CBD for Sleep, Is It Effective? The Latest Research [Includes Q&A with Dr. Patel]

cbd for sleep
michel moninger

Written by Michel Moninger

Published November 3, 2020

Medically Reviewed by Dr. Rachna Patel

Sleep is one of the most often overlooked aspects of life. Even with a healthy diet and a regular schedule of exercise, you can still find your life full of pain and stress when you aren’t getting enough sleep.

In fact, a recent study referred to sleep insufficiency as “a public health epidemic that is often unrecognized, under-reported, and that has rather high economic costs”1 (Chattu et al., 2018, 1). Obviously, sleep disturbances affect many today and can have far-reaching effects. 

There is a number of possible tools that can help overcome sleeping difficulties. Emerging research seems to indicate that CBD could be a viable tool in promoting restful sleep and improvement of sleep disturbances.

But is CBD for sleep a practical tool?

It should be noted that at this time there are no FDA-approved treatments using CBD for sleep deprivation or insomnia. However, as research continues, this may likely change soon.

The term “sleep disturbances” covers a wide range of conditions, each presenting their own challenge.

One reference work defined them this way. “Sleep disturbances encompass disorders of initiating and maintaining sleep (DIMS, insomnias), disorders of excessive somnolence (DOES), disorders of sleep-wake schedule, and dysfunctions associated with sleep, sleep stages, or partial arousals (parasomnias)”2 (Walker et al., 1990, 77). Put simply, you can have trouble falling asleep, staying asleep, sleeping too much, sleeping at the wrong time, or trouble with having a restful night’s sleep.   

The cause of these problems varies greatly. For some, the underlying issue is hormonal in nature. An imbalance in certain hormones can throw off the sleep-wake cycle and circadian rhythms. This can lead to difficulty staying awake during the day, falling asleep at night, and staying asleep through the night.

For others, the primary cause can be an environment or learned behaviors. Extended use of electronics, working late hours, drinking caffeinated beverages, or staying active late into the night can contribute to difficulty falling asleep. Some sleep problems have even been linked to heredity (Sehgal & Mignot, 2011, 194). Therefore, it is difficult to tout one solution as a “cure-all” for all sleeping problems.

Some common solutions to sleeping disturbances include prescription and over-the-counter medications, lifestyle changes, herbal supplements, and many more natural sleep remedies.

While some of these have proven to be successful in treating one or more sleeping disorders, there is still much to be learned about sleep. One research article was so moved by the complexity of sleep and sleeping disorders to plainly state, “Sleep remains one of the least understood phenomena in biology”3 (Sehgal & Mignot, 2011, 194).

Many claims that these steps are either inefficient or cause numerous side effects. For example, side-effects of some common sleeping medications include decreased cognitive ability, decreased coordination, dizziness, stomach pains, increased risk of injury, and more4 (Fitzgerald & Vietri, 2015). Other potential cures include things like meditation, lifestyle adaptation, and exercise.

While research continues in the full effectiveness of these methods, many who have tried it find it to be insufficient for serious sleeping disturbances.

How Sleep Disorders are Treated

There is a number of readily available treatments for sleeping disorders. These range from natural remedies for sleep to medications that might even need a doctor’s prescription to access.

As with any treatment, you should talk to your doctor before beginning and closely monitor your personal reaction.

One of the primary methods currently used to treat insomnia and other sleep disorders is sleep medication. These medications can work through a number of different mechanisms. Most sleep medications work to actively sedate you, forcing your body to enter a sleep state.

While this is effective in actually falling asleep, it can have long-lasting negative effects, including fatigue, drowsiness, difficulty with memory and concentration, and much more4 (Fitzgerald & Vietri, 2015). These after-effects can make a serious impact on the quality of one’s life, even more than not sleeping.

Other approaches to dealing with sleep disorders are less invasive and rely more on the human body’s existing structures and mechanisms to assist. Some use mindfulness and meditation to improve sleep quality5 (Black et al., 2015, 494).

In one study, mindfulness techniques were provided to participants as a key tool for managing sleep disturbances. Those who utilized mindful meditation techniques demonstrated improved quality of sleep and a decrease in sleeping disorders as opposed to those who were simply offered education on the biology of sleep and lifestyle modifications.

