They say cannabis helps with sleep, but what if you'd rather not get high? Learn more about the differences between THC and CBD for sleep, with expert weigh-in on strains to try out. CBD (cannabidiol) is commonly used to treat sleep symptoms like insomnia. Learn more about cannabinoids, how CBD works, its forms & effects on the body. There are a lot of questions about this experimental sleep aid. Here’s what we know about CBD and sleep.
Does CBD help or hinder sleep?
What most of us wouldn’t give for a good night’s sleep. Without it, we can’t function at peak emotional, physical, and mental levels, yet in today’s high-stress, plugged-in world, so many of us don’t get decent sleep.
Ailments like insomnia, sleep apnea, narcolepsy, and excessive daytime sleepiness cause consumers to turn to over-the-counter and prescription pharmaceuticals for relief, yet many of these medications have their own serious side effects and adverse risks.
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For that reason, many consumers are exploring natural sleep aids like cannabis. We know THC-rich varieties can help people achieve sleep, but what about those sensitive to or afraid of its intoxicating effects?
Can cannabidiol (CBD), a non-intoxicating cannabis compound, also offer sleep benefits?
CBD and sleep: What does the research say?
As CBD has exploded onto the market, consumers are turning to the cannabinoid to treat many ailments, including insomnia. The insurgence of CBD has also prompted a sizable uptick in the number of preclinical and clinical studies looking at CBD’s value in treating a whole host of disorders. However, very few studies center on CBD and sleep.
In a recent Consumer Reports survey on CBD, 10% of respondents report using CBD as a sleep aid. The majority of them said it worked, but that evidence is anecdotal. Without controlled studies, it is difficult to tell whether CBD is truly acting alone to induce sleep. There are several complicating factors.
First, high-CBD strains often contain myrcene , a terpene that is said to be sedating. Although controlled studies on humans are lacking, myrcene’s sedative effects are well established in the animal literature, and for centuries, herbalists have been using hops as a human sleep aid. As it turns out, hops have high myrcene levels.
Therefore, if a person uses a high-CBD strain and says it helps them sleep, it is hard to tell whether CBD, myrcene or the two working in combination is the active agent. However, it’s worth noting that most people aren’t smoking or vaporizing myrcene-rich CBD flowers for sleep. Rather, most are using a CBD concentrate that contains little to no myrcene whatsoever.
Very few researchers have looked at isolated CBD as a sleep aid. Instead, researchers have looked at CBD in conjunction with other cannabinoids like THC. In a 2017 extensive literature review entitled Cannabis, Cannabinoids, and Sleep: a Review of the Literature, the research team found that CBD and THC were indeed the two cannabinoids most often cited as sleep-inducing aids.
Multiple cannabinoids muddy the waters
THC has a sedative effect and can reduce the time it takes to fall asleep. Some research shows that the entourage effect , or harmonized interaction between cannabis compounds like CBD and THC, seems to carry over to sleep.
Sulak explained that CBD may just be reducing symptoms like anxiety, which allows the person to relax so that their natural sleep mechanism can take over.
However, THC does not put a person in a sleep state. Neither does CBD. Instead, THC is a sedative and has other properties helpful to sleep. For example, THC makes a person feel comfortable while remaining still, called catalepsy.
Because CBD doesn’t alter consciousness in the same way that THC does, is it even possible that CBD can work alone as a sleep aid?
Dr. Dustin Sulak, DO, is the founder of Healer.com and Integr8 Health, a Maine medical practice that uses medical cannabis as a treatment for a variety of ailments. Sulak explained that CBD may actually just be reducing symptoms like anxiety, which allows the person to relax so that their natural sleep mechanism can take over.
To demonstrate Sulak’s point, here is one such published example, where a Colorado research team looked at outcomes of psychiatric patients who received CBD in a clinical setting to help with anxiety and sleep complaints. CBD was given as an adjunct to usual treatment. Within the first 30 days of CBD use, anxiety decreased in nearly 80% of patients and sleep scores improved by nearly 70%. CBD was well tolerated by the vast majority of patients.
But was CBD directly responsible for this outcome? And, given that a fairly large group of people with insomnia also have depression and anxiety , what exactly is CBD working on? This is where the waters become even more muddied.
Sulak’s practice has over 8,000 patients, so he sees the connection between sleep and chronic disease every day. “Sleep is extremely important,” he said. “Almost all of our most prevalent chronic diseases require healthy sleep for the patient to get better.”
