Study register · detailSystematic Review · Sleep Disorders · 2022
Use of Cannabidiol in the Management of Insomnia: A Systematic Review
Ranum et al.·Cannabis and Cannabinoid ResearchImpact 2.5
MixedGRADEHigh28 citations
Samplek = 34 Studien
DurationInception to December 29, 2021
EndpointInsomnia symptoms
Blindingunklar
DesignSystematic Review
”Key finding
All 34 studies reported improvements in insomnia symptoms in at least a portion of participants; however, only 4 of 7 CBD-predominant and 12 of 16 CBD+THC studies with hypothesis testing showed significant improvements, and only 2 studies focused on patients with insomnia.
Summary
Systematic review on CBD in insomnia; k=34 studies (only 2 focused on insomnia patients, of which 1 case report). Of 7 studies with a CBD-predominant arm, 4 showed significant improvement of insomnia outcomes; of 16 studies with nearly equal CBD:THC ratios, 12 showed significant improvement. Limitations: heterogeneous study designs, often non-validated subjective measurement instruments, lack of objective sleep measurements.
P
PopulationAdults with insomnia or sleep disorders (various underlying conditions), pooled k=34 studies
I
InterventionCannabidiol (CBD) alone or in combination with delta-9-THC (approximately equal ratio), various forms of administration
O
Outcome4 of 7 studies with CBD-predominant therapy and 12 of 16 studies with CBD:THC combination reported significant improvement of insomnia symptoms; all 34 studies reported at least partial improvement
Confidence in the evidence
Very lowLowModerateHigh
High
The highest of four GRADE levels, the effect estimate is very reliable.
Background: Cannabidiol (CBD), one of the major cannabinoids derived from the cannabis plant, is available over the counter. CBD is often used by patients for the management of insomnia, yet research supporting CBDs effectiveness as a treatment for insomnia is inadequate. Objective: The objective of this review was to critically evaluate the literature regarding the therapeutic benefits of CBD in the management of insomnia. Methods: A comprehensive search of the following databases from inception to December 29, 2021, was conducted: Ovid MEDLINE((R)) and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily, Ovid Embase, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus. The search included randomized controlled trials, nonrandomized experimental studies, cross-sectional studies, cohort studies, case series, and case reports. Risk of bias was assessed with the Agency for Healthcare Research and Quality design-specific recommended criteria. Results: Thirty-four studies were eligible for inclusion. All studies reported improvement in the insomnia symptoms of at least a portion of their participants. Of the 34 studies, 19 studies used CBD predominant therapy and 21 studies used nearly equal ratios of CBD to Delta(9)-tetrahydrocannabinol (THC). Of the studies that performed hypothesis testing, 4 of 7 studies with a CBD predominant arm and 12 of 16 studies with a nearly equal ratio of CBD to THC arm reported significant improvement in insomnia outcomes. However, only 2 of the 34 studies focused on patients with insomnia, of which 1 study was a case report. Additionally, several studies used nonvalidated subjective measures, and most studies failed to include objective measures for symptom assessment. Conclusions: The results of our systematic review suggest that CBD alone or with equal quantities of THC may be beneficial in alleviating the symptoms of insomnia. Nevertheless, future research assessing CBDs effectiveness in population of patients specifically with insomnia utilizing validated subjective and objective measures is necessary before definitive inferences can be made.