Study register · detailRCT · Sleep Disorders · 2026
Acute Effects of Oral Cannabinoids on Sleep and High-Density EEG in Insomnia: A Pilot Randomised Controlled Trial.
Suraev et al.·Journal of sleep researchImpact 3.0
MixedGRADEModerate8 citations
Samplen = 20 Pat.
Durationone night + next day
ControlPlacebo
EndpointPolysomnography
Blindingdoppelblind
DesignRCT
Cannabinoidkombination
THC:CBD1:20
Max. dose210.0 mg
Routeoral
”Key finding
THC/CBD reduced total sleep time and suppressed REM sleep, without objective impairment of daytime wakefulness, but with increased self-reported sleepiness.
Summary
n=20 patients with DSM-5-diagnosed insomnia, single dose THC 10 mg + CBD 200 mg vs. placebo. THC/CBD reduced total sleep time by −24,5 min (p=0,05, d=−0,5) and REM sleep by −33,9 min (p<0,001, d=−1,5), prolonged REM latency by +65,6 min (p=0,008, d=0,7). No change in Wake After Sleep Onset (+10,7 min, p>0,05). High-density EEG showed regional gamma decrease in N2, delta decrease in N3, and beta/alpha increase in REM. No objective alertness effect the following day, but slight subjective sleepiness (+0,42 points, p=0,02, d=0,22).
P
PopulationAdults with DSM-5-diagnosed insomnia, n=20 (16 female, mean 46,1 years)
OutcomeTHC/CBD reduced total sleep time (−24,5 min, p=0,05, d=−0,5) and REM sleep (−33,9 min, p<0,001, d=−1,5), prolonged REM latency (+65,6 min, p=0,008, d=0,7); no significant change in WASO or objective daytime sleepiness
Confidence in the evidence
Very lowLowModerateHigh
Moderate
The third of four GRADE levels, the effect estimate is probably reliable.
Downgraded for
Imprecision
Quality profile
Sample size★★★★★
BlindingDouble-blind
Effect sizeMixed
Citations / year★★★★★
Authors
Suraev A, McGregor IS, McCartney D, Marshall NS, Kao CH, Wassing R, D'Rozario AL, Wong KKH, Yee BJ, Sivam S
Cannabinoids, particularly Delta9-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/.