Connect with us


Journal Club: Sleep and cannabis-based medicines

The latest issue of the Journal Club explores the benefits of cannabis-based medicines for sleep.



sleep and cannabis-based medicines

The latest issue of the Journal Club explores the benefits of cannabis-based medicines for sleep and insomnia.

To sign up to the Journal Club mailing list, click here

sleep and cannabis-based medicines

For this edition of the journal club, the focus is on sleep. There is abundant anecdotal evidence supporting the soporific effect of cannabis, with sufferers from a range of conditions reporting that it assists in the management of insomnia [1,2].

Additionally, somnolence is a commonly listed adverse event (AE) in clinical trials involving cannabis-based medicinal products (CBMPs).

However, to date, most of the evidence has been gathered from CBMP studies focusing on chronic pain that include sleep as a secondary end-point. In this issue of the Journal Club, two recent clinical trials are highlighted that specifically investigate the effect of CBMPs in patients with insomnia.

The first study is a randomised, double-blind, placebo-controlled trial evaluating the safety and efficacy of nightly administration of a sublingual cannabinoid extract (ZTL-101 – a 20:1 THC:CBD preparation) in 23 patients with chronic insomnia. The placebo contained the same terpenes as ZTL-101 (in order to match smell, taste, and colour), but no cannabinoids.This was a crossover design so the 23 patients in the study took either ZTL-101 or placebo for a period of two weeks and then – following a one-week washout period – switched to the other treatment for a further two weeks.

Insomnia symptoms were assessed using the Insomnia Severity Index (ISI). Overall, ISI scores at the end of two weeks were significantly lower with ZTL-101 than with placebo. Compared to placebo, ZTL-101 also decreased self-reported sleep onset latency, and increased total sleep time, sleep quality, and the feeling of being rested on waking. No serious AEs [adverse effects] were reported. Forty mild AEs were reported (36 during ZTL-101), with the majority being headache, dizziness, and dry mouth.

In summary, this study demonstrated that nightly sublingual administration of a THC-predominant extract for two weeks improved insomnia symptoms and sleep quality relative to placebo without significant AEs in patients with chronic insomnia. 

The second study is a naturalistic, retrospective trial investigating the use profile and perceived efficacy of cannabinoids for the management of insomnia.

Data was collected using the Strainprint app, which allows users to log and monitor their symptoms pre- and post-cannabis use. In total, the study examined 991 medical cannabis users with insomnia across 24,189 tracked cannabis use sessions.

Overall, cannabinoids were perceived to be efficacious across all genders and ages, and no significant differences were found among ingestion methods. Although all product categories were perceived as efficacious, predominant Indica strains were found to reduce insomnia symptomology more than predominant sativa strains and CBD-predominant formulations.

In summary, this study showed that medical cannabis users perceive a significant improvement in insomnia with cannabinoid use, with indica strains being reported as more effective than sativa strains or CBD alone. This emphasises the importance of both THC and terpene content in maximising outcomes for patients with insomnia.

If you are a doctor and would like to discuss either of the clinical papers featured in this edition of the journal club or the broader medical cannabis literature, please reach out on

Read more from the Journal Club here

1 Bonn Miller.M, Babson.K, Vandrey.R. Using cannabis to help you sleep: heightened frequency of medical cannabis use among those with PTSD (2014). Drug Alcohol Depend 136:162-5
2 Russo.E, Guy.G, Robson.P. Cannabis, pain, and sleep: lessons from therapeutic clinical trials of Sativex, a cannabis-based medicine (2007). Chem Biodivers 4(8):1729-1743

Sarah Sinclair is a respected cannabis journalist writing on subjects related to science, medicine, research, health and wellness. She is managing editor of Cannabis Health, the UK’s leading title covering medical cannabis and CBD, and sister titles, Cannabis Wealth and Psychedelic Health. Sarah has an NCTJ journalism qualification and an MA in Journalism from the University of Sunderland. Sarah has over six years experience working on newspapers, magazines and digital-first titles, the last two of which have been in the cannabis sector. She has also completed training through the Medical Cannabis Clinicians Society securing a certificate in Medical Cannabis Explained. She is a member of PLEA’s (Patient-Led Engagement for Access) advisory board, has hosted several webinars on cannabis and women's health and has moderated at industry events such as Cannabis Europa. Sarah Sinclair is the editor of Cannabis Health. Got a story? Email / Follow us on Twitter: @CannabisHNews / Instagram: @cannabishealthmag


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.

Copyright © 2023 PP Intelligence Ltd.