CBD and Sleep Explained
Since CBD exploded onto the scene, it has become famous for its ability to reduce seizures, alleviate anxiety, and manage chronic pain. According to Consumer Reports, an estimated 11% of users are also using CBD to help them sleep, although according to SingleCare, this number could be as high as 42%.
But CBD is still relatively new, so it’s understandable that you’d question the legitimacy of its use.
An increasing amount of evidence appears to support the use of CBD as a sleep aid and in this article, we’ll present the scientific research available, as well as cover the safety and dosage aspects of using CBD for sleep, should you wish to try it for yourself.
5 ways CBD may help sleep:
- CBD may be able to increase the amount of deep sleep you get by enhancing levels of endocannabinoids and adenosine available in the brain
- CBD has been shown to act as a sedative at higher doses by influencing secretion of cortisol, our body’s primary stress hormone
- CBD displays anti-anxiety effects which could help you get to sleep faster, as well as stay asleep for longer by decreasing the time spent in anxiety-induced REM sleep
- CBD is an effective analgesic and may help you get to sleep easier and stay asleep for longer alleviating pain symptoms
- CBD may be able to help some of the complications that can arise from obstructive sleep apnea by reducing inflammation and lowering blood pressure while exerting cardioprotective benefits
CBD has dose-dependent effects, increasing alertness at lower doses and displaying sedative effects at higher doses
America, We Have a Problem
According to the CDC, roughly one in three adults don’t get enough sleep and approximately 70 million Americans suffer from chronic sleep problems.
If you, like so many others, are having trouble sleeping at night, it’s more important to address the problem than you may realize. Yes, having a bad night’s sleep is likely to leave you feeling more tired, irritable, and less productive, but did you know that in the long-term it can also have serious impacts on your physical and mental health?
To quote the CDC once more, “Sleeping less than seven hours per day is associated with an increased risk of developing chronic conditions such as obesity, diabetes, high blood pressure, heart disease, stroke, and frequent mental distress.”
Counting sheep isn’t getting you anywhere and it seems like the harder you try, the more awake and frustrated you feel. So, can CBD help? According to CBD users themselves, CBD is effective in alleviating sleep problems (as well as anxiety and stress), as you can see from the graph below.
But let’s take a look at what the science says about how it might be working.
Does CBD help with sleep?
The most common type of sleep disorder is insomnia, which includes difficulty in falling asleep and difficulty staying asleep. Insomnia can be acute or chronic, depending on whether it’s a one-off event that lasts just a few days or weeks (acute), or a more regular occurrence of a few days per week for at least a month (chronic).
Types of insomnia can then be broken down further into primary insomnia, where there is no external cause or condition that may be causing poor sleep, and secondary insomnia that is caused by medication or a health issue, such as anxiety or pain. Secondary insomnia is by far the most common reason that people suffer from poor sleep.
Endocannabinoid Signaling and Sleep
One of the main reasons the scientific community is studying CBD’s potential as a sleep aid is due to the role of our body’s own naturally-occurring endocannabinoids (endogenous cannabinoids) and how our endocannabinoid system influences our sleep/wake cycle.
The endocannabinoid system is a complex chemical signalling network that plays an essential part in regulating a whole host of vital physiological and cognitive processes. Not just sleep, but also pain response, immune function, memory, emotion, motor skills, and more.
When our endocannabinoid system is functioning optimally, our brains and bodies are able to achieve and maintain a state of homeostasis, or harmony.
A growing number of respected scientists believe that deficiencies in our endocannabinoid systems are at the root of all human disease and hope that supplementing our bodies with phytocannabinoids (from plants) can help it achieve its goals.
Of course, the problem is working out which cannabinoids do what, as well as how they’re doing it.
One study on rats showed that endocannabinoid signalling in the brain (at CB1 cannabinoid receptors) helps to regulate sleep stability. Another study on rats, published in the Oxford University Press, also found that the presence of anandamide, one of our body’s own natural endocannabinoids, in the brain significantly increased slow-wave sleep (deep sleep), which may be a result of increasing adenosine levels in the basal forebrain.
Combine this information with the fact that CBD has been shown to enhance signaling of our natural endocannabinoids by acting as a reuptake inhibitor of anandamide, it becomes clearer to see why it’s thought that CBD could potentially aid sleep.
