CBD for Insomnia - April 2024

Why Are People Turning to CBD for Insomnia?

The prevalence of insomnia in the general population ranges from 8 to 40%. While up to 30% of the population reports experiencing some symptoms of insomnia, another 8 to 10% suffers from chronic insomnia^[5].

Numerous studies showed how CBD may potentially help with sleep problems, such as insomnia and its symptoms.

A study on the effects of CBD on the sleep-wake cycle of rats indicated that CBD oil increased the duration of the pre-“deep sleep” phases while reducing rapid eye movement (REM) or the final phase of sleep in which dreaming occurs^[6].

A 2014 research on patients with Parkinson’s disease also showed that CBD improved the symptoms of RBD, an REM sleep behavior disorder associated with nightmares and poor sleep^[7]. 

Chronic insomnia is often closely linked to anxiety. People who have trouble staying asleep, or experience sleeplessness, are often anxious about aspects of their waking life or their poor sleep patterns^[8]. 

A 2019 case series in The Permanente Journal looked into CBD’s effects on sleep and anxiety. 

Research pointed out that CBD had a calming effect on the central nervous system and may help with neuropsychiatric disorders without the side effects of over-the-counter drugs or prescribed sleep medications^[9]. 

However, these results fluctuated over time, prompting researchers to suggest that people may achieve short-term results with CBD intake^[10]. 

How CBD Oil Works to Help with Insomnia

The endocannabinoid system (ECS) is responsible for keeping the body’s state of homeostasis, allowing proper enzyme action and cell function. It regulates sleep, pain sensation, metabolism, memory, mood, and appetite.

The ECS functions via its two central receptors, CB1 and CB2. These receptors connect with chemical messengers or endocannabinoids in the body and signal the ECS to perform its functions.

CB1 and CB2 receptors also bind with compounds from outside the body, called phytocannabinoids that are abundant in Cannabis sativa.

Two of the most well-studied phytocannabinoids are CBD and THC.

CBD (cannabidiol) is a natural compound derived from the cannabis plant. It has been linked to multiple health benefits, such as relief from pain and anxiety^[11]. 

Unlike marijuana, most CBD oils contain only trace amounts of THC (less than 0.3%). THC (tetrahydrocannabinol) is another well-known cannabinoid that produces psychoactive effects.

Endocannabinoids, through the CB1 receptor, regulate the stability of non-REM sleep^[12].

Studies on CBD and THC observed that both cannabinoids affect the ECS components involved in modulating the body’s circadian rhythm, including the promotion and maintenance of sleep.

Researchers attributed this modulation to both cannabinoids‘ relationships with CB1 and CB2 receptors^[13]. 

The Pros and Cons of CBD for Insomnia

The Pros

• In a 2014 research, it was observed that CBD improved RBD (REM sleep behavior disorder) symptoms^[14].
• Patients who took CBD reported better sleep and lower anxiety levels^[15]. 
• Findings indicated that CBD acts as a natural sleep aid without the side effects of prescribed sleep medications^[16]. 
• CBD showed promise in reducing sleep latency in insomniacs while promoting quality of sleep^[17].
• A study’s authors reported that CBD produced little to no side effects that can affect the subjects’ daytime activities^[18].
• CBD is generally a safe alternative to insomnia treatments. According to the World Health Organization (WHO), CBD “is generally well-tolerated with a good safety profile^[19].”
• The National Institute on Drug Abuse (NIDA) classified CBD as “non-addictive^[20].”

The Cons

• Research suggested CBD’s limitation as a long-term insomnia treatment.
• Studies on CBD’s efficacy as a treatment for medical conditions, such as insomnia, are still limited.
• The US Food and Drug Administration (FDA) has yet to approve the use of CBD on insomnia. Hemp-derived CBD products with less than 0.3% THC are legal under federal laws. However, CBD is still illegal in some state laws.
• Side effects of CBD may include diarrhea, dry mouth, reduced appetite, fatigue, and drowsiness^[21].
• CBD may adversely interact with select medications^[22].

CBD and Alternative Treatments for Insomnia

There are alternative and holistic treatments an individual may try to help with insomnia. 

Some studies suggested that herbal supplements, like valerian root, may help with the onset of sleep and sleep maintenance^[23]. 

Chamomile is another alternative treatment for insomnia. The FDA has considered this herb as safe without known adverse effects^[24]. 

A study also reported that a mixture of essential oils, like lavender, reduced sleep disturbances and increased well-being in older adults^[25].

