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Novel formulation of cannabinoids THC and CBN improves sleep – study

Participants slept on average 20 minutes longer while taking the tablet



Participants slept on average 20 minutes longer while taking the tablet

A novel formulation of the cannabinoids THC and CBN was found to improve sleep in medical cannabis patients.

The study, which appeared in the American Journal of Endocannabinoid Medicine, concluded that a repeat-action tablet formulation of THC and CBN was associated with improved sleep quality in participants.

A sleep-tracking device was used to measure sleep in 35 medical cannabis consumers, with an average age of 47 years.

According to the study, the most common medical conditions for which participants reported taking cannabis were sleep/insomnia (69 percent), pain (40 percent), and generalised anxiety disorder (29 percent).

The most common concerns cited were waking up too often during the night, not feeling well rested upon awakening in the morning (74 percent); and taking too long to fall asleep at night and waking up too early in the morning (26 percent).

The authors wrote: “The use of cannabis to improve sleep quality and treat sleep-related disorders has received increased attention due to the expanded legalisation of cannabis for medical use in 36 states and Washington DC. 

“Data on the effects of delta-9-tetrahydrocannabinol (THC), in combination with cannabinol (CBN), on sleep is preliminary; however, preclinical research indicates that CBN may prolong sleep and be particularly effective when combined with other cannabinoids.”

Participants who completed the study slept an average of six hours and 29 minutes per night before starting on treatment, sleeping an average of 20 minutes longer while taking the tablet.

There was also a 22 percent increase in reported feelings of restfulness upon waking, with an 18 percent increase in reported overall sleep quality during the product use.

Sleep quality was reported to rise from an average rating of 53.32 (on a 100-point sleep quality scale) before product use to 65.21 during product use.

Each tablet contained 10mg of THC and 5mg of CBN and were administered as a repeat-action dosage form, meaning half of the doses released immediately after oral administration, and the remaining half released two to three hours later. 

Authors of the study concluded: “This study found that an oral product containing a combination of THC and CBN was directly associated with both improved objective and perceived sleep quality and duration in a sample of patients taking medical cannabis.

“However, there were no significant changes in the objective sleep measurements specific to remaining sleep, despite the participant-perceived improvements, including reports of longer time in bed and total sleep time records.”

The full study is published in the American Journal of Endocannabinoid Medicine (AJEM).

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Medical cannabis may reduce pain levels in fibromyalgia patients – study

The study also showed potential positive results for patients with rheumatoid arthritis and diabetic neuropathy



Pain level: A doctors stethoscope next to two cannabis leaves on a wooden surface

A new study on patients diagnosed with fibromyalgia and other inflammatory rheumatic diseases, reports a reduction in pain levels following medical cannabis use.

The study revealed patients experienced reduced levels of pain and better sleep quality following their use of medical cannabis products.

The study surveyed 319 patients about their use of medical cannabis products. Those with fibromyalgia accounting for 82 percent of the group, reported a mean pain level reduction of 77 percent. They also reported sleep quality improvement of 78 percent.

The researchers noted the demographic and clinical parameters before documenting the type of cannabis consumed, the method of consumption and the amount.

Other pain conditions enrolled in the study included rheumatoid arthritis patients and those experiencing diabetic neuropathy. The group included 14 with mechanical back pain, eight with physical injuries, seven with rheumatoid arthritis, and seven with diabetic neuropathy. All groups recorded potentially significant levels of improvement in their symptoms.

Pain level reduction

According to the results, the THC concentration, duration of consumption, and dose had potentially significant effects on pain reduction. Only the duration of consumption had an independent significant effect on sleep quality improvement.

The data was published in the journal Pain Research and Management.

The authors wrote: “Medical cannabis (MC) has a favourable effect on pain level and sleep quality among nearly the entire spectrum of resistant ‘chronic pain syndromes’ seen or referred to rheumatology clinics, including inflammatory diseases resistant to biological treatment.”

“Cannabis should be seriously considered in every ‘chronic pain condition’ whenever the accepted modalities of treatment are insufficient for alleviating patient’s pain and sleep problems.”

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Read more: What is fibromyalgia and can medical cannabis help?

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CBD and sleep: could choosing different terpenes help with good night’s rest?

Terpenes such as linalool, pinene and myrcene are thought to help with sleep issues such as insomnia or poor quality sleep



The terpenes found in cannabis are thought to help with sleep issues such as insomnia. Did you know that terpenes can also be found in other plants?

Cannabis may help with lengthening sleep time, improving the quality and shortening the time it takes to fall asleep. Combining CBD with different terpenes could help to potentially strengthen its effectiveness such as lavender in the evening for relaxation.

What are terpenes?