Sulak said that if he can fix a patient’s sleep disturbance, it serves as a unifying treatment that can help multiple patient conditions like diabetes and chronic pain. While Sulak does treat sleep disorders, he very rarely does so with CBD in any form, whether pure CBD or a CBD-dominant cannabis strain.
Instead, Sulak often uses THC with a sedating terpene profile. He achieves excellent results, even when using low doses.
The dosing dilemma
Depending on who you ask, CBD has been reported as having either a stimulating or a calming effect, thus adding confusion to the overall equation. While there is very little published evidence regarding dosing, research to date indicates that at higher doses, CBD has a calming effect; yet at lower doses, CBD has a stimulating effect.
In a 1977 animal study, the “ hypnotic-like effects ” of CBD were first studied. Since then, very few CBD dosing studies have been performed, but the evidence seems to indicate that the effectiveness of CBD depends on whether the person has a normal sleep rhythm or whether the person has a sleep disorder.
In a 2018 study on 27 healthy subjects , a high CBD dose (300 mg) qualifying as a clinically anxiolytic dose had no effect on the sleep-wake cycle. CBD was given 30 minutes prior to bedtime and sleep recordings were made for eight hours thereafter.
In a similar study, very high CBD doses (600 mg) had a sedative effect, but in subjects with insomnia, much lower doses of 160 mg reduced sleep disruption and increased total sleep duration. Conversely, very low doses of 25 mg had no effect.
CBD and REM sleep
CBD has been found to help with certain sleep anomalies that occur during rapid eye movement (REM) sleep. There are two types of sleep: non-rapid eye movement sleep (NREM) and rapid eye-movement (REM) sleep. NREM sleep progresses through a 90-minute cycle leading up to REM sleep, in which brain wave activity increases and dreaming occurs. REM sleep is also the time when previously learned is solidified into a memory.
In normal REM sleep, the limb muscles become temporarily paralyzed so that a person cannot act out dreams. In Parkinson’s disease as well as REM behavior disorder , people are able to flail and act out vivid and violent dreams. CBD at doses ranging from 75 to 300 mg was shown in a preliminary study to help these patients, and in an early case study, high-dose CBD helped a pediatric PTSD patient .
Low-dose CBD formulations seem to keep people awake and not alter the sleep cycle. However, this may one day prove beneficial for circadian rhythm disorders like excessive daytime sleepiness and narcolepsy because they may help people stay awake during daylight hours.
So, should you be using CBD for sleep?
Every individual’s body is unique, and therefore the effect of CBD will be highly individualized. Sulak explained that he would be open to using CBD in his own practice if a patient had not responded well to THC. Some patients are extraordinarily sensitive to THC and have symptoms during the night or still feel impaired in the morning. Sulak said he would likely select CBD strains that contained high levels of myrcene (luckily, there are plenty of options ).
Sulak said that CBD may offer benefit for people with sleep disturbances, and he feels it is important to move forward with pragmatically designed clinical trials, meaning a trial that does not provide every patient with the same exact treatment. Instead, an algorithm type approach would be used, starting with one treatment and moving to others if the previous ones are unsuccessful.
Sulak also stated that Americans are desperately in need of education on understanding sleep hygiene and the critical importance of sleep for health and happiness. “Most people don’t know that sleep disturbances are associated with decreased analgesic (pain-relieving effects) of opioids and antidepressant drugs, so it’s such a vicious cycle,” he said. “It’s wonderful to use cannabis to break that cycle,” Sulak said.
CBD is safe, even at high doses
Sulak said that he ensures his patients that CBD is extraordinarily safe, so if it is not effective at low to moderate doses of 10 to 50 mg, CBD is safe to try at higher doses of 100 to 200mg. In a 2018 study , single doses of 1,500 mg, 3,000 mg or 6,000 mg were administered to healthy subjects daily for six days. While the study was not aimed at researching CBD’s effects on sleep, it demonstrated that CBD is indeed safe.
However, it’s important to note that research has a long way to go in establishing drug interactions associated with cannabinoids. While CBD appears to be safe on its own, consider consulting a medical professional before adding CBD or other cannabis products to your regimen.
