There is a close relationship between cannabis, CBD, and sleep, and it is a positive one. Research has shown that both marijuana and CBD have sleep-promoting benefits that patients with sleep disorders can tap into.  Cannabis has sedative effects when they are consumed in moderate doses. Consuming high amounts of cannabis in most cases is likely to harm sleep. It is advisable to always stay within regular consumption limits. CBD has been studied and proven to relieve symptoms such as anxiety, fatigue, and pain that affect sleep adversely. Certain terpenes in cannabis help to boost the sleep-enhancing effects of marijuana and CBD. As a patient, the most important thing is to find the perfect balance between cannabis and CBD that will help you sleep better.

About 70 million Americans struggle to fall asleep when they check into their beds each night. Worldwide, about 1 in every 3 adults suffer from regular insomnia. Several factors can be attributed to this worrying statistic. This includes the daily pressures of living in the fast-paced 21st century, poor diet and sedentary lifestyle, overdependence on sleeping pills, and poor sleeping habits among others.

Many patients with sleeping disorders have turned to sleeping pills to help them sleep better at night. These drugs include antidepressants that tackle sleeplessness and anxiety, benzodiazepines for sleepwalking and night tremors, Ramelteone that targets the sleep-wake cycle, and Suvorexant that promotes wakefulness. Over-the-counter sleeping aids containing antihistamines are also a popular option for many insomniacs. While the effectiveness of these drugs may vary, addiction is a possibility with most sleeping pills.

Many patients are turning to cannabis and CBD to help them deal with their sleep issues. In this article, you’ll learn if and how and when you should be using cannabis and CBD for sleep, how much to take, and how to handle adverse effects should they show up.

Let’s get started.

What is CBD?

CBD is one of the numerous bioactive compounds that are present in cannabis and falls under a category that is known as cannabinoids. To date, scientists have isolated about 140 +/-  different cannabinoids from cannabis. But with all the limitations to cannabis research, the ones that have been studied may not exceed a dozen. Fortunately, CBD is among the most studied cannabinoids and much is now understood about how CBD affects health. The potential therapeutic benefits of CBD include:

  • Anti-inflammatory and analgesic
  • Anti-anxiety
  • Anti-tumor
  • Anti-epilepsy
  • Anti-depressant
  • Neuroprotectant
  • Anti-psychotic
  • Anti-diabetic

Marijuana on the other hand refers to a variety of cannabis Sativas and Indicas, that may have a higher amount of the psychoactive cannabinoid tetrahydrocannabinol (THC) depending on the cannabinoid concentrations and ratios. THC is the cannabinoid that causes the typical “marijuana high.” The amount of THC will vary from one strain to another. Strains that contain high amounts of THC include Hawaiian, Lemon Meringue, Laughing Budhaa, Thai, and Silver Haze among others. The potential therapeutic benefits of THC include:

  • Analgesic and anti-inflammatory
  • Prevents nausea and vomiting
  • Neuroprotectant
  • Anti-tumor
  • Sedative
  • Increases appetite
  • Anti-bacterial
  • Anti-oxidant
  • Reduces intraocular pressure

The Science behind Cannabis, CBD and Sleep

Sleep is one of the vital functions in the body that are under the control of the endocannabinoid system (ECS) which is made up of endocannabinoids (eCBs), receptors, and enzymes. Endocannabinoids have been linked to normal and disrupted sleep patterns, showing the involvement of the ECS in sleep regulation. [1]

Both THC and CBD interact with the ECS through different mechanisms. Studies have shown that THC binds to the endocannabinoid receptor (CB1) through which it exerts its effects. CB1 receptors are predominantly located in the brain and the central nervous system. CBD on the other hand exerts its effects through various mechanisms. It has a low affinity for both the CB1 & CB2 receptors.

Here’s how CBD and cannabis can help you sleep better.

Cannabis & Sleep

Several studies, from decades ago, have highlighted the sleep-promoting effects of cannabis. Such studies have shown that acute exposure to marijuana reduces the amount of time it takes to fall asleep, reduces the active phase of sleep that is associated with dreaming, and increases the length of deep sleep. [1]

Dosing on cannabis has helped patients with insomnia to fall asleep sooner and stay asleep for a longer time.  A 2017 survey study involving 1,500 patients served at a New England medical cannabis dispensary showed that over 60% of the patients decreased their use of sleeping pills after starting treatment with medical cannabis.