Terpenes are the active aromatic molecules found in plants that cause smell and taste. Most people associate them with cannabis plants as they are high in concentration but there are other plants or fruits such as pine, lavender and lemon. In nature, these terpenes protect the plants from animal grazing or infectious germs. Some terpenes play a protective role in helping the plant to recover from damage. Others can act as an immune system to keep away infectious diseases.

There are thousands of different terpenes in existence with different potential benefits such as reducing inflammation, lowering anxiety, increasing feelings of calm or relaxation. One benefit is their ability to potentially improve our sleep patterns and make it easier to fall asleep. Individual terpenes have different effects such as sedation and stimulation. 

Brands use isolated terpenes to create the flavours and scents of many everyday products, such as perfumes, body products, and even cleaning products.

Here are three different terpenes to try for sleep

Terpenes: A wooden scoop of lavender next to a bottle of purple oil with a cork top


Linalool is the naturally occurring terpene found in lavender. It may have the same benefits that CBD is associated with. It is thought to help with anxiety, depression and sleep issues. This is why lavender is often associated with sleep. Linalool can also be found in geraniums, roses, chamomile and cannabis. It may also increase adenosine which is a sedating hormone that can help us to fall asleep.

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A Japanese study reported that linalool could potentially help to reduce sleep problems in dementia patients. During the study, 19 patients inhaled lavender before trying to fall asleep for 20 days. The patients reported better, longer sleep on the days where they inhaled the lavender than when they did not.

Another study published in Phytomedicine in 2002 examined the anti-inflammatory effect of linalool as well as linalyl acetate. It found that both linalool and linalyl may play a major role in anti-inflammation activity caused by essentials oils containing them.

Terpenes: A pile of dark green pine needles

Learn more: Provacan share the top categories of CBD for consumers 


Pinene is the terpene found in pine. Pinene provides the fresh scent of many different plants, including pine needles, rosemary, and basil. Pinene is also responsible for the ‘Christmas smell.’

A study from 2017 reveals that the amount of pinene in the air of a forest could be therapeutic. Pinene can be a bronchodilator that allows more air into the lungs. It is thought to have an anti-inflammatory effect and may act as an anti-bacterial protecting the body from germs.

When it comes to sleep, another animal study has shown potential for increasing non-REM sleep, reducing the time it takes to fall asleep and lowering anxiety.

a bag of green hops spilled across a brown wooden floor


The terpene myrcene can be found in hops, lemongrass and thyme. The flowers of the cannabis plant also contain myrcene. Hops and ylang-ylang also contain myrcene and have been associated with sleep.

One study on mice revealed that myrcene could be a powerful antioxidant protecting the brain against oxidative damage following a stroke. Although this study used very high concentrations of myrcene.

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Anecdotal evidence suggests that eating a ripe mango before consuming cannabis can boost the psychoactive effects due to the myrcene content of the fruit. This is thought to be because it naturally synergises with THC allowing it to easily bridge the blood-brain barrier.

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“It’s perfect torture” – Restless legs syndrome, cannabis and sleep

Cannabis may provide some much needed relief to patients who have suffered years of disrupted sleep as a result of RLS



restless legs syndrome cannabis sleep

Restless legs syndrome is one of the least understood conditions among the medical profession, but cannabis may provide some much needed relief to patients who have suffered years of disrupted sleep and “perfect torture”.

Imagine lying in bed and every hour you are woken by an overwhelming sensation to move your legs. It’s a deeply unpleasant, crawling sensation seeping from your feet, to your calves and up into your thighs. 

The only way to stop it is to get up and walk around until it eases. This could take 10 minutes, but it could take hours. It happens every night without fail. You can’t remember the last time you slept for more than two hours at a time. 

“It’s perfect torture,” says 61-year-old Julie Gould whose life has been consumed with restless legs syndrome (RLS) for almost three decades.

“It’s like someone prodding you every hour while you try to sleep. But it’s not only that, it’s the feeling inside, it’s so horrible.”

Julie Gould, restless legs syndrome

Julie Gould has lived with restless legs syndrome for almost three decades

Julie has refractory RLS, which doctors believe to be caused by scarring in her spinal cord as a result of multiple sclerosis (MS), which she was diagnosed with in 1994.

Despite being on strong medication such as oxycontin for five years, nothing has touched the condition which wakes her three to four times a night, leaving her sleep completely disrupted and as a result fuels her MS symptoms.

“It always hits you, the minute you lie or sit down and the only stop the sensation is to move around,” says Julie.

“It has a knock on effect on my MS, but MS is nothing compared to restless legs, it really is torturous.

“I wish doctors would understand how serious it is.”

