Cannabis for sleep in older adults: use has outpaced the science.

Draghmeh K.; Gupta P.; Yaggi H.; D'Souza D. · Journal of cannabis research · 2026

**Background & Methods** This review examines cannabis use for sleep disturbance in older adults (age >50), a population with rapidly increasing use despite limited evidence. The paper synthesizes existing literature on cannabinoids and sleep, highlighting the discrepancy between clinical practice and available scientific evidence in this age group. **Key Findings** • Subjective perception of improved sleep with cannabis use is frequently not supported by objective measures such as polysomnography or actigraphy data, suggesting a disconnect between patient-reported benefits and measurable sleep outcomes. • Age-related physiological changes including altered sleep physiology, pharmacokinetics, body composition, endocannabinoid system function, multimorbidity, and polypharmacy significantly affect cannabinoid efficacy and safety in older adults, making findings from younger populations non-generalizable to this population. • Tolerance development and withdrawal-related sleep disruption with regular THC and cannabis use complicate interpretation of longer-term efficacy, while evidence for CBD and CBN remains sparse and inadequate to guide clinical practice. **Dosage & Administration** Not reported. The paper notes that experimental studies have used products and formulations substantially different from those currently available in clinical practice. **Safety & Adverse Effects** Not reported as specific adverse events. However, the review identifies tolerance development and withdrawal-related sleep disruption as complications of regular and repeated THC/cannabis use that may negatively impact sleep quality during discontinuation. **Evidence Quality** This is a narrative review rather than a primary experimental study. Major limitations include: most existing cannabinoid-sleep research was conducted in younger adults with poor generalizability to older populations; rigorous randomized controlled trials specifically enrolling older adults are virtually nonexistent; methodological heterogeneity in study designs and cannabinoid formulations limits comparability; reliance on subjective rather than objective sleep measures in many studies; and absence of long-term safety and efficacy data. The authors conclude that high-quality, age-specific RCTs incorporating both subjective and objective sleep measures, pharmacokinetic data, drug interaction profiles, and longer-term outcomes are urgently needed to establish evidence-based recommendations for cannabis use in older adults with sleep disturbance.

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