Eliminating environmental disturbances proved to be helpful, but these techniques were less effective than specialized meditation.

There are also times that a sleep disorder is present, but secondary to other medical conditions. 

For example, people who suffer from chronic pain tend to have difficulty sleeping. Certain environmental allergic reactions can make it difficult to fall asleep or stay asleep.

Some people have difficulty sleeping as a result of sleep apnea, a breathing condition that is triggered at night.

Each of these conditions stems from a different cause and therefore will have a different solution, whether through medication, environmental change, or even the use of medical equipment.

Of course, there are some conditions that may not be resolved through meditation or medication.

Each individual reacts differently to different treatment approaches. What works for one person may not work for another. What has worked for one person in the past may not necessarily work for them again in the future.

Because of that, it is important to be knowledgeable and educated on available options for treatment.

How CBD Oil for Sleep can Help

In recent years, interest in CBD for sleep and in general has grown significantly. Along with this public interest is an increase in research and high-quality studies into the effectiveness of CBD for various treatments.

At this time, the FDA has not approved CBD specifically for use as a sleep aid or in the treatment of sleeping disorders. However, recent studies and research indicate that this may be a promising tool in assisting with sleep disorders.

How exactly does CBD work to help with sleep? 

The exact function of CBD involves the body’s endocannabinoid system. This system is an internal structure that the body uses to manage certain neurotransmitters.

These transmitters, created within the body, are known as endogenous cannabinoids, or endocannabinoids6 (Lu & Mackie, 2015, 516-525). Endocannabinoids function very similarly to cannabinoids found in cannabis, including CBD and THC.

When these components are introduced into the body, they are able to coordinate with the endocannabinoid system and promote changes in the body’s hormone levels, physical state, and more. CBD in particular has been observed to reduce anxiety and stress7 (Grinspoon, 2020).

An important distinction must be made between CBD and THC. Both THC and CBD are derived from plants in the cannabis family and are being investigated for their potential uses as herbal remedies.

THC, however, is commonly known for its psychoactivity. THC is the component of cannabis that produces a euphoric “high” sensation. Therefore, it has been suggested that THC may in fact impair the quality of sleep on a long-term scale8 (Babson et al., 2017, 23).

CBD, on the other hand, is known for having a more calming effect on the body. Published research into the beneficial effects of CBD exclusively in the treatment of sleeping disorders is low but continues to grow.

That being said, CBD has more frequently been used to treat stress, PTSD, and epilepsy. In many of these studies, participants reported improved sleep9 (Kuhathasan et al., 2019, 383).

Although sleep is not always the primary outcome investigated in these studies, it is usually reported as a benefit associated with reduced stress, improved neurological functioning, or pain management.

One study focusing specifically on CBD for sleep was conducted recently involving 72 participants10 (Shannon et al., 2017, 23). In this study, all participants were provided with CBD as a treatment for anxiety and sleep disorders.

These participants ranged from 18-72 years of age and were mostly provided with CBD in capsule form at 25mg/d, with some provided with 50 or 75 mg/d. Dosages and continued use of CBD were closely monitored by doctors and adjusted as needed on a case-by-case basis.

As a group, overall anxiety and sleep disorder symptoms diminished over time through the use of CBD. After one month, about 66% of participants reported improvement in sleep due to CBD. A few participants noticed side effects and discontinued the use of CBD oil for sleep. 

In another study, participant data was collected over a much larger sample size11 (Vigil et al., 2018, 75). In this study, intake methods of CBD were varied and included vaporizing, capsules, pipe, and more.

Insomnia symptoms were measured by user-reported data on a scale of 1-10, with 1 being little to no symptoms and 10 being the most severe intensity level. On average, users indicated a change of -4.5 on a scale of 1-10 (a 6/10 lowering to a 2.5/10, 9/10 lowering to a 4.5/10). While many noticed negative side effects while utilizing CBD and other cannabinoids, nearly all found some improvement as indicated by noting at least one positive side-effect. 

This study, while sampling a larger group in a more natural environment, also allowed for a greater variation of the dosage, purity, and frequency of CBD usage, as well as the involvement of THC and other cannabinoids. 

