SLEEP AND RESPIRATORY NEUROBIOLOGY: Edited by Lee Brown and Winfried Johannes RanderathUpdates in the use of cannabis for insomniaEarl, David C.a; Proano, Marcob Author Information aDepartment of Psychiatry bDepartment of Internal Medicine, University of New Mexico, Albuquerque, New Mexico, USA Correspondence to David C. Earl, MD, PharmD, 1101 Medical Arts Ste 2, Albuquerque, NM 87102, USA. Tel: +1 505 272 6110; fax: +1 505 272 6112; e-mail: [email protected] Current Opinion in Pulmonary Medicine: November 2022 - Volume 28 - Issue 6 - p 511-514 doi: 10.1097/MCP.0000000000000914 Buy Metrics Abstract Purpose of review This review aims to summarize recent updates in the area of cannabis use for insomnia. Recent findings Cannabis products have continued to become more potent, particularly in regard to delta-9- tetrahydrocannabinol (THC) concentration. Additionally, the use of cannabis has continued to become more accepted with less legal restrictions. The reported use of cannabis for relief of symptoms in sleep disorders appears to be increasing, however the specific effects of cannabinoids on sleep varies with cannabinoid type and concentration. Some evidence supports claims of efficacy of cannabinoids in sleep disorders such as insomnia, while other evidence is either lacking or in some cases contradictory. Regular cannabis use has been associated with withdrawal which can profoundly alter sleep. Also, clinicians should be aware of the potential effects of cannabis on the metabolism of other medications as well as the fact that cannabis use has been reported in a significant number of women in the periods before, during, and after pregnancy. Summary Cannabis use has been becoming more and more prevalent in the setting of relaxed restrictions and easier consumer level access to cannabis and cannabis products. A relative paucity of high quality evidence regarding the effects of cannabis on sleep and the treatment of insomnia symptoms remains. The optimal type, concentration, ratio, and dosage form of cannabinoids in the treatment of insomnia symptoms needs further clarification. As the trend of acceptance and use of cannabis continues, more high quality evidence to help guide clinicians in their recommendations will hopefully become available. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.