.02; I2 = 89 %]. Non-CBD cannabinoids demonstrated greater efficacy [SMD 0.82; 95 % CI 0.24-1.40; p = 0.005], whereas CBD-only therapies showed no significant effect [SMD 0.13; 95 % CI -0.38-0.65; p = 0.61].
Conclusion: Cannabinoids, particularly non-CBD formulations, improve sleep quality, justifying further investigation as therapeutic options for insomnia or poor sleep.