Evidence Level
CBD has rapidly growing but still emerging evidence for anxiety and sleep. Shannon et al. (2019) provided the largest clinical observation, but it was a retrospective case series, not an RCT. Linares et al. (2019) provided the strongest RCT evidence for acute anxiety, showing an inverted U-shaped dose response peaking at 300mg. Zuardi et al. (1993) was an early RCT demonstrating CBD's anxiolytic effects in a simulated public speaking test. The sleep evidence is weaker — most studies note sleep improvement as a secondary outcome of anxiety reduction. The main concerns are regulatory inconsistency (CBD product quality varies enormously), significant CYP450 drug interactions, and the limited number of large, well-designed RCTs. The FDA has only approved CBD (as Epidiolex) for specific epilepsy conditions, not for anxiety or sleep.