Chronic exposure to marijuana and other CB1-activating compounds has been shown to produce modest sleep improvement. Additionally, self-reported patient reports suggest similar benefits. [2]

Some studies have also shown that withdrawal of marijuana causes sleep disruption that may present as nightmares and decreased total sleeping time.

CBD & Sleep

Anxiety Relief

Anxiety is a major cause of sleep problems and leads to insomnia. If not addressed, anxiety can lead to myriad anxiety disorders that complicate sleep. People with anxiety often exhibit the following symptoms:

  • Difficulty falling asleep
  • Frequent night waking
  • Frequent nightmares
  • Panic attacks at night
  • Frequent limb movements at night

Research done in 2019 shows that CBD can help control anxiety caused by insomnia. [3] Additionally, it can also manage different types of anxiety such as panic disorders, social anxiety disorder, obsessive-compulsive disorder, and post-traumatic stress disorder.

CBD & Cortisol

CBD exerts its sleep-promoting effects by regulating the hormone cortisol which promotes wakefulness. Normally, cortisol levels are high in the morning and low in the evening. However, stress causes the excessive production of cortisol and this is what keeps you awake through the night. Some studies have shown that CBD lowers the levels of cortisol in the body. As a result, those with stress-related insomnia can sleep through the night. One study showed that CBD interferes with the production of cortisol and this results in sedation. [4]

Cannabis, CBD, & Pain Control

Chronic pain or any type of pain can make you lack sleep at night and even during the day. A review by Frontiers in Pharmacology revealed that CBD can indeed soothe the pain. [5]

Another study was done in 2021 and still proved that CBD is helpful when it comes to managing pain. [6] Scientists are still doing more research, but the available studies can still help you decide on whether to use CBD for your sleep.

How To Consume Cannabis and CBD

Marijuana and CBD come in a variety of formulations to suit the different needs and preferences of patients. You can choose any of the methods listed below as long as it is accessible and legal in your state.

  • Tinctures and oils. Place one or two drops beneath the tongue and hold for about 20 seconds before swallowing. The uptake is also fast; you should begin feeling the effects within minutes.
  • Edibles such as gummies and chocolates and infused beverages such as tea and coffees. Beware that your CBD and THC will take a detour through the digestive system before they finally land in the bloodstream. Therefore, give yourself at least half an hour to an hour to wait for the effects to set in.
  • Topicals such as lotions, ointments, creams, and balms.
  • Pills and capsules.
  • Marijuana and CBD vapes
  • Marijuana and CBD concentrate, such as wax and shatter. They offer high concentrations of THC or CBD.
  • Smokable forms such as marijuana flower

Some states have placed restrictions on how marijuana and CBD can be consumed. Therefore, it is important to check with your local laws before choosing a method of consumption. Also, note that the consumption method will affect how soon you begin to experience the effects of CBD and cannabis. If you need a quick fix, you are better off smoking or vaporizing the product. Sprays and tinctures are also good when you need an almost immediate response. Edibles are a good choice when you want sleep-promoting effects that linger, but can afford to wait for some time.

How To Dose Cannabis and CBD for Sleep

Dosing cannabis for sleep will vary based on several factors. This includes one’s unique physiology and how you respond to cannabinoid treatment. Other individual factors such as body fat percentage, frequency of consumption, age, and the severity of the sleep disorder will also play a role in the dosing needs of the patient.

A 2020 study highlighted the need for standard dosing for cannabis products. The researchers stated that “A standardized measure for 9‐tetrahydrocannabinol (THC) content in cannabis products is necessary to advance research both on the adverse effects of cannabis (e.g. risks for brain development, mental illness and addiction) and on the drug’s potential medical uses. [7]

A consensus report that was published in 2021 involving twenty global experts from nine countries developed recommendations on dosing medical cannabis.  [8] In summary, the experts recommended starting with a minimal amount of CBD (5 mg CBD twice daily) and titrating by 10 mg every 2 to 3 days until the patient reaches their goals, aiming for a maximum of up to 40 mg/day. The doctor may also consider adding THC with a starting dose of 2.5 mg daily and titrating by 2.5 mg every 2 to 7 days while aiming for a maximum daily dose of 40 mg/day of THC. As much as these recommendations were given for pain, the study showed they are safe and effective doses for treating insomnia.

Can you overdose on CBD?

According to research, 300-mg oral doses of CBD can be consumed safely daily for up to six months.

