Acute Effects of Oral Cannabinoids on Sleep and High‐Density EEG in Insomnia: A Pilot Randomised Controlled Trial

Summary & key facts

Researchers gave 20 people with diagnosed insomnia a single oral dose that contained 10 mg of THC and 200 mg of CBD. They used a very detailed brain-recording cap to watch sleep and measured next-day alertness. The dose cut total sleep by about 25 minutes and strongly reduced REM sleep, changed specific brain-wave patterns during different sleep stages, and caused a small increase in how sleepy people said they felt the next day, but it did not change objective tests of alertness, thinking, or simulated driving about nine hours later.

Key facts:

• This was a small pilot study with 20 adults who had insomnia. Most were women and the average age was about 46 years.
• Participants took a single oral dose containing 10 mg THC and 200 mg CBD. The study compared that dose with a placebo.
• Total sleep time was reduced by about 25 minutes after the cannabinoid dose compared with placebo.
• Time spent in REM sleep was strongly reduced by about 35 minutes, and it took about 65 minutes longer for people to reach REM sleep after the dose.
• There was no clear change in the amount of time awake after first falling asleep.
• Detailed brain recordings showed less very-fast brain activity during light sleep, less very-slow activity during deep sleep, and more medium-speed brain activity during REM sleep after the dose.
• There was no change in objective next-day alertness tests, cognitive tests, or simulated driving measured roughly nine hours after taking the dose.
• People reported slightly more sleepiness the next day on a self-rating scale. The increase was small but statistically detectable.
• Because this was a single small study with one dose and mostly female participants, the results are preliminary. They do not tell us about repeated use, different doses, or long-term effects.

Abstract

Cannabinoids, particularly Δ9-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/.

Topics

Cannabis and Cannabinoid Research Sleep and related disorders Sleep and Wakefulness Research

Categories

Cognitive Neuroscience Life Sciences Neuroscience

Tags

Alertness Alternative medicine Anesthesia Audiology Cannabidiol Cannabis Computer science Electroencephalography Insomnia Medicine Operating system Pathology Pharmacology Placebo Psychiatry Psychology Sleep (system call) Sleep onset Sleep onset latency Slow-wave sleep

Substances

Cannabis

Conditions & symptoms

Sleep disorder Poor sleep