All in all, studies have indicated that there may be a reason to believe that CBD can be helpful as an herbal remedy for sleep. Like any medication or other supplement, individual reactions can vary.

Personal preference, lifestyle, body chemistry, adherence to the regimen, and interactions with medications or other supplements can all impact the effectiveness and side effects of taking CBD for sleep.

Even treatments that have worked in the past may not continue to work as the body continues to grow and adapt to circumstances.

However, further investigation must be done. In addition, as CBD products are not currently regulated by the FDA as medication, personal research into the quality and dosage is needed.

Always research any new supplements for sleep or other conditions thoroughly before trying them. This article is not intended to serve as a medical guide. Talk to your physician before beginning any new natural sleep remedies or supplements for sleep.

As with any supplement, side effects to CBD may be present. Some reported side effects include dose-related liver damage, overall sedation and lethargy, change in thoughts and behavior, and potentially more12 (Meissner & Cascella, 2020).

As research continues to grow, we will better understand the potential adverse effects of CBD and the mechanism by which we can avoid these. If you notice a change in one of these areas or others, talk to your doctor about your CBD use. 

cbd school cbd for sleep

CBD for Sleep Q&A with Dr. Rachna Patel

What is the best CBD to THC ratio for sleep?

When it comes to selecting the appropriate ratio of CBD & THC, it boils down to the severity of sleep disturbance you’re experiencing. 

My patients who experience mild to moderate sleep disturbance – difficulty sleeping a couple of times a month to a couple of times a week – find high CBD products helpful, whether these CBD products are marijuana-based or hemp-based CBD products. 

The patients who experience severe insomnia – can’t sleep without the help of medication – on the other hand, find high THC products more beneficial. And these high levels of THC are most commonly available in the form of marijuana-based products. 

Which types of CBD products are best for treating sleep disorders?

The best method of administration varies by the type of difficulty a patient is experiencing. 

For example, someone who has trouble staying asleep would benefit the most from using an oral form of CBD, such as a CBD chocolate or CBD gummy. While folks struggling to fall asleep or experience frequent awakenings through the course of the night benefit from using a CBD vape pen. 

Selecting the appropriate method of administration boils down to how long it takes to take effect and how long the effect lasts.

What results have your patients experienced by using CBD for sleep disorders?

With sleep, the results my patients have experienced have been quite impressive. 

Patients have reported being able to fall asleep easily, stay asleep for a healthy 7 to 9 hours, fewer awakenings through the night, being able to fall back asleep should they experience awakenings, and most importantly, waking up feeling refreshed, not groggy. 

But it goes even beyond that. Getting a good night’s sleep has had a ripple effect on my patients. The benefits of a good night’s sleep from CBD has improved their emotional, mental, and physical wellbeing as well – from improved mood to reduced pain – overall improving the quality of their life. 

How much CBD should I take to help me sleep?

When it comes to figuring out how much CBD to use, it varies from person to person. 

As an example, I had 2 patients of similar body shape and size who both struggled with Insomnia and were otherwise healthy with no other medical problems.

They were on no prescription medications. They both used the exact same CBD product.

One patient needed 2.5 mg to sleep better and the other patient needed 50 mg of CBD to sleep better. And there you go – that’s a huge variation in milligrams of CBD needed from person to person! 

If your doctor doesn’t recommend a dosage, it’s best to start with a smaller amount and gradually increase it. This could mean starting with as little as 1mg a day.  If you need more, increase gradually until you hit your sweet spot and feel that it’s effectively helping you sleep.

Overall, you want to aim for the minimal effective dose. You don’t want to take too little, wherein the CBD product is not effective. But, you don’t want to take too much, wherein you start to experience the side effects of CBD.

Make sure you alert your physician first that you’re using CBD as CBD does have the potential to raise liver enzymes in very specific cases.

When should I take CBD to aid with sleep?

The most ideal time to consume CBD products for sleep is at nighttime. CBD products should always be taken on a full stomach. 

Also, remember you don’t have to take the CBD products on a daily basis to help with sleep. You want to aim for the minimal effective frequency.

