Pilot Study Examines Effects of CBD-Coated Pillowcases on Sleep Quality

A recently published study examined the effects of CBD-infused pillowcases on sleep cycles and quality in shift nurses (1). The cannabinoid CBD has been demonstrated to have a beneficial effect on sleep and anxiety, the study’s abstract noted. However, these effects of CBD through absorption of CBD through the skin are yet to be fully understood. Researchers aimed to test CBD-coated pillowcases to support sleep quality without the potential adverse effects of oral or inhaled CBD. The study, “Pilot Study on the Effect of Cannabidiol-Coated Fabric for Pillow Covers Improves the Sleep Quality of Shift Nurses,” was published in the journal Healthcare in March 2025.

This study involved 55 shift nurses (10 men, 45 women) ages 20 – 40 years old, with poor sleep quality demonstrated at baseline. The participants mainly worked fixed day shifts, though 12 worked rotating shifts. Exercise habits were also measured. The study lasted four weeks total, with the first week to establish baseline sleeping patterns, and the CBD-coated pillowcase used during the second and third week, plus a post-experiment week.

Pre- and post-sleep patterns and quality were measured with the Pittsburgh Sleep Quality Index (PSQI) and using a Fitbit Charge 3 tracker. The higher the score on the PSQI (0-21), the worse the sleep quality. Drowsiness, mood, and other changes were measured with Epworth Sleepiness Scale (ESS) and Hospital Anxiety and Depression Scale (HADS).

Highlighted results after three weeks of using include:

• The average overall PSQI decreased from 9 to 7
• Four participants (7.3%) achieved PSQI scores of less than 5
• There was no change to sleep structure, but light and deep duration increased slightly from baseline
• Significant reductions in anxiety levels were reported as well as improvements in mood

The influence of the CBD on anxiety mood could be attributed to interactions with the skin’s endocannabinoid system, the researchers suggested, resulting in both local and systemic effects. Exercise was described as a factor in the effect of the impact of the CBD. If a participant did not have an exercise habit, the impact on sleep quality was more pronounced, either positive or negative. More personalized dosing and adjusted delivery methods could be useful to enhance therapeutic effects of CBD, the researchers also suggested.

Limitations to the study included the small sample size and short duration of the study, plus the lack of control for other factors affecting sleep.

Overall, the CBD intervention resulted in benefits to sleep quality. “The use of pillow covers coated with CBD enhanced the sleep duration of healthy adults with poor sleep, leading to an increase in duration in the form of deep sleep from baseline to two weeks after intervention,” the researchers concluded. “This study also found that the CBD intervention significantly reduced anxiety.”

Reference

1. Afzal, M.; Huang, CL.; Huang, SH.; Li, C.-I.; Liao, WC.; Yang, JC.; Ma, WL. Pilot Study on the Effect of Cannabidiol-Coated Fabric for Pillow Covers Improves the Sleep Quality of Shift Nurses. Healthcare 2025. DOI: 10.3390/healthcare13060585