It’s all in your head

Despite being among the most common neurological conditions in the world and affecting over one million people in the UK alone – at least 100,000 of whom will have it as severely as Julie – RLS is still not taught at medical school.

“Sadly not only do GPs not know about it and they actually mistreat it because they don’t know how to deal with the drugs that are available for it,” explains Julie, who has recently launched her own campaign to raise awareness of the condition among medical professionals.

“It’s been confirmed to me that it isn’t taught at medical school, it isn’t taught during GP training, and doctors really have no idea how to prescribe drugs properly for it.”

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She continues: “People have lost their jobs because of it, they can’t travel by plane or car, their lives are severely disrupted, because doctors dismiss it as ‘oh it’s just fidgety legs’, you’re exaggerating. They say it’s all in your head, that it’s psychological.”

More than half of Project Twenty21 patients experience poor sleep

Until Julie joined Project Twenty21, the Drug Science initiative to improve access to medical cannabis for patients and build the UK’s largest body of evidence for its efficacy, the longest she had slept in 28 years undisturbed was around one hour.

Taking cannabis oil gave her three to four hours of deep sleep for the first time. 

“I took it at night in the form of drops and it put me into a deep sleep so the RLS didn’t filter through until the effects of the cannabis wore off. It seemed to stay just below the surface so it didn’t wake me up,” she says.

“To get four hours of sleep in a block after 28 years of never getting more than one hour’s sleep has just been fantastic. 

“That four hours makes all the difference. It’s transformed my life, just to get sleep is the most precious thing in the world.”

While sleep isn’t one of the primary qualifying conditions for Project Twenty21, data from the study shows poor sleep affects many of the patients enrolled for other conditions. 

More than half (56.6 percent) said that their sleep patterns interfere with their daily activities, either quite a lot or significantly, with 31.5 percent reporting insomnia as a secondary condition. 

cannabis and sleep

More than half of Project Twenty21 patients experience poor sleep

Over a third (36.9 percent) experience severe or very severe problems falling asleep, 36 percent have problems staying asleep and 31.5 percent report difficulties with waking up too early. 

Follow up analysis with these patients are expected to examine whether prescribed cannabis helps improve sleep and sleep quality.

Read more: Can CBD help me sleep?

The worst pain imaginable 

As soon as Project Twenty21 launched last year Julie knew she wanted to be involved. She first tried cannabis to manage the symptoms of her MS 20 years ago, restoring to asking her adult children to access it for her when she had a severe attack.

“With MS you can experience excruciating nerve pain, which is supposed to be the worst pain imaginable,” she says.

“You literally cannot move with it, you have to just sit and go through it, nothing touches it.”

Julie, who was involved in the MS Society’s campaign for NHS access to cannabis-based drug Sativex, continues:  “I’ve known cannabis can help MS for a long time.

“If I ever had an attack I would source illegal cannabis through my children, because it was the only thing that relieved that pain. The doctors weren’t giving me anything for it and I didn’t care if they arrested me.”

She adds: “The one thing I was worried about was the quality of the cannabis you get on the street, but at the time I would have taken anything to deal with the pain.”

Symptom-free for the first time in 10 years

While researching RLS Julie came across studies in the US which showed buprenorphine, a drug similar to methadone and commonly used in those struggling with heroin addiction, was having positive results at a low dose in patients with the condition.

While most doctors are reluctant to prescribe it, Julie’s GP was open to the idea. 

She has now found a combination of buprenorphine and medical cannabis – which helps manage the common side effects such as nausea – has got her condition under control for the first time. 

“For the first time in 10 years, I had no RLS symptoms day or night, but I was waking up with extreme nausea,” she says.

“Then I had a brainwave: people use cannabis for nausea. I can now take the drug that stops the RLS and the cannabis oil has so far completely stopped the extreme nausea. I’m ecstatic, I’m hoping that this will be miraculous for me.”

Following her success, Julie is now keen to raise awareness of Project Twenty21 among other RLS patients. 

“I know the doctors at Project Twenty21 are now familiar with the fact that RLS is a neurological condition and cannabis can certainly help with sleep and for a lot of people it can actually reduce the sensations,” she says.

“Every time I go on my forum I say if you’re having problems with your RLS or with sleep, consider this.”

Julie adds: “I have no problem with the stigma attached to drugs. I literally don’t care if someone thinks I’m on opioids or cannabis, I’m just a believer in being open, if something helps then let’s talk about it.”

Read more: How medical cannabis can relieve symptoms of migraine


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Cannabis Health is a journalist-led news site. Any views expressed by interviewees or commentators do not reflect our own. All content on this site is intended for educational purposes, please seek professional medical advice if you are concerned about any of the issues raised.

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