Despite the overall lack of CBD sleep studies, the National Academies of Sciences, Engineering and Medicine concluded in a 2017 report that moderate evidence exists for cannabinoids to improve short-term sleep outcomes in a variety of conditions. As more research is conducted, CBD may well benefit patients who have ailments like obstructive sleep apnea, fibromyalgia, chronic pain, and anxiety.
CBD Oil Keeps Me Awake At Night
In recent years, the use of marijuana and CBD for the treatment of a variety of conditions has risen significantly. Specifically, CBD has been found to have potential health benefits for symptoms like insomnia. Here’s a little background on what CBD is and how it impacts your sleep and body.
What Are Cannabinoids and CBD?
Cannabinoids are chemical compounds that bind or attach to certain receptors in the central nervous system and act as chemical messengers. Depending on the specific cannabinoid, it may have varied effects on the body.
The most well-known and probably most researched cannabinoids include cannabidiol (CBD) and tetrahydrocannabinol (THC). We know that THC is the cannabinoid that leads to the “buzz or high” from cannabis use.
CBD differs from THC and does not cause psychoactive effects or a “high.” Because it does not cause the psychoactive effects and it might help certain conditions, such as pain, anxiety, and insomnia, CBD is gaining traction as a possible treatment for several diseases.
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How Do CBD and Cannabinoids Work?
Not everything is completely understood about how cannabinoids (including CBD) work. What we do know from research is that CBD and cannabinoids interact with proteins and cells in the brain. A relatively newly discovered system may also hold some answers.
The Endocannabinoid System and Sleep
Researchers discovered that the endocannabinoid system plays a role in maintaining certain body functions, such as mood, appetite, sleep, and regulating circadian rhythms. Within the endocannabinoid system is a network of cannabinoid receptors in the brain and central nervous system.The two primary receptors identified are CB1 and CB2.
Cannabinoids attach to these cells and have various effects. As far as how they may affect sleep, some research indicates that the cannabinoid CBD may interact with specific receptors, potentially affecting the sleep/wake cycle.
Additionally, CBD may also decrease anxiety and pain, which can both interfere with restful sleep. By reducing certain symptoms, it’s also possible that sleep may improve.
What Does the Research Say About CBD?
Although more studies need to be performed, some research supports the theory that CBD and cannabinoids may improve sleep. This study published in the journal, Medicines, involved 409 people with insomnia. Data was collected from June 2016 to May 2018. Participants rated their symptoms of insomnia on a scale of 1 to 10 with 10 being the most severe. Starting symptoms were rated 6.6 on average.
The participants were treated using the cannabis flower with varied combustion methods including vape, pipe, and joint. THC potency on average was 20 percent and limited to 30 percent. CBD potency was on average 5.7 percent and limited to 30 percent. After using cannabis, participants rated symptoms on average to be 2.2, which was a decrease of 4.5.
The results indicated the cannabinoids in cannabis decreased symptoms of insomnia. But the study involved using the cannabis flower, which contains several cannabinoids. It’s difficult to determine if relief from insomnia was due to CBD or another cannabinoid.
In another study published in the Permanente Journal, 72 adults with anxiety and poor sleep were involved. The participants completed anxiety and sleep assessments at the start of the study and at the first-month follow up. Study participants were given 25 mg of CBD in capsule form. Those that predominantly had sleep complaints took the dose in the evening. Participants that had anxiety as their predominant complaint took CBD in the morning.
After the first month, anxiety scores decreased in 79 percent of the people. Sleep scores improved in 66 percent of the participants, which indicated less trouble sleeping. The results suggest that CBD decreased sleep difficulties in many of the participants. But while the decrease in anxiety symptoms remained steady for the duration of the study, the sleep scores fluctuated over time.
Several smaller studies have also supported the use of CBD oil to improve sleep. For example, a case study involving a 10-year-old girl with post-traumatic stress disorder and poor sleep was treated with CBD. A trial of 25 mg of a CBD supplement was administered at bedtime. An additional 6 to 12 mg of CBD was given via a sublingual spray during the day for anxiety. Sleep quantity and quality gradually improved over five months.
Though there is plenty of supporting evidence that shows CBD and cannabinoids can improve sleep, the results are not conclusive and more research needs to be done.
Forms of CBD
CBD is extracted from the cannabis plant and known as CBD oil. But it can be a little complicated. CBD may be extracted from either the marijuana or hemp plant, which are both strains of the Cannabis sativa plant. But they are harvested differently. Hemp comes from the seeds and stalks of the plant, which contains less THC than marijuana.
