Cochrane has published a systematic review concluding that the evidence on medical cannabis for insomnia is too weak and uncertain to support firm conclusions. Released on 12 October 2026 and carrying a publication date of 13 October in the Cochrane Database of Systematic Reviews (DOI 10.1002/14651858.CD016216.pub2), the review was led by Dr Lucia Varela of the University of Manitoba in Canada, with Dr Luis Garegnani of the Universidad Hospital Italiano de Buenos Aires in Argentina as senior author. It pooled nine randomised studies covering 537 adults aged 18 to 76. Eight compared a regulated medical cannabis product with a placebo, and one compared it with the antidepressant amitriptyline. Across sleep and recovery and satisfaction, total sleep time and daytime functioning, the reviewers reported little to no clinically meaningful improvement over placebo. Mild adverse events such as dry mouth and dizziness were more common with cannabis than with placebo, although the authors said that finding rests on a small pool of studies.
What the certainty rating rests on
The review rated its certainty of evidence from very low to low, citing high risk of bias, inconsistent results between trials, small samples, wide variation in the products tested, and a longest follow-up of 12 weeks. Women made up 72.66% of participants and the sample skewed younger. Quality of life improved somewhat in pooled analysis, but at very low certainty, with results compatible with anything from slight worsening to large improvement. Varela said "the research currently available is not sufficient to reliably answer whether medical cannabis helps people with insomnia", and stressed this does not show the treatment is ineffective. Garegnani said the evidence is "too weak and uncertain to draw firm conclusions". The authors declared no relevant conflicts.
What this means in practice
This review looked at a prescription medicine, not anything sold as a food supplement. The NHS says medical cannabis "can only be prescribed on the NHS by a specialist hospital doctor" and lists three uses: rare severe epilepsy, chemotherapy-induced nausea and vomiting in adults, and muscle stiffness and spasms in multiple sclerosis. Insomnia is not among them, and the NHS tells people "do not ask a GP for a referral for medical cannabis" outside those conditions. On CBD sold over the counter, the same NHS page says: "Health stores sell certain types of CBD. However, there's no guarantee these products will be of good quality." Very low certainty means the trials cannot settle the question either way. It changes nothing about any product in Perqen's 1,393-product catalogue, because none of them were tested in it.
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