When counting sheep no longer helps: insomnia is a serious problem for many people. According to an evaluation by the german Barmer health insurance fund, the number of Germans suffering from problems falling asleep or sleeping through the night increased by 111 percent from 2005 to 2017 . Moreover, according to a recent study from the United Kingdom, the corona pandemic appears to be another driver of poor sleep . However, there is reason for hope: even though the empirical data base is still rather small, there is increasing evidence for an improvement in sleep quality when treated with medical cannabis.
What are the causes of sleep disorders?
The causes of disturbed sleep are manifold. The frequency of secondary sleep disorders that arise as a result of cardiovascular diseases, multiple sclerosis, Parkinson’s disease or restless legs syndrome is striking. All types of chronic pain play a special role: they have a high potential to significantly impair the night’s rest of those affected. In addition, there is a close correlation between diagnosed sleep problems and mental illnesses such as depression, anxiety disorders, psychoses or schizophrenia .
It is often difficult to distinguish between cause and consequence in insomnia, which is a so-called multifactorial event.
Medical cannabis: effective for insomnia?
Several recent studies suggest an efficacy of pharmaceutical cannabis for sleep disorders. However, most studies do not primarily focus on the sleep problems of those affected, but on various other conditions associated with disturbed sleep.
Review paper on cannabis and sleep from 2019
In a meta-analysis, Canadian researchers concluded that cannabinoids can improve sleep quality, reduce sleep disturbances, and shorten the time it takes to fall asleep. The analysis included data from patients suffering from multiple sclerosis, post-traumatic stress disorder (PTSD) and chronic pain .
Positive effects of medical cannabis on sleep quality:
- Shortens the phase of falling asleep
- Increases deep sleep phase
- Improves overall sleep quality
CBD has a calming effect
In a retrospective study, a calming effect of CBD on the central nervous system was found in patients with anxiety and sleep disorders. However, the effect on sleep decreased after a few months . Interest in this cannabinoid for a wide range of neuropsychiatric disorders is particularly high.
Medical cannabis reduces the feeling of fatigue and stress
In a recent randomized double-blind study conducted by the Centre for Sleep Science at the University of Western Australia, researchers investigated the efficacy of a medicinal cannabis product in the treatment of chronic insomnia. They found that patients in the treatment group had a particularly improved quality of life. Panelists reported feeling less stressed, less tired, and more rested overall .
However, empirical studies addressing the primary effect of cannabinoids such as CBD and THC on sleep disorders are lacking to date. Medical experts hope that a broader empirical data base will, among other things, provide information on the correct dosage form and appropriate dosing.
 Barmer Gesundheitsreport Schlafstörungen 2019: Schriftenreihe zur Gesundheitsanalyse – Band 17. Thomas G. Grobe, Susanne Steinmann, Julia Gerr.
 Pieh, C., Budimir, S., Delgadillo, J., Barkham, M., Fontaine, J. R. J., & Probst, T. (2020b). Mental health during COVID-19 lockdown in the United Kingdom. Psychosomatic Medicine, Publish Ahead of Print(4). https://doi.org/10.1097/PSY.0000000000000871.
 Kuhathasan, N., Dufort, A., MacKillop, J., Gottschalk, R., Minuzzi, L., & Frey, B. N. (2019). The use of cannabinoids for sleep: A critical review on clinical trials. Experimental and Clinical Psychopharmacology, 27(4), 383–401. https://doi.org/10.1037/pha0000285
 Shannon, S. (2019). Cannabidiol in Anxiety and Sleep: A Large Case Series. The Permanente Journal, 23. https://doi.org/10.7812/tpp/18-041
 Walsh, J. H., Maddison, K. J., Rankin, T., Murray, K., McArdle, N., Ree, M. J., Hillman, D. R., & Eastwood, P. R. (2021). Treating insomnia symptoms with medicinal cannabis: a randomized, crossover trial of the efficacy of a cannabinoid medicine compared with placebo. Sleep. https://doi.org/10.1093/sleep/zsab149