Background <p>Despite limited research, cancer patients are opting for compounds found in cannabis, like tetrahydrocannabinol (THC) and cannabidiol (CBD), to improve their sleep. The purpose of this study was to examine the therapeutic value of cannabis for sleep.</p> Methods <p>Patient-reported symptom responses were obtained from 1962 cancer patients enrolled in the Minnesota Medical Cannabis Program (MMCP) from 2015 to 2023. Multivariable logistic and linear regression models were used to evaluate the associations between changes in reported sleep disturbance scores and the dose of THC, the dose of CBD, and the cannabinoid ratio (THC:CBD). Logistic and linear regression models were adjusted for sex, age, race, ethnicity, body mass index, and MMCP enrollment fee category. Linear regression models were additionally adjusted for baseline sleep disturbance score.</p> Results <p>Compared to the highest quintile category of CBD dose, lower dose quintiles were 29–35% less likely to be associated with at least a 30% improvement in sleep disturbance scores. Sleep disturbance scores improved by 1.87 points on a 0–10 ordinal scale for cancer patients with CBD doses in the top quintile, and approximately 1.5 points for doses in lower quintiles. THC and THC:CBD doses were not consistently related to changes in sleep disturbance scores.</p> Conclusion <p>Higher CBD doses may be associated with clinically meaningful improvements in sleep in cancer patients enrolled in a medical cannabis program.</p>