High-Density EEG Demonstrates Benefits of CBD in Patients With Insomnia

In patients with insomnia disorder, an acute dose of cannabidiol (CBD) 200 mg plus    delta-9-tetrahydrocannabidiol (THC) 10 mg reduced total sleep time and demonstrated a clear effect on rapid eye movement (REM) sleep suppression, according to study results presented at the 2023 Annual Meeting of the American Academy of Sleep Medicine and the Sleep Research Society, held from June 3 to 7 in Indianapolis, Indiana.

Although the use of medicinal cannabis is a popular alternative to common sleep aids, few studies are available that use complex sleep electroencephalographic (EEG) techniques to evaluate the effect of cannabinoids in patients with insomnia disorders.

For the current study, researchers sought to examine total sleep time and wake after sleep onset as the coprimary outcomes of the study. Additionally, for secondary outcomes, they investigated next-day neurobehavioral function and sleep architecture metrics via overnight polysomnography with high-density EEG.

A total of 20 participants with insomnia disorder were enrolled in the randomized trial — 16 women and 4 men. The mean participant age was 47.1±8.7 years. All of the study participants completed 2 24-hour in-laboratory visits, at which time they received a single oral dose of CBD 200 mg/THC 10 mg or a matched placebo.

The researchers found that compared with placebo, treatment with CBD/THC was associated with statistically significant decreases in total sleep time (–24.5 minutes; P =.047), with no significant changes in wake after sleep onset (+10.7 minutes; P =.422). Further, the use of CBD/THC was linked to significantly reduced time spent in REM sleep (–8.1%; P< .001) and increased REM sleep latency (+65.6 minutes; P =.008).

Based on high-density EEG analysis, a significant decrease in high-frequency EEG activity overlying the posterior and the frontal cortex during N2 sleep was observed with CBD/THC therapy vs placebo. Moreover, CBD/THC reduced delta activity in the posterior region of the brain during N3 sleep, compared with placebo. Treatment with CBD/THC also increased alpha and beta activity during REM sleep in the posterior regions of the brain vs placebo (P <.05 for all measures).

The researchers also noted that CBD/THC did not impair next-day (+12 hours posttreatment) alertness, cognitive function, or simulated driving performance
(P >.05 for all measures). A total of 85 nonserious, mild adverse events were reported, with the most common being drowsiness, fatigue, and dry mouth.

“Further research is required to determine the impact of chronic cannabinoid dosing on REM sleep and other objective sleep outcomes in insomnia disorder,” the researchers concluded.