As a reuptake inhibitor of anandamide, CBD has the ability to slow down the body’s natural breakdown processes of this neurotransmitter, which results in more anandamide available in the brain, which in turn also boosts our adenosine levels.
This mode of action not only helps us sleep more deeply, but also lends CBD some of its powerful neuroprotective and anti-inflammatory properties.
CBD as a Sedative
At higher doses, CBD has also been found to act as a sedative by influencing cortisol secretion.
A small human clinical trial showed that CBD had significant effects on cortisol levels and was “also found to have a sedative effect as determined by the self-evaluation scales”.
If CBD can make you feel more sleepy, then it should (in theory), also be able to help you fall asleep more quickly.
Indirect Ways CBD May be Able to Aid Sleep
It’s also thought that CBD can help to improve sleep in other ways, by alleviating the potential root causes of your sleep problem.
Dr Joseph Maroon, a clinical professor and world-renowned neurosurgeon at the University of Pittsburgh, agrees that CBD can indeed help some people sleep better.
Having extensively researched the effects of cannabis on the brain, Dr Maroon believes that the secret to CBD’s success in aiding sleep is primarily attributed to its ability to alleviate pain and anxiety. Pain and anxiety are common causes of sleep problems, including secondary insomnia, as they can make it more difficult to go to sleep, as well as stay asleep.
Anxiety and Sleep
Evidence supporting Dr. Maroon’s theory includes one 2015 study on mice that showed CBD efficiently suppressed anxiety-induced REM sleep and, according to another research paper, the less time your brain spends in a dream state, the more time it spends in deep sleep, which means you’re less likely to wake up so often.
A 2016 case report also discussed how CBD oil helped a ten-year-old girl suffering from insomnia caused by post-traumatic stress disorder. Pharmaceuticals provided only short-term relief with major side effects, but regular administration of CBD oil resulted in a maintained reduction in anxiety and increased both her sleep quality and duration. This study supported the use of CBD as a safe treatment for anxiety and improving sleep in sufferers of PTSD.
A few years later, in 2019, a larger case series involving 21 subjects found that, alongside the reduction in PTSD symptoms, 38% of the patients also reported an improvement in their quality of sleep. While 38% isn’t a huge number, having more restful sleep is probably a huge deal to the five or six people that CBD was able to help in this trial.
Interestingly, the study recorded other benefits that included decreased anxiety, improved focus, and improved mood.
A larger 2019 human clinical study showed more positive results. in this study, CBD was administered to patients that presented with primary issues of anxiety and/or poor sleep and the results showed that CBD effectively reduced anxiety in 79% of participants and improved sleep scores in 67% of the 72 subjects.
Pain and Sleep
The relationship between pain and sleep is an unfortunate vicious cycle. If you suffer from chronic pain, it’s likely that it will lead to poor sleep, but did you know that, according to the Journal of Neuroscience, lack of sleep also increases your experience of pain?
Pain is the number one reason for people taking CBD and, according to CBD users, it works.
Forbes Magazine recently published results of a survey that showed that 80% of CBD users found it to be very or highly effective and a massive 42% of them now use CBD instead of traditional pain medications such as Tylenol and Vicodin.
But it isn’t just anecdotal evidence that suggests CBD can effectively alleviate pain, there is also compelling scientific evidence that supports the use of CBD for pain.
CBD vs THC for Sleep
Cannabis in general has been used to relieve pain throughout the ages and there are multiple studies that back up the use of both THC and CBD in this manner that have also reported improvements in sleep.
Sativex, a medication developed by GW Pharmaceuticals, is prescribed in the UK for cancer-related pain and symptoms of MS. The same pharmaceutical giant also developed Epidiolex, the USA”s first CBD-based, FDA-approved medication for treatment-resistant epilepsy.
Unlike Epidiolex, which is pure CBD, Sativex contains equal parts of THC and CBD and went through several clinical trials before being approved for use in the UK in 2010.
During phases I-III of clinical trials, Sativex was administered to 2,000 patients, with 1,000 patient-years of exposure. These studies showed that Sativex effectively demonstrated “marked improvement in subjective sleep parameters in patients with a wide variety of pain conditions including multiple sclerosis, peripheral neuropathic pain, intractable cancer pain, and rheumatoid arthritis”.
