- Insomnia is a common condition in the U.S.
- There is a growing body of research supporting cannabidiol (CBD) as an effective treatment for insomnia.
- The endocannabinoid system (ECS) is instrumental in regulating the body’s sleep-wake cycle.
- CBD interacts cannabinoid receptors to simulate wakefulness or drowsiness, depending on the dosage of the CBD.
- Several preliminary human studies found cannabinoids were effective in treating various types of sleep disorders.
- CBD has been found to help alleviate symptoms of other conditions (such as anxiety, depression, and pain) it also lends itself to sleep promotion.
How Cannabidiol (CBD) Effects Sleep
Insomnia involves trouble falling asleep, difficulty sleeping through the entire night, and/or early waking with the inability to get back to sleep. Cannabidiol (CBD) is used for a variety of health conditions, including arthritis, anxiety, and to promote relaxation and sleep. CBD is a single compound found in the cannabis plant. The scientific name for cannabis is Cannabis sativa (C-sativa). The Cannabis sativa/hemp plant is very complex; it has over 400 chemical components and over 60 of them are cannabinoids. Delta-9-tetrahydrocannabinol (THC) and CBD are its major compounds.7 THC is the psychoactive component of the cannabis plant that causes a person get high. Although the cannabis plant has THC and CBD, CBD derived from the hemp plant has minimal amounts (less than 0.3%) of THC, which is not enough to cause a person to get high. 4
The Importance of a Healthy Sleep Pattern
Insomnia is a condition that involves a lack of satisfactory sleep. A person with insomnia has trouble falling asleep, difficulty sleeping through the entire night, and/or early waking while being unable to fall back asleep. To be considered insomnia, sleep problems must cause an impairment in functioning or severe distress.1 In the U.S., the incidence of insomnia is on the rise; so too is the use of natural treatment modalities, such as cannabinoids or CBD for sleep.1
Sleep is an essential function required for a healthy nervous system, as well as overall health and wellness. Adequate sleep contributes to many factors, including: 3
- Robust energy levels
- Cognitive function
- Cardiovascular health
- Healthy hormone levels
- A strong immune system
- Overall homeostasis
The sleep-inducing effects of the cannabis plant have long been known, but only recently has science began unraveling the details on exactly how the body’s endocannabinoid system (ECS) maintains a regular sleep pattern, and how the effects of plant-based cannabinoids, such as cannabinol (CBD), can affect sleep. How do CBD and other hemp derived cannabinoids work as sleep aids and are they safe and effective? 2
How The Endocannabinoid System Effects Sleep
According to a 2010 British Journal of Pharmacology publication, the endocannabinoid system (ECS) helps to regulate the body’s sleep-wake cycle. 5
The sleep-wake cycle is one of the most common of the body’s circadian rhythms. 5 The sleep-wake cycle is how the body maintains and promotes sleep. Circadian rhythms are those with a cycle length of approximately 24 hours. Circadian rhythms impact several body processes, including sleep and wakefulness, hormonal changes, and body temperature. 6
Scientists hypothesize that the endocannabinoid system acts as a link between the body’s circadian rhythms, specifically its sleep-wake cycle, and its physiological processes, including sleep. 5
Lack of adequate sleep is thought to disrupt the normal function of the ECS. Endocannabinoids work on endocannabinoid receptors to help the body recover from abnormal sleep patterns that are a result of sleep deprivation. Based on the scientific findings regarding how critical the ECS is in regulating the sleep-wake cycle, it’s essential to consider the impact of exogenous cannabinoids, such as CBD and other phytocannabinoids, on sleep.1 Learn more about exogenous cannabinoids here.
How Does CBD Impact Sleep?
Cannabinoids, such as CBD, can bind with receptors to stimulate wakefulness or drowsiness. The ECS regulates the CB1 cannabinoid receptor, which is thought to contribute to sleep regulation. The signaling molecules, anandamide and 2-AG promote sleep via activation of the CB1 receptor. 11 Learn more about signaling molecules, such as anandamide and 2-AG here.
It’s important to note that CBD has been found to help treat other conditions that may interfere with a healthy sleep pattern, such as alleviating symptoms of pain, depression, anxiety and more.
Several preliminary studies are starting to show that cannabidiol is safe and may improve the sleep pattern.