Overall, there’s a common misconception that CBD products need to be taken on a daily basis. It’s only in rare instances that I have my patients take CBD products on a daily basis.

In fact, I tell them to take CBD products at most every other day. You can certainly take CBD products less than every other day. Many of my patients have, even when it comes to using CBD for sleep. 

Because CBD is fat-soluble, it gets stored in the fat cells in your body. And over a period of days, the CBD is slowly released into your bloodstream.

Can I take CBD with melatonin to help me sleep?

In the patients I’ve treated, none have reported any adverse drug to drug interactions when using CBD for sleep difficulties along with melatonin. Although truth be told that the vast majority of my patients usually stop using melatonin once they start using CBD products to help them sleep.

The CBD alone is effective in improving the quality of sleep. 

What are the possible side effects of taking CBD as a sleep aid?

The side effects of CBD are dose-dependent. Taking too low of a dose could have a stimulating rather than a sedating effect. And, taking too much CBD could cause fatigue, lethargy, or grogginess.

So, it’s incredibly important to take the amount of CBD that’s right for you, not the amount that’s right for Sally or Joe. 

Disclaimer: This article is in no way intended to serve as medical advice or replace the recommendations of your doctor. Talk to your doctor before pursuing any supplements or treatments. CBD and other cannabinoids are classified as food/dietary supplements, NOT as FDA-approved medications. We therefore cannot make any medical claims or give any medical advice concerning the healing powers of cannabis. This article is here to share the available literature on the subject. We can (and do) encourage you to research and try cannabis-based products as you see fit.

References

1Chattu, V. K., Manzar, M. D., Kumary, S., Burman, D., Spence, D. W., & Pandi-Perumal, S. R. (2018, Dec 20). The Global Problem of Insufficient Sleep and Its Serious Public Health Implications. Healthcare (Basel, Switzerland), 7(1), 1. 

2Walker, H. K., Hall, W. D., & Hurst, J. W. (Eds.). (1990). Clinical Methods: The History, Physical, and Laboratory Examinations (3rd ed.). Boston: Butterworths.

3Sehgal, A., & Mignot, E. (2011). Genetics of Sleep and Sleep disorders. Cell, 146(2), 194-207. 

4Fitzgerald, T., & Vietri, J. (2015, December 9). Residual Effects of Sleep Medications Are Commonly Reported and Associated with Impaired Patient-Reported Outcomes among Insomnia Patients in the United States (G. Pillar, Ed.). Sleep Disorders, 2015(607148).

5Black, D. S., O’Reilly, G. A., & Olmstead, R. (2015, Apr 1). Mindfulness Meditation and Improvement in Sleep Quality and Daytime Impairment Among Older Adults With Sleep Disturbances. JAMA Internal Medicine, 175(4), 494-501.

6Lu, H.-C., & Mackie, K. (2015, Oct 30). An introduction to the endogenous cannabinoid system. Biological Psychiatry, 79(7), 516-525.

7Grinspoon, P. (2020, Apr 15). Cannabidiol (CBD) — what we know and what we don’t. Harvard Health Publishing. Retrieved Oct 24, 2020, from https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476

8Babson, K. A., Sottile, J., & Morabito, D. (2017, Apr). Cannabis, Cannabinoids, and Sleep: a Review of the Literature. Current psychiatry reports, 19(4), 23.

9Kuhathasan, N., Dufort, A., MacKillop, J., Gottschalk, R., Minuzzi, L., & Frey, B. N. (2019, May 23). The use of cannabinoids for sleep: A critical review on clinical trials. Experimental and clinical psychopharmacology, 27(4), 383-401. 

10Shannon, S., Lewis, N., Lee, H., & Hughes, S. (2017, Jan 7). Cannabidiol in Anxiety and Sleep: A Large Case Series. The Permanente Journal, 23, 18-041.

11Vigil, J. M., Stith, S. S., Diviant, J. P., Brockelman, F., Keeling, K., & Hall, B. (2018, Jul 11). Effectiveness of Raw, Natural Medical Cannabis Flower for Treating Insomnia under Naturalistic Conditions. Medicines (Basel), 5(3), 75.

12Meissner, H., & Cascella, M. (2020). Cannabidiol (CBD). In StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.

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