A scientific review done in 2011 showed that consuming 1,500 mg daily was safe for the participants. [9] Another review proved that the use of 1,500 mg daily for four weeks had no negative effects on the participants. [10]

Unfortunately, several CBD brands mislabel their products and the amount of CBD on the product label might not always be accurate. This means that you may be consuming more or less CBD than you think you are,

An analysis done on 84 CBD products confirmed that 26% of CBD products had less CBD than what was written on the label. [11] Still, on the same analysis, it was confirmed that around 43% of the products had more CBD content than what was written.

The rule of thumb is to always purchase your CBD from a reputable source. It never harms to go the extra mile to request to view third-party results that confirm the actual amount of CBD in the product. This should also allow to rule out the presence of contaminants such as heavy metals or pesticides.

Side Effects of CBD and Cannabis

The side effects of CBD and cannabis will vary from person to person. When they occur, they may include the following:

Mild Side Effects

  •        Diarrhea and vomiting
  •        Dry eyes and mouth
  •        Disorientation
  •        Body weakness
  •        Restlessness, shaking and sweating
  •        Headaches and irritability
  •        Hunger pains

Marijuana can cause feelings of dehydration so it is always advisable to hydrate adequately. Adjusting to an appropriate dose will also help to minimize some of the side effects. The following tips are useful when you are medicating with cannabis.

  • Begin the day with a healthy balanced diet that has vegetables, proteins, and fruits to increase your energy.
  • Implement an active lifestyle. Exercise three or four times a week, you can start with light exercises. Your mood will be boosted and you’ll be removing unwanted toxins from your system.
  • Hydrate your body. Preferably drink two liters of water or more every day. Quit caffeine and sugary drinks like sodas.
  • Seek support from your loved ones. You can also try outpatient rehabilitation programs or support group therapies.

Severe Side Effects

  •       Extreme weight loss or weight gain.
  •       Suicidal feelings and depression
  •       Nightmares upon withdrawal
  •       Anxiety and paranoia

If you experience severe side effects you should stop your cannabis intake immediately and consult your healthcare provider.

References

  1. Andrew J. Kesner (2020). Cannabinoids, Endocannabinoids and Sleep.Front. Mol. Neurosci.,
  2. Bonn-Miller, M. O., Boden, M. T., Bucossi, M. M., & Babson, K. A. (2014). Self-reported cannabis use characteristics, patterns and helpfulness among medical cannabis users. The American journal of drug and alcohol abuse, 40(1), 23–30.
  3. Shannon S, Lewis N, Lee H, Hughes S. Cannabidiol in anxiety and sleep: A large case series. Perm J 2019;23:18-041.
  4. Zuardi, A. W., Guimarães, F. S., & Moreira, A. C. (1993). Effect of cannabidiol on plasma prolactin, growth hormone and cortisol in human volunteers. Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas, 26(2), 213–217.
  5. Vučković, S., Srebro, D., Vujović, K. S., Vučetić, Č., & Prostran, M. (2018). Cannabinoids and Pain: New Insights From Old Molecules. Frontiers in pharmacology, 9, 1259.
  6. Martin J. De Vita, et al. (2021). The effects of cannabidiol and analgesic expectancies on experimental pain reactivity in healthy adults: A balanced placebo design trial.” Experimental and Clinical Psychopharmacology.
  7. Volkow, N. D., & Weiss, S. (2020). Importance of a standard unit dose for cannabis research. Addiction (Abingdon, England), 115(7), 1219–1221.
  8. Bhaskar, A., Bell, A., Boivin, M. et al. Consensus recommendations on dosing and administration of medical cannabis to treat chronic pain: results of a modified Delphi process. J Cannabis Res 3, 22 (2021).
  9. Bergamaschi, M. M., Queiroz, R. H., Zuardi, A. W., & Crippa, J. A. (2011). Safety and side effects of cannabidiol, a Cannabis sativa constituent. Current drug safety, 6(4), 237–249.
  10. Iffland, K., & Grotenhermen, F. (2017). An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies. Cannabis and cannabinoid research, 2(1), 139–154.
  11. Bonn-Miller, M. O., Loflin, M., Thomas, B. F., Marcu, J. P., Hyke, T., & Vandrey, R. (2017). Labeling Accuracy of Cannabidiol Extracts Sold Online. JAMA, 318(17), 1708–1709.



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