Because the THC content in CBD oil may vary, depending on the state it’s sold, there may be restrictions. For example, in some states, CBD oil is sold legally if all of the THC is removed. If CBD oil still contains THC or other cannabinoids, it may only be sold in states that have legalized marijuana use.
Depending on the laws in your state, you may need a doctor’s prescription for CBD oil. But laws continue to change quickly, so in the near future, it may be different.
CBD oil can be placed under the tongue. It may also be infused in different products including the following;
- Edibles: Various types of edibles infused with CBD oil are available including gummy bears, cakes, and cookies. Edibles usually list the concentration of CBD in milligrams.
- Vaporing: CBD extract can be used in a vaporizer or vape pen. As the extract heats up, it creates a vapor that is inhaled.
- Tinctures: CBD also comes in tinctures. A few drops of the liquid can be added to drinks.
CBD oil is available in different concentrations. Since research is ongoing, the exact dose to treat sleep issues may not be fully known. It might take some trial and error to determine what works best.
Because there are so many different ways to ingest CBD, there are tons of CBD products to choose from. If you aren’t sure where to start, here are the CBD products we recommend to try if you want to improve your sleep.
Overall, there is scientific research that supports the theory that there are CBD health benefits. While more research needs to be done, the use of CBD can potentially decrease your symptoms of insomnia and help you get more quality sleep. If you struggle with sleep issues, the best first step is to consult your doctor and learn more about causes and treatments.
Can CBD Improve Your Sleep? The Experts Weigh In
There are a lot of questions about this experimental sleep aid. Here’s what we know about CBD and sleep.
There are many proven strategies to better the quality of your sleep, such as leaning away from blue light and alcohol in the hours before you hop into bed, and opting for room-darkening curtains and keeping the temperature cool. But these days, more and more companies are marketing products that include a unique ingredient for better shuteye: CBD.
Used in everything from trendy lotions and lattes to massage oils, CBD — short for cannabidiol — is one of the most prominent chemical compounds found in the cannabis plant. While effects vary from person to person, research shows that CBD can have a calming effect on people.
Humans have been cultivating the cannabis plant since at least 4,000 B.C. Not surprisingly, we’ve developed various strains based on how the plant is used. Hemp is a cannabis plant that contains high levels of CBD and low levels of THC — or delta-9-tetrahydrocannabinol, the chemical compound that causes the “high” in cannabis plants. Marijuana, its psychoactive cousin, has low levels of CBD and high levels of THC.
Because of its THC levels and the resulting “high,” marijuana has far fewer uses than hemp. Every day, hemp is utilized in tens of thousands of ways, from rope and insulation to cooking oils, protein powders, and CBD products, which are often derived from hemp and are sometimes marketed as “THC-free.”
What the latest research says about CBD for sleep
CBD interacts with the body’s endocannabinoid system (ECS), a vast receptor system that’s constantly working to maintain homeostasis as we go throughout our day. On its quest to restore balance, the ECS influences nearly every system in the human body. CBD supports the ECS, helping it respond to imbalances in inflammation, brain health, pain, the stress response, and — you guessed it — the sleep-wake cycle.
CBD is biphasic, which means low doses and high doses can cause opposite effects. Those effects also vary from person to person. Whereas melatonin puts you in a state of calmness before sleep, CBD can make you feel alert when it’s taken in low or moderate doses. In higher doses, studies have associated CBD use with increased sleep. However, in one 3-month study where participants with anxiety took 25 mg to 50 mg of CBD, researchers found that sleep improvements decreased month over month.
Researchers are continuing to explore the complex dynamics between CBD and sleep. A recent study of persons suffering from Parkinson’s disease indicated that the cannabinoid was able to reduce REM (rapid eye movement) sleep disorders. A 2019 sleep-quality study found more patients experienced improved sleep than disrupted sleep when using CBD. But when it comes to CBD and sleep, most research backs the need for further study. (One current large-scale clinical study, for example, is exploring the impacts of CBD for patients with diagnosed insomnia.)
Since research is still relatively new, there is no guidance on CBD’s long-term efficacy.
Here are other considerations:
1. Be wary of extreme promises and CBD claims
Currently the Food and Drug Administration (FDA) has only approved one CBD product, and that’s for the treatment of seizures. The FDA is aware that some companies are marketing products containing CBD in ways that violate the Federal Food, Drug and Cosmetic Act and that may put the health and safety of consumers at risk, and it is monitoring unproven CBD claims around serious diseases and product contamination.