Melatonin is a hormone regulating the sleep-wake cycle and other circadian rhythms^[26]. It may be used as a supplement to help individuals fall asleep more quickly.

CBD oil also showed the potential to relieve symptoms of insomnia^[27]. Some CBD teas or topicals contain chamomile and lavender to produce calming and relaxing effects.

Several CBD gummies and capsules are also infused with melatonin to promote restful sleep. 

CBD Dosage for Insomnia 

CBD dosage varies from person to person. It depends on different factors, including age, height, weight, and genetics.

It is recommended to look at the label for the potency or concentration of the CBD product before using it. The CBD concentration is the amount of CBD per container, while the potency is the amount of CBD per serving. 

First-time CBD users are advised to start with low daily doses of CBD, between 1mg CBD per kilogram of the user’s body weight to 50mg CBD per kilogram of body weight (< 1mg/kg to 50mg/kg per day)^[28]. 

Once the body gets used to CBD, the dosage can be gradually increased. 

How to Take CBD for Insomnia

CBD oils may be taken as tinctures, capsules, gummies, topicals, or vapes. 

CBD tinctures are taken sublingually by using a dropper to place the oil under the tongue. The oil tincture can also be added to food and drinks. However, it may affect CBD absorption.

CBD capsules are recommended for those who want precise CBD dosage. These supplements are sometimes formulated with ingredients like melatonin to act as a natural sleep aid.

CBD may also be consumed through edibles, such as CBD gummies or mints. In these forms, CBD may take a while to kick in, so it is best to take an edible around 30 minutes before bedtime^[29]. 

Some CBD gummies are also infused with melatonin to support a good night’s sleep. However, be wary of products containing added sugar, which may make it difficult to fall asleep. 

Topicals are applied directly to the skin. These CBD products are often mixed with essential oils to promote calmness, relaxation, and better sleep. 

Lastly, vaping provides faster effects and better absorption of CBD into the body^[30]. However, it was found that vape use may cause several lung diseases and injuries^[31]. 

Conclusion

CBD showed potential in reducing sleep latency and improving the sleep quality of people with sleep disorders, such as insomnia and RBD (REM sleep behavior disorder). 

Although there is significant research suggesting how CBD may improve sleep and relieve insomnia symptoms, the results are not conclusive. 

It is recommended to consult a medical professional to talk about the severity of insomnia symptoms before taking CBD products or other sleep-inducing supplements. 

CBD is not approved by the FDA to treat, cure, or mitigate any sleep disorder or disease other than certain rare childhood seizures. Always consult your doctor for personal advice.

