A prospective polysomnographic study found significant sleep disruption in people with multiple sclerosis compared to healthy controls, and a 6-week nabiximols trial resulted in significant improvement in both patient-reported and objective polysomnographic sleep measures.
People with MS showed significantly reduced sleep efficiency compared to healthy controls.
People with MS had significantly reduced total sleep time compared to healthy controls.
People with MS exhibited significantly more nocturnal awakenings and higher arousal index compared to healthy controls.
People with MS had a significantly greater periodic limb movement index and reduced proportion of REM sleep compared to healthy controls.
A 6-week nabiximols trial significantly improved self-reported sleep quality in people with MS.
A 6-week nabiximols trial significantly improved objective polysomnographic measures of sleep efficiency and total sleep time in people with MS.
A 6-week nabiximols trial significantly reduced arousal index and periodic limb movement index in people with MS.
A 6-week nabiximols trial significantly increased the proportion of REM sleep in people with MS.
This research suggests that people with multiple sclerosis (MS) experience substantial disruptions to their sleep compared to healthy individuals of similar age and sex. Using overnight sleep studies (polysomnography), the researchers found that MS patients slept less efficiently, woke up more often during the night, had more leg movements during sleep, and spent less time in REM (dreaming) sleep. These objective findings matched the patients' own reports of poor sleep quality, as measured by a standard questionnaire called the Pittsburgh Sleep Quality Index. The study also tested whether nabiximols — a cannabis-based mouth spray approved for MS-related spasticity — could improve sleep in these patients. After six weeks of treatment, participants showed meaningful improvements across all the sleep measures that had been abnormal at the start of the study. Sleep efficiency went up, total sleep time increased, nighttime awakenings and leg movements decreased, and REM sleep was restored closer to normal levels. Patients also reported feeling that their sleep quality had improved. This research suggests that nabiximols may offer benefits beyond its current approved use for muscle stiffness in MS, potentially also helping to address the sleep disruption that is common in this condition. The authors propose that the therapeutic indications for nabiximols be broadened to include MS patients who experience significant sleep problems. However, the study was small (19 MS patients) and did not include a placebo control group, so larger controlled trials would be needed to confirm these findings.
Fortunato F, Saraceno A, Barone S, Sturniolo M, Bruno P, Martino I, et al.. (2026). Nabiximols improves sleep architecture in multiple sclerosis: A prospective polysomnographic study.. Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics. https://doi.org/10.1016/j.neurot.2026.e00840