- A 2019 experiment demonstrated how adults experienced sedative effects after taking cannabidiol (CBD)(1).
- The Anxiety and Depression Association of America (ADAA) mentioned how anxiety could lead to sleep issues(2). A study has shown how CBD reduced the anxiety of 79% of human subjects(3).
- A 2019 study concluded that CBD helped improve sleep quality among 71.4% of patients with autism spectrum disorder (ASD)(4). The Journal of Clinical Pharmacy and Therapeutics shared a study that described how four patients treated with CBD has reduced the frequency of REM sleep behavior disorder (RBD) events(5).
- Another study discovered that CBD activity in the endocannabinoid system might have neuroprotective, antidepressive, and anxiolytic benefits(6).
CBD for Sleep
CBD Oil vs. Sleep Disorders
The human sleep cycle comprises four stages of non-rapid eye movement (NREM) sleep and rapid eye movement (REM) sleep. The first three stages are NREM sleep, followed by the fourth stage, REM sleep.
A good night’s sleep or a healthy sleep cycle experiences all four stages of sleep. NREM stages account for 75% to 80% of sleep time, while REM accounts for 20% to 25% of sleep time(7).
An individual with insomnia may have trouble sleeping and maintaining a regular sleep-wake cycle. Some may even have difficulty getting to the first two stages of sleep.
The disruption of this cycle may lead to many health issues, such as hypoxemia (low oxygen) and dyspnea (shortness of breath), pain conditions, and neurodegenerative diseases(8).
A 2017 study published in Current Psychiatry Reports mentioned that CBD might have therapeutic potential for treating insomnia and other poor sleep conditions. The study continued by acknowledging that CBD may hold promise for excessive daytime sleepiness and REM-sleep behavior disorder(9).
A crossover study compared CBD with nitrazepam (a hypnotic drug). The authors found that a dose of 160 mg of CBD increased sleep duration among human subjects(10).
REM-sleep behavior disorder (RBD), a parasomnia, is defined by undesired events during sleep. Parasomnias are disruptive sleep disorders.
An individual may suddenly wake between stages two to four in the sleep cycle. This condition often involves confusional arousal (disorientation of time and place), sleep terrors, loss of muscle atonia, and sleepwalking(11).
RBD is prevalent among men over 50 years old and among patients with Parkinson’s disease. A study described the beneficial effects of CBD in reducing RBD symptoms among patients with Parkinson’s(12).
Researchers treated four patients with CBD during the study, which resulted in the reduced frequency of RBD-related events. Upon discontinuation of the treatment, RBD complex movements and symptoms returned(13).
The study stated that although positive results have been observed among patients, the mechanism of therapeutic action remains unknown. More research is needed to confirm the efficacy and implications of CBD.
CBD Oil vs. Anxiety-Related Sleep Disorders
Post-traumatic stress disorder (PTSD) develops after a traumatic event. PTSD is frequently associated with night terrors and disturbed sleep(14).
A study posted in the Journal of Alternative and Complementary Medicine has demonstrated how CBD treatment (of over two months) decreased the severity of PTSD symptoms in healthy human subjects. The study showed examples of how CBD dosage of 12mg and 32mg have decreased anxiety symptoms and sleep disturbances in patients(15).
Another study found that out of 72 subject patients with anxiety, 57 experienced improvements during the first month of taking CBD(16).
The Frontiers of Pharmacology also published a recent study that experimented on how CBD affects children with autism spectrum disorder (ASD). Children with ASD often suffer from comorbidity of symptoms, including anxiety and sleep disorder.
Parents have reported that CBD may have improved ASD symptoms. Among the 53 children (ages 4-22 years old), sleep problems improved in 71.4% and worsened in 4.7%, while anxiety improved in 47.1% and worsened in 23.5%(17).
CBD Oil vs. Restless Leg Syndrome
Restless Leg Syndrome (RLS) is a neurological disorder wherein the individual feels pain or discomfort when the legs are at rest. Moving the legs or walking may temporarily relieve the pain.
A recent study posted in Sleeping & Breathing discussed the potential benefit of cannabis use among patients presenting with refractory RLS. The study added that patients had reported total remission of RLS symptoms following cannabis use(18).
The author proposed more clinical trials to study the effect and implications of cannabis use for RLS symptoms.
How CBD Oil Works to Help With Sleep
The endocannabinoid system (ECS) is made of G-protein receptors located throughout the human body, such as cannabinoid receptor one (CB1) and cannabinoid receptor two (CB2).
These receptors are found mostly in the central nervous system, the immune system, and the peripheral nervous system.
It has been mentioned in a study from Pharmacological Reviews that modulating the ECS might lead to therapeutic promises in a wide range of conditions and diseases(19).
A review posted in Elsevier discussed the role of the CB1 receptor in the regulation of sleep. The author mentioned how the localization of the CB1 receptor in sleep-inducing areas might be a potential mechanism for sleep promotion(20).
According to a study, CBD activity on G-protein receptors might drive its neuroprotective, antidepressive, and anxiolytic benefits(21).
Moreover, a study released in Current Neuropharmacology discussed how CBD microinjections into the lateral hypothalamus (next to the pituitary gland) led to the enhancement of dopamine to increase wakefulness during daylight hours(22).
The endocannabinoid system modulates pain signals in the body. The cannabinoid receptors may be found in pain circuits (from sensory nerve endings to the brain)(23).
Clinical trials seemed to indicate that the compounds of hemp plants (Cannabis sativa), such as CBD and THC, may be promising treatments for difficult to treat painful conditions(24).
Risks of CBD
Although legal in the United States, CBD remains highly unregulated. Individuals are encouraged to research which brands are safe and legitimate.
CBD may present a few side effects, such as dry mouth, diarrhea, sleepiness, drowsiness, and reduced appetite(25).
Another study published in Molecules discovered that extremely high doses of CBD might cause liver injury(26).
It is also not advisable to take CBD in conjunction with