1. Gates, P. J., Albertella, L., & Copeland, J. (2014). The effects of cannabinoid administration on sleep: a systematic review of human studies. Sleep medicine reviews, 18(6), 477-487.
2. Murillo-Rodriguez, E., Blanco-Centurion, C., Sanchez, C., Daniele, P., & Shiromani, P. J. (2003). Anandamide enhances extracellular levels of adenosine and induces sleep: an in vivo microdialysis study. Sleep, 26(8), 943-947.
3. Shannon, S., Lewis, N., Lee, H., & Hughes, S. (2019). Cannabidiol in anxiety and sleep: a large case series. The Permanente Journal, 23.
4. Suraev, Anastasia, Ronald R Grunstein, Nathaniel S Marshall, Angela L D’rozario, Christopher J Gordon, Delwyn J Bartlett, Keith Wong, et al. “Cannabidiol (CBD) and Δ9-Tetrahydrocannabinol (THC) for Chronic Insomnia Disorder (‘CANSLEEP’ Trial): Protocol for a Randomised, Placebo-Controlled, Double-Blinded, Proof-of-Concept Trial.” BMJ Open 10, no. 5 (2020). https://doi.org/10.1136/bmjopen-2019-034421.
5. Fernandez-Mendoza, Julio, and Alexandros N. Vgontzas. “Insomnia and Its Impact on Physical and Mental Health.” Current Psychiatry Reports 15, no. 12 (2013). https://doi.org/10.1007/s11920-013-0418-8.
6. Chagas, M. H. N., Crippa, J. A. S., Zuardi, A. W., Hallak, J. E., Machado-de-Sousa, J. P., Hirotsu, C., … & Andersen, M. L. (2013). Effects of acute systemic administration of cannabidiol on sleep-wake cycle in rats. Journal of Psychopharmacology, 27(3), 312-316.
7. Chagas, M. H., Eckeli, A. L., Zuardi, A. W., Pena‐Pereira, M. A., Sobreira‐Neto, M. A., Sobreira, E. T., … & Tumas, V. (2014). Cannabidiol can improve complex sleep‐related behaviours associated with rapid eye movement sleep behaviour disorder in Parkinson’s disease patients: a case series. Journal of clinical pharmacy and therapeutics, 39(5), 564-566.
8. Molen, Y. F., Carvalho, L. B. C., Prado, L. B. F. D., & Prado, G. F. D. (2014). Insomnia: psychological and neurobiological aspects and non-pharmacological treatments. Arquivos de neuro-psiquiatria, 72(1), 63-71.
9. Ibid.
10. Ibid.
11. De Gregorio, D., McLaughlin, R. J., Posa, L., Ochoa-Sanchez, R., Enns, J., Lopez-Canul, M., … & Gobbi, G. (2019). Cannabidiol modulates serotonergic transmission and reverses both allodynia and anxiety-like behavior in a model of neuropathic pain. Pain, 160(1), 136.
12. Pava, M. J., Makriyannis, A., & Lovinger, D. M. (2016). Endocannabinoid signaling regulates sleep stability. PloS one, 11(3), e0152473.
13. Ibid.
14. Ibid.
15. Ibid.
16. Ibid.
17. Ibid.
18. Carlini, E. A. (1981). Cunha. JA, Hypnotic and anti-epileptic effects of CBD. Journal of Clinical Pharmacology, 21, 4178-4278.
19. World Health Organization (WHO). (2018). Cannabidiol (CBD) Critical Review Report. https://www.who.int/medicines/access/controlled-substances/CannabidiolCriticalReview.pdf
20. NIDA. Researching Marijuana for Therapeutic Purposes: The Potential Promise of Cannabidiol (CBD). National Institute on Drug Abuse website. https://www.drugabuse.gov/about-nida/noras-blog/2015/07/researching-marijuana-therapeutic-purposes-potential-promise-cannabidiol-cbd. July 20, 2015. Accessed July 21, 2020.
21. Machado Bergamaschi, M., Helena Costa Queiroz, R., Waldo Zuardi, A., & Crippa, A. S. (2011). Safety and side effects of cannabidiol, a Cannabis sativa constituent. Current drug safety, 6(4), 237-249.
22. Brown, J. D., & Winterstein, A. G. (2019). Potential adverse drug events and drug–drug interactions with medical and consumer cannabidiol (CBD) use. Journal of clinical medicine, 8(7), 989.
23. Bent, S., Padula, A., Moore, D., Patterson, M., & Mehling, W. (2006). Valerian for sleep: a systematic review and meta-analysis. The American journal of medicine, 119(12), 1005-1012.
24. Srivastava, J. K., Shankar, E., & Gupta, S. (2010). Chamomile: a herbal medicine of the past with a bright future. Molecular medicine reports, 3(6), 895-901.
25. Chien, L. W., Cheng, S. L., & Liu, C. F. (2012). The effect of lavender aromatherapy on autonomic nervous system in midlife women with insomnia. Evidence-based complementary and alternative medicine, 2012.
26. Cagnacci, A., Elliott, J. A., & Yen, S. S. (1992). Melatonin: a major regulator of the circadian rhythm of core temperature in humans. The Journal of Clinical Endocrinology & Metabolism, 75(2), 447-452.
27. Cao, H., Pan, X., Li, H., & Liu, J. (2009). Acupuncture for treatment of insomnia: a systematic review of randomized controlled trials. The journal of alternative and complementary medicine, 15(11), 1171-1186.
28. Millar, S. A., Stone, N. L., Bellman, Z. D., Yates, A. S., England, T. J., & O’Sullivan, S. E. (2019). A systematic review of cannabidiol dosing in clinical populations. British journal of clinical pharmacology, 85(9), 1888–1900. https://doi.org/10.1111/bcp.14038
29. Paudel, K. S., Hammell, D. C., Agu, R. U., Valiveti, S., & Stinchcomb, A. L. (2010). Cannabidiol bioavailability after nasal and transdermal application: effect of permeation enhancers. Drug development and industrial pharmacy, 36(9), 1088-1097. https://doi.org/10.3109/03639041003657295 
30. Ibid.
31.  Broderick, S. (2020). What Does Vaping Do to Your Lungs? Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/wellness-and-prevention/what-does-vaping-do-to-your-lung