Cannabinoids for anxiety disorders and sleep problems: What current research shows

Anxiety disorders and sleep problems are among the most common health complaints worldwide. Scientific studies show that both conditions are closely linked. It is estimated that 60 percent of people with anxiety disorders also suffer from sleep disturbances. Accordingly, there is great interest in new therapeutic approaches. A recent scoping review from 2025 by researchers at the University of Florida and the University of Central Florida analyzed the existing study situation on cannabinoids in anxiety disorders and sleep problems. The results show interesting potentials but also make it clear that many questions remain open.

Why anxiety and sleep disorders often occur together

Anxiety and poor sleep influence each other. People with anxiety disorders often have difficulty falling or staying asleep. At the same time, chronic sleep deprivation can increase or even trigger anxiety. The researchers point out that both complaints may have similar biological causes. These include, among others:

• Changes in cortisol regulation
• Disorders of stress processing
• Impairments of executive functions in the brain
• Changes in important neurotransmitter systems

These connections make it sensible to investigate therapeutic approaches that could simultaneously affect both complaints.

The growing importance of cannabinoids in research

In the past ten years, the scientific literature on medical cannabis and cannabinoids has increased significantly. According to the authors of the review, the number of related publications has increased about 15-fold. Particularly in focus is cannabidiol (CBD), a non-intoxicating component of the cannabis plant. Unlike THC, CBD does not cause typical psychoactive effects and is therefore often studied as a potentially well-tolerated option. Products such as CBD oil are also increasingly of interest to researchers and users, especially in connection with stress, inner restlessness, and sleep quality.

Structure of the review

For the analysis, numerous scientific databases were searched, including:

• PubMed
• EMBASE
• Cochrane Library
• PsycINFO
• CINAHL
• LILACS

In total, the scientists identified 1,132 relevant publications. After a systematic selection, 29 studies finally met the inclusion criteria. The studies examined included:

1. Randomized clinical trials
2. Observational studies
3. Cohort studies
4. Case series
5. Cross-sectional studies

This resulted in a comprehensive overview of the current state of knowledge.

What results were observed?

The evaluation shows that cannabinoids – especially CBD – showed positive effects on anxiety symptoms and sleep disturbances in several studies. About 45 percent of the included investigations reported improvements in both endpoints. However, the studies differed considerably in terms of:

• Participant groups
• Doses
• Duration of treatment
• Used cannabinoids
• Measurement methods

These differences make it difficult to derive general recommendations.

Positive indications of improvements

Several studies showed improvements in:

• subjective sleep quality
• problems falling asleep
• nighttime awakenings
• anxiety scores on standardized scales
• general well-being

Which CBD dosages were studied?

An important aspect of the review concerns the dosages used.

Studies in people with anxiety and sleep problems

Particularly interesting are investigations that specifically included people with anxiety disorders or sleep problems.

Combination of CBD and melatonin

A case series observed 20 patients over three months. The participants received:

• 2.5 mg CBD extract
• 1.5 mg melatonin

The results showed significant improvements in both sleep quality and anxiety scores.

CBD between 25 and 75 mg daily

Another case series examined adults with anxiety and sleep disorders. After three months, the following were observed:

Improvements in sleep quality

The average scores on the Pittsburgh Sleep Quality Index (PSQI) improved continuously over the observation period.

Reduction of anxiety symptoms

The scores on the Hamilton Anxiety Rating Scale (HAM-A) also decreased significantly. These results suggest that moderate CBD doses could be interesting for certain groups of people. However, case series are study types with limited informative value.

Why the study situation does not yet allow clear recommendations

Despite the positive indications, the authors come to a cautious conclusion.

Lack of standardization

A central problem is that the studies used very different products:

• CBD isolates
• Full-spectrum extracts
• THC-dominant preparations
• Combinations of various cannabinoids

This makes it difficult to compare results.

Different dosages

The amounts used ranged from a few milligrams to several hundred milligrams per day. To date, it is unclear:

• Which dose is optimal
• Which duration of intake is sensible
• Which groups of people could benefit particularly
• Different patient groups

Many studies examined people with very different underlying conditions, for example:

• chronic pain
• Parkinson’s disease
• stress / inner restlessness

It is therefore difficult to assess which effects are specifically attributable to anxiety or sleep disorders.

What does this mean for practice?

The current review provides interesting indications that cannabinoids, especially CBD, could have positive effects on anxiety and sleep in some people. At the same time, the data show that the scientific evidence is not yet sufficient to derive general dosage recommendations. Those interested in CBD oil or other cannabinoid-containing products should consider that individual reactions can vary and that current research still contains many open questions.

Conclusion: Promising approaches, but further research needed

The scoping review from the University of Florida arrives at a balanced result: Cannabinoids, especially CBD, show potential in supporting people with anxiety disorders and sleep problems. Numerous studies report improvements in sleep quality and reductions in anxiety symptoms. Nevertheless, the great methodological diversity of the studies and the lack of standardized dosing protocols currently prevent clear conclusions. For the future, the authors call for high-quality clinical trials with clearly defined dosages, standardized measurement methods, and targeted investigations of people with diagnosed anxiety or sleep disorders. Only then will it be possible to answer more precisely what role cannabinoids and other natural active substances can play in the treatment of these widespread complaints.

Source:

Cannabinoids for Anxiety and Sleep Disturbances: A Scoping Review. Med Cannabis Cannabinoids. 2025 Oct 22;8(1):219-237. doi: 10.1159/000548890. eCollection 2025 Jan-Dec.

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