Sleep and Marijuana Products in 2020

Abstract

The growing availability, legality, and use of marijuana products in the USA has contributed to increased patient and clinician interest in the treatment of sleep disorders, especially insomnia and restless legs. What should clinicians know about these drugs and what should they tell patients that inquire about using them? Increasing numbers of studies are being published revealing clear subjective improvement of sleep-onset latency, subjective improvement of sleep disruptions, and subjective improvement of restless legs symptoms. However, objective findings are most often mixed, with some studies demonstrating improvement of sleep characteristics, and some demonstrating worsening. There is a trend for improvement in sleep with short-term use of marijuana products and a longer-term attenuation of effect, or possibly worsening. Evidence for their effectiveness in these disorders is robust from subjective patient reports but limited or mixed in objective measures. Discussions with patients should be individualized and risks and benefits weighed. Future large, randomized, placebo-controlled studies are needed to help clarify the discrepancy between subjective and objective measures.