Decoding Cannabis: Can CBD oil with THC help you sleep better?

Why are so many people searching for natural sleep aids?

It is safe to say that almost all of us have been there. The wee hours of the night, when silence shifts from comforting to strangely heavy. The world has gone still, but your mind suddenly speeds up, and each turn of your head on the pillow reinforces the feeling that sleep is slipping further away. 

It is right there, in these silently frustrating moments, where many of us begin mulling over the idea of trying natural sleep aids.  

Out comes the phone (which is usually the worst thing for the issue at hand, but we do it anyway) and up pops Google. One minute you are reading about herbal teas, the next you're dissecting the potential side effects of benzodiazepines and externally sourced melatonin. But, before long, you’ll have most likely stumbled across CBD oil for sleep (or medical cannabis for sleep issues), and that might be why you're reading these words right now.  

This write-up is part of our Decoding Cannabis blog series, where newer medical cannabis research papers are translated into something a little easier to wade through. Today, we are focusing on one of the recent pieces of research into medical cannabis treatment for insomnia.

Why does this study matter now?

CBD oil for sleep is one of the more heavily searched terms of the past few years here in the UK, especially when natural sleep aids are being considered. 

But the question “Can the inclusion of THC actually boost the effectiveness of CBD oil for insomnia?” has not been answered with strong clinical evidence.

Earlier studies either focused on CBD alone or used medical cannabis products without standardised cannabinoid ratios, making it difficult to compare results. This trial stands out for its precise formulation, clear dosage control, and rigorous double-blind design.

Titled “Medicinal cannabis improves sleep in adults with insomnia: a randomised double-blind placebo-controlled crossover study”, this study is what many would call a gold-standard study. It minimises bias, levels the playing field between treatment and placebo, and allows the results to be taken seriously in both medical and patient communities.

So, does an almost balanced THC:CBD oil help people with insomnia? 

Let’s see what the research shows…

What this new trial on CBD oil for sleep (with THC) set out to uncover

The idea behind testing this CBD:THC oil for sleep is simple enough: find out whether pairing CBD with THC can help people who live with persistent insomnia, and see if it nudges the body’s own melatonin production along the way.

Each participant was given the cannabinoid oil and the placebo at different times (with a “washout period” of one week in-between). This gap helped ensure that any effects from the first phase of the trial had worn off before the second began, making the results more reliable, and the fact that all participants tried both the medical cannabis oil and the placebo allowed for a direct, personal comparison of the two. 

What makes this trial different from other CBD oil for sleep research?

Most studies up until this point on CBD oil for sleep have relied mainly on self-reported improvements. By measuring melatonin levels throughout the study's timeline, the researchers were able to dig into an objective biological marker alongside patient feedback. 

How was the study designed and delivered?

The trial followed 29 adults living with chronic insomnia and compared two weeks of cannabis oil treatment with a placebo, separated by a one-week washout period. 

But, is 29 participants enough to make truly concrete claims about efficacy, especially when the study only ran for a short period? 

Realistically, no. But the results were very encouraging. 

The cannabis oil given to the participants had 20 mg/mL of CBD and 10 mg/mL of THC. This kind of mixed profile mirrors how many natural sleep aids combine multiple active ingredients to create potentially complementary effects, and also how cannabis cultivars naturally produce a mix of cannabinoids. 

The study participants were asked to gradually titrate their dose. Titration simply means slowly upping the amount of oil they took each day, until they felt the effects were helping and also not causing any heavy side effects. 

Each was asked to take 0.2 ml on day 1 (which equals 2 mg THC and 3 mg CBD) and then slowly increase the dose, up to a max dose of 1.5 ml (15 mg THC/22.5 mg CBD).

What were the results of the medical cannabis for insomnia study?

Across two weeks on the active cannabis oil, the study group saw clear changes in how they slept and in how they felt the next day. 

The biggest takeaway was that, by the end of the treatment phase, a whopping 65% of participants no longer met the threshold for clinical insomnia after just two weeks of treatment with the medical cannabis oil. Their Insomnia Severity Index scores improved noticeably compared with the placebo period. This is extremely impressive, especially when compared to other natural sleep aids, and even pharmaceutical interventions. 

Sleep tracking showed that total sleep time grew by an average of 33 minutes a night, with light sleep making up around 21 of those minutes. Participants also said their sleep felt better, rating quality improvements of up to 80%.

Saliva samples taken at midnight told another part of the story. Melatonin levels were about 30% higher during the cannabis oil phase, compared with a 20% drop when on placebo. The researchers noted this as a possible clue to how THC and CBD together may influence circadian rhythm, through interactions with the endocannabinoid system, and the 5

Daytime reports backed up the nighttime data. People described sharper concentration, steadier alertness, and better mood on the mornings after treatment nights. 

Were there any heavy side effects reported?

Yes, two participants reported more serious side effects, but both were resolved overnight after lowering the dose. 

• One participant experienced a bout of tachycardia on a dose of 1.4 ml during night 13, but they lowered their dose to 0.4 ml the next day and found that they then experienced no side effects going forward. This participant requested an ongoing prescription for the medical cannabis oil once the study had run its course. 
• The other had a period of extreme dizziness on a dose of 0.8 ml, which was resolved when lowering the dose to 0.4 ml.

All other side effects reported were considered to be mild, short-lived, and also resolved as the dose was lowered. These included morning drowsiness, dry mouth, vivid dreams, and a slight increase in appetite. Most eased after the first few nights as participants adjusted to their optimal dose.

How many of the study participants found the treatment effective?

At the end of the trial, 96% of the study participants found “cannabis oil an acceptable treatment for insomnia”, with 79% stating that they wish to continue treatment. Of the 6 who decided to discontinue medical cannabis treatment, 5 cited reasons outside of side effects (work restrictions, concerns around driving). 

That is all really compelling data. 

What this means for patients seeking a UK medical cannabis prescription for sleep issues

While small in scale, the findings from this study suggest that pairing CBD with THC may offer up even greater benefits for people struggling with stubborn insomnia than CBD oil alone. In just two weeks, patients who had tried other natural sleep aids without success were sleeping longer, waking less often, and feeling brighter the next day.

And these types of treatment options are now totally legal in the UK (and have been since November 2018). 

As long as you have tried at least two conventional treatment options, have no history of psychosis, and are over the age of 18, you may very well qualify for a UK legal medical cannabis prescription.

How can patients check if they are eligible for this treatment?

The quickest way to find out is to use Releaf’s medical cannabis eligibility checker. It’s free, takes less than 20 seconds, and there is no obligation to move forward unless you choose to. 

If you do potentially qualify for treatment, you can book an initial consultation with our world-class clinical team (which comes with a full money-back guarantee) and join more than 100,000 others in Releaf’s growing community!