Supplementary Material for: CANNABINOIDS FOR ANXIETY AND SLEEP DISTURBANCES: A SCOPING REVIEW

Background: At least 60% of individuals with anxiety disorders report sleep disturbances, which might be explained by shared physiological mechanisms, including cortisol dysregulation and executive function skills disruption. The scientific literature regarding medical cannabis as a potential therapeutical candidate for these conditions increased about 15 times in the last 10 years. However, assessments of cannabinoid exposure, anxiety, and sleep are inconsistent across studies, and the quality of the evidence is not often assessed. Methods: We developed a Scoping Review to examine the current knowledge on cannabinoid use for anxiety and sleep disturbances. A search strategy was run on PubMed, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, CINAHL, LILACS, and PsycINFO. Papers were selected by duplicate using PRISMA guidelines. Quality assessment was conducted for included studies and data extraction was performed according to our predefined protocol. Results: From 1,132 retrieved documents, 29 studies met the inclusion criteria, including randomized clinical trials, observational studies, and case series. Cannabinoids, particularly cannabidiol (CBD), showed potential efficacy in improving anxiety symptoms and sleep disturbances. However, substantial heterogeneity in study design, cannabinoid types, and dosing regimens limited the generalizability of findings. Approximately 45% of studies reported positive effects on both outcomes, yet few provided standardized dosing protocols or effect sizes. Conclusions: The evidence suggests cannabinoids may have beneficial effects on anxiety and sleep disturbances, but methodological limitations and the lack of standardized dosing hinder definitive conclusions. Future research should prioritize dose-response relationships and standardized methodologies to better inform clinical practice.