August 2025 Healer Webinar: Research on Cannabis and Sleep, Part II

On August 13, 2025, Dustin Sulak, an osteopathic general practitioner, founder of Healer, a cannabis education and product resource, presented the latest installment of the monthly webinar series that began in 2018. This month’s webinar focused on cannabinoids for sleep, sleep apnea, and the potential effect of inflammation. Read Part I of this webinar coverage for analysis of the first three studies.

The fourth out of seven studies discussed in this month’s Healer webinar was not published in a peer-reviewed journal, but was a collection of data from registered medical cannabis patients and their experiences and purchases. The 41-page report, “Obstructive Sleep Apnea Patients in the Minnesota Medical Cannabis Program: Experience of Enrollees During the First Five Years,” was published in May 2025 by the Minnesota Office of Cannabis Management (OCM). The report covered data from August 2018 through July 2023 and involved 2,982 medical cannabis patients with sleep apnea who made at least one purchase during the time period. Highlighted results include: 60.8% reported at least a 30% reduction in disturbed sleep within four months, and 73.6% of those patients maintained at least 30% improvements for another four months. Out of all the patients, nearly 40% were able to achieve at least 30% reduction of symptoms and maintain it for at least four months. Dr. Sulak stated he was impressed by the results and compared cannabis to common pharmaceutical interventions for sleep apnea. “Targeting the endocannabinoid system makes so much more sense,” he explained. “It's a very upstream target, compared to just targeting the norepinephrine and the muscarinic receptors, which are way downstream and cause a bunch of side effects.”

Next, Dr. Sulak covered a poster and abstract submission at the PROMIS (Patient-Reported Outcomes Measurement Information System) International Conference in 2024. The Australian longitudinal study, titled "Prescribed cannabinoids associated with greater patient-reported improvements in sleep,” monitored sleep disturbances for 12 months in 546 patients prescribed cannabis for insomnia. The patients were most often prescribed CBD-only, followed by CBD-THC balanced, then CBD-dominant, and finally THC-dominant types. Meaningful improvements in sleep disturbance were reported from al types, though THC-dominant types were associated with greater improvements than CBD-dominant types. “Individualized treatment is likely to provide the best results, but don’t waste too much time and energy with a CBD only treatment,” Dr. Sulak concluded.

The sixth study, “Same-Day Sedative and Night-Time Sleep Effects Following Combined Cannabinoid Formulations: A Randomised-Controlled Trial,” was published in Clinical Drug Investigation in June 2025. In this study, 20 healthy adult participants were given a dose of 1 mL THC:CBD oil of 1:1, 1:16, or placebo once in the morning over five weeks. Highlighted results include: daytime sleepiness was not increased after the dose, and the low dose did not affect total sleep time, sleep-onset latency, and number of awakenings compared with placebo. Dr. Sulak suggested that while no functional or memory tests were performed, information on daytime sleepiness could be more useful than nighttime sleepiness. “I do think even though it didn't show up in this study after a single dose, I sincerely believe that strategically treating the symptoms during the day can help sleep at night,” he added.

The final study discussed in this webinar was, “Inflammatory state moderates response to cannabis on negative affect and sleep quality in individuals with anxiety,” published in Frontiers in Behavioral Sciences in June 2025. In this study, 147 participants were assigned one of three cannabis chemovars, THC + CBD, THC, or CBD, and could consume the products as desired for four weeks. Results were compared to a group of 24 participants with anxiety who did not use cannabis. Overall, there were no changes in average cytokine levels in any group, though chemovars higher in CBD produced more consistent improvements while improvements by THC dominant chemovars varied based on inflammatory status at baseline. Dr. Sulak stated that most cannabinoids are anti-inflammatory, with CBD more than THC. He explained that the study’s limitations were significant: cannabis was not used every day, it was not taken before bed, and only flower was used. “It's not a great study, but they're asking interesting questions, ‘does somebody's baseline internal physiology predict their response to cannabis, and could it help inform what cannabis strategy would be most effective for them to shorten the path of trial and error?’” Dr. Sulak commented. “Don't make any definite conclusions based on this data. It's extremely early, preliminary. Many factors that mediate one's response to cannabis for sleep, besides inflammation. Inflammation might just be one of them.”