In addition to this, no tolerance to Sativex was recorded, nor any need for increases in dosage in extended studies of up to four years. Although Sativex is a combination of two cannabinoids, these studies provide a promising glimpse into the power of cannabinoids and their effects on both pain and sleep.
It also forms a strong argument for the use of full-spectrum products that contain (federally-legal) trace amounts of THC, over broad-spectrum, THC-free formulas. But let’s not forget that other cannabinoids, such as CBC and CBG, also display strong analgesic effects. So, if you live in a THC zero-tolerance state and can only legally access broad-spectrum products, they still might be worth a try.
A Comprehensive Review of All Available Research on Sleep
A comprehensive literature review on CBD and sleep was published in Current Psychiatric Reports in 2017. It examined all of the available data on using CBD for sleep (only up to 2017) and presented compelling evidence that supports CBD’s calming effect on the central nervous system.
More importantly, it concluded that CBD may indeed have the potential to treat insomnia, as well as the fact that it “holds promise” for the treatment of REM sleep behavior disorder and excessive daytime sleepiness.
Can You Use CBD for Sleep Apnea?
Obstructive sleep apnea (OSA) is the most common type of sleep apnea and describes a serious condition that occurs when the muscles in the back of your throat relax too much when you’re asleep. This causes your upper airway to be blocked, which interrupts your breathing and sleep.
Symptoms include snoring, regular nighttime awakenings (insomnia), excessive daytime sleepiness, dry mouth when you wake up, and choking and/or gasping for air when you wake up. Sleep apnea may lead to cognitive impairment, depression, and anxiety. It is also linked to high blood pressure and heart problems and studies show that people with sleep apnea have a higher risk of death.
Contributing factors to sleep apnea include obesity, older age, smoking, diabetes, high blood pressure, taking sedatives (including alcohol), and there is some evidence to also suggest that OSA should be viewed as a chronic inflammatory disease.
While there are no direct studies on whether CBD can help sleep apnea, there are studies to show that CBD may have the ability to help manage diabetes, lower blood pressure, and reduce chronic inflammation, which is why some sleep apnea sufferers hope that CBD can help them.
Research shows that in lower doses, CBD can also be used as a wake-inducing agent by increasing alertness, as it’s only at higher doses that it has a more sedating effect. This suggests that a lower dose of CBD may be able to help to combat your day fatigue, while a higher dose could help you sleep better at night.
CBD vs THC for Sleep Apnea
While there haven’t been any human clinical studies on CBD and sleep apnea to date, there has been one on the effects of THC on sleep apnea.
Dronabinol, a synthetic THC-based drug that is used to treat nausea and vomiting in patients undergoing chemotherapy, was recently tested on 72 patients with sleep apnea.
According to the authors, Dronabinol targets “the brain and nerves that regulate the upper airway muscles. It alters the neurotransmitters from the brain that communicate with the muscles.” The human clinical trial administered Dronabinol to patients with moderate to severe obstructive sleep apnea and proved to be a great success.
Patients treated with Dronabinol experienced fewer sleep apnea-related events, less self-reported sleepiness, and those receiving higher doses (10mg) also reported greater overall treatment satisfaction.
If you live in a state where you have legal access to THC, then you may wish to try products with equal parts of THC and CBD. However, if THC is still illegal in your state, then we recommend that you choose full-spectrum CBD products that contain trace amounts of THC or delta 8 THC products.
Trace amounts of THC (found within compliant full-spectrum CBD products) won’t get you high, but they may make a difference to the product’s overall effects. Delta 8, on the other hand, most-likely will make you feel high. Find out more about delta-8 THC here, or check out some great legal-THC options here.
CBD for REM Sleep Behavior Disorder
REM Sleep Behavior Disorder (RBD) is a relatively rare disorder, which often occurs alongside neurodegenerative conditions. In 2014, the Journal of Clinical Pharmacy and Therapeutics published a study that showed CBD to be effective in substantially reducing the frequency of RBD-related events in patients with Parkinson’s disease, with no side effects.
Just four patients were treated with CBD in this study, so a larger study is needed, but the results are extremely promising.
Is CBD Safe?