To feel more confident about your purchase, you can ask the brand for a certificate of analysis (COA), which lets you know if the product contains the amount of CBD advertised.
A COA will also list:
- how much CBD, THC, and other cannabinoids the product has
- potential contaminants, such as heavy metals, pesticides, or microbes
- which lab did the testing; make sure it’s a third-party lab
2. Effects will vary, based on your health
As with the 100+ other cannabinoids found in the cannabis plant, CBD can have different effects on different people. One study found that it can increase sleep duration for people with clinical conditions, while another published in Frontiers in Pharmacology found that CBD had zero impact on sleep in healthy volunteers.
Dr. Dustin Sulak, an integrative medicine physician based in Maine, has seen mixed results with patients who use CBD. “There’s a portion of people who take it before bed and sleep great, and then others who are not affected,” he says, adding that some research has found that CBD can actually keep individuals awake at night. “Like everything when it comes to cannabis, there’s a wide individual variability.”
3. Sleep issues stemming from anxiety and pain disorders may benefit from CBD
“For many people, their sleep issues may be rooted in anxiety,” says Dr. Chris Winter, sleep specialist and Sleep Advisor to Sleep.com. “It’s not that they can’t sleep, it’s that they’re scared that they cannot. That anxiety loop can make it such that people will take longer to fall asleep, and that’s where I can see CBD coming into play.”
One 2020 study found that individuals who took CBD for treatment for anxiety and depression reported less symptoms and an improvement in their ability to perform daily functions. The three-month study mentioned above also found sustained decrease in anxiety symptoms with use of CBD.
Studies show that pain, especially the anxiety around pain disrupting sleep, may be treated with CBD. One analysis concluded that CBD is effective for pain management, especially when inhaled.
Ways to use CBD
There are many methods for using CBD. Inhalation, sublingual, digestive, transdermal, topical, and intranasal are the delivery methods currently used for CBD products, and the one you choose can directly impact how quickly it enters your bloodstream — and how strongly you feel its effects.
You can use CBD through oral, inhaled, sublingual, transdermal, and topical forms such as:
- oils, sprays and tinctures for under the tongue
- nasal and mouth sprays
- pills and capsules
- juice for vape pens and vapes
- topical oils, lotions, patches, and bath bombs
- beverages, gummies, and other edibles
- transdermal patches
Since the FDA doesn’t regulate CBD, it can be hard to know if the product contains the amount advertised on the packaging. An analysis of CBD products online found that 26% of products has less CBD, while 43% had more. Some products were also found to include THC, which can be dangerous for children if accidentally consumed.
If you choose to purchase a CBD product, look for labels that identify the CBD isolate and indicate whether or not the product contains broad- or full-spectrum CBD. Then check the COA to identify the level of CBD and other chemicals in the product. If a product is labeled full-spectrum CBD, then it will have trace amounts of THC and the other cannabinoids found naturally in the cannabis plant.
Some CBD products are formulated with other ingredients that help with sleep, such as lavender and melatonin.
Risks and side effects of CBD
Although researchers are still exploring CBD’s long-term implications, its documented side effects are mild. When researchers looked at people who took 1,500mg daily, experts reported that the most common issues included tiredness, diarrhea, and changes in appetite/weight.
The Mayo Clinic reports additional symptoms such as dry mouth and drowsiness. The appearance of these symptoms may depend on how much CBD you’re taking and if CBD is interacting with any existing medications you’re already taking. Talk to a doctor before adding CBD to your bedside table.
Still, Sunak says that the risks associated with CBD use are quite low. “Because it’s typically so well tolerated, even into the triple digits in terms of milligrams, that offers room for individuals to experiment with products and see how it makes them feel, especially with sleep,” he says.
What is the bottom line on CBD?
A little fuzzy? We hear you.
If you want to completely avoid CBD, there are plenty of alternative, researched-backed supplements and techniques to try. For anxiety and stress, we love progressive muscle relaxation, essential oils, and journaling before bed. When it comes to pain and sleep, try heat compresses, massages, or switching up your pillows and mattress.
Additional reporting by Emily Hubbell
Emily Abbate is a freelance writer, certified trainer and run coach, and host of the podcast Hurdle. You can find her work in GQ, Shape, Runner’s World, and other health and fitness publications.