Cannabis and sleep architecture: A systematic review and meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of polysomnographic studies
PubMed 40967124 · doi:10.1016/j.smrv.2025.102164
What was done
Systematic review and meta-analysis synthesizing polysomnographic (PSG) evidence on the effects of cannabis on objective sleep architecture. Eighteen studies were identified, of which nine met criteria for quantitative meta-analysis.
What was found
The abstract reports no specific numerical effect sizes or confidence intervals. Cannabis administration showed no consistent impact on total sleep duration, sleep onset latency, wake time, sleep efficiency, or sleep stages. Early reports of rapid eye movement (REM) sleep suppression were largely derived from small trials using high tetrahydrocannabinol (THC) doses with methodological constraints, while newer studies using lower therapeutic doses showed mixed or null effects on REM sleep. In contrast, withdrawal from active cannabis use was consistently linked to sleep disruption, including reduced total sleep time, prolonged sleep onset latency, and REM rebound.
Why it matters
This review highlights a mismatch between popular subjective reports of cannabis as a sleep aid and objective polysomnographic metrics, while confirming that cessation after regular use predictably disrupts sleep architecture.
Limits
The abstract provides no numerical data, pooled effect sizes, or variance estimates. Only half of the identified studies were suitable for meta-analysis. Included trials had substantial heterogeneity in cannabinoid composition, dosage, participant baseline health, and history of cannabis exposure.
Cited by
- supports THC use suppresses REM sleep, and discontinuation causes a rebound increase in REM sleep and vivid dreaming.