It’s widely accepted that, as long as you buy your CBD from a reputable source, CBD has an extremely favorable safety profile. Side effects of CBD are infrequent and mild, which is why the natural health benefits offered by CBD are often preferred over, more harmful and addictive, over-the-counter and prescription sleep aids.
One study found that 74% of CBD users report that they feel no adverse side effects from CBD at all. The World Health Organization also agrees that CBD is well tolerated (even at high doses of 1,500mg per day and has a good safety profile.
However, you do need to be aware of possible drug interactions before introducing CBD into your diet. For example, if you’re taking blood thinners, then CBD may change the way these drugs work in your system, in a similar way that eating a grapefruit would.
For this reason, if you’re on medication, you should always consult your doctor before trying something new.
How to Take CBD for Sleep
As mentioned earlier, higher doses of CBD are needed for sleep, which is why most people prefer to take higher potency products, such as oils, tinctures, capsules, and gummies. If you prefer to smoke high-CBD hemp flower, then you may wish to consider topping the flower with a CBD concentrate, like CBD crumble or wax.
This will substantially increase the amount of CBD you can take at one time, while still allowing you to enjoy the natural aromas and flavors of the hemp plant.
If you’re taking your product orally (swallowing or ingesting it), then you should take your CBD at least an hour before bed. If your chosen method of consumption has faster-acting effects, like sublingual dosing and inhalation, you can take your CBD closer to your bedtime, around 30 minutes for sublingual or 10-15 minutes for smoking.
The Best CBD Dosage for Sleep
Unfortunately, working out your ideal CBD dosage for sleep can take some time, and the reason for this is that CBD is not a one-size-fits-all kind of solution. The matter of dosing is still very much understudied, but (anecdotally) appears to have a need for a more personalized approach.
What works for one person won’t necessarily for the next, which could be down to a number of reasons including (but not limited to) age, sex, metabolism, weight, diet, and chemical make-up. And, maybe more importantly, the dosage may also depend on the type and severity of your symptoms, with pain and sleep often needing higher doses.
The scientific studies quoted here have administered an extraordinarily wide range of doses. For example, in the anxiety and sleep case series, 25mg of CBD per day was administered to patients. A handful of patients were increased to dosages of either 50mg or 75mg and one patient’s dose was gradually increased to 175mg per day.
On the other hand, Epidiolex is dosed at 5mg per kilogram (2.2lbs) of body weight.
Generally speaking, we advise newcomers to CBD to start with low doses (10mg) and increase their dose gradually until they find their “sweet spot”.
However, in the case of sleep, things aren’t that simple. As discussed, at lower doses CBD has actually been shown to be a wake-inducing agent, leaving you feeling more focused and alert. For this reason, we usually advise people to start at around 25mg, which appears to be a successful dosage for sleep for many people, and then you can gradually increase the dose from there if needed.
If you took your first dose of CBD for sleep and feel like it kept you awake, then you should increase the dose immediately, but if you didn’t notice any change, I wouldn’t be too quick to increase your dose.
Sometimes it can take CBD a few weeks to properly get into your system and start affecting change, in the case of managing pain symptoms especially. The good news is that some companies offer 30-day money-back guarantees that allow you to try their products for a few weeks and then if the product doesn’t work for you, you can return the (open and well-used) product for a full refund.
Sleep Dosage: Top Tips
Keep a diary or a sleep chart to make a note of the dose you take each night and how you feel you slept. To simplify matters, give yourself a score out of 10 for how well you think you slept or how rested you feel.
You could also download a sleep app which could potentially provide you with some insightful data about your sleep, including an educated guess of how much time you spent in deep sleep (based on small movements you make). Some apps will also allow you to keep notes, so you could also record your dosage trial information within the app.
I’m not sure how accurate these apps are and I’ve also had mishaps with my phone falling off the bed and/or picking up my partner’s movements, but it may prove to be more reliable if hooked up to a smart watch.
Does CBD Oil Help With Sleep?: Conclusion
Although a lot more research is needed, it’s clear to see why CBD is being studied so extensively in connection with its ability to aid sleep.
CBD can potentially help you fall asleep faster by acting as a sedative at higher doses and it may also improve sleep duration by helping you sleep more deeply, thanks to its role as a reuptake inhibitor of anandamide.
However, it’s thought that CBD’s ability to alleviate anxiety and pain is the number one reason for why CBD is helping so many people sleep better at night.