A 2019 Human Study
A long-term 2019 human study was conducted to evaluate the effectiveness of CBD on sleep and anxiety. In the study, CBD was given as an adjunct treatment for 103 study participants seen in a clinical setting. Most of the study participants were given oral dosages of 25 mg of CBD per day. 9 Some study participants were given 50 or 75 mg of CBD per day, and one of the study participants was given an increased dose of 175 mg per day. The patients who complained mostly of anxiety were administered the CBD in the morning and those with predominant complaints of insomnia took the CBD in the evening hours. Monthly documentation was performed to record the improvement or status in sleep patterns and anxiety. The study findings in the last sample of study participants included: 9
- Within the initial 4 weeks, anxiety levels decreased in 57 out of 72 (79.2%) of the study participants
- During the first 4 weeks, 48 (66.7%) of the study participants showed an improvement in sleep scores (but the improvement ratings fluctuated over time)
- The chart review showed that the CBD was well tolerated in all except 3 patients in the study
The study concluded that CBD provided a decrease in anxiety symptoms and helped improve sleep in over half of the study participants, but while the CBD provided steady relief for those with anxiety, the sleep scores fluctuated.
A 2017 Review Study
A 2014 to 2017 review of recent study data on the effects of CBD for sleep suggests:1
- Cannabidiol (CBD) may have the potential for an effective treatment for insomnia.
- THC may lower sleep latency (i.e., the time it takes for fall asleep), but long-term effects may involve impaired sleep quality.
- Synthetic cannabinoids (i.e., nabilone and dronbinol) could provide short-term benefits for sleep apnea because these drugs have a modulatory impact on serotonin-mediated apneas.
- CBD may improve REM sleep disorder with daytime sleepiness.
- Nabilone may help alleviate nightmares linked with PTSD.
- Nabilone may improve sleep in those with chronic pain.
CBD for Sleep: Dosage Study
CBD differs in its effect on sleep, based on the dosage. 1 Low-doses of CBD have a stimulating effect and conversely, high doses result in a sedating effect. An older, human study, published in the Journal of Clinical Pharmacology, found that a dosage of 160 mg per day of CBD “increased total sleep time and decreased the frequency of arousals during the night.” 8
- Babson KA, Sottile J, Morabito D. Cannabis, cannabinoids, and sleep: a review of the literature. Curr Psychiatry Rep. 2017;19(4):23. https://doi.org/10.1007/s11920-017-0775-9
- Kesner AJ, Lovinger DM. Cannabinoids, endocannabinoids and sleep. Front Mol Neurosci. 2020;13:125. doi:10.3389/fnmol.2020.00125 https://doi.org/10.3389/fnmol.2020.00125
- NIH News in Health. The Benefits of Slumber. https://newsinhealth.nih.gov/2013/04/benefits-slumber Updated April, 2013.
- U.S. Food & Drug Administration. What You Need to Know (And What We’re Working to Find Out) About Products Containing Cannabis or Cannabis-derived Compounds, Including CBD. https://www.fda.gov/consumers/consumer-updates/what-you-need-know-and-what-were-working-find-out-about-products-containing-cannabis-or-cannabi s updated March 5, 2020.
- Vaughn LK, Denning G, Stuhr KL, De Wit H, Hill MN, Hillard CJ. Endocannabinoid signaling: has it got rhythm?: Endocannabinoid signaling and biological rhythms. British Journal of Pharmacology. 2010;160(3):530-543. https://doi.org/10.1111/j.1476-5381.2010.00790.x
- UCLA Health. UCLA Sleep Lab. Circadian Rhythms. https://www.uclahealth.org/sleepcenter/circadian-rhythms
- Atakan Z. Cannabis, a complex plant: different compounds and different effects on individuals. Therapeutic Advances in Psychopharmacology. 2012;2(6):241-254. https://doi.org/10.1177/2045125312457586
- Carlini EA, Cunha JM. Hypnotic and antiepileptic effects of cannabidiol. The Journal of Clinical Pharmacology. 1981;21(S1):417S-427S. https://doi.org/10.1002/j.1552-4604.1981.tb02622.x
- Shannon S. Cannabidiol in anxiety and sleep: a large case series. TPJ. 2019;23. doi:10.7812/TPP/18-041 https://doi.org/10.7812/TPP/18-041
- Arthritis Foundation. CBD for Arthritis Pain? What You Should Know. https://www.arthritis.org/health-wellness/healthy-living/managing-pain/pain-relief-solutions/cbd-for-arthritis-pain
- Murillo-Rodríguez E, Budde H, Veras AB, et al. The endocannabinoid system may modulate sleep disorders in aging. CN. 2020;18(2):97-108.https://doi.org/10.2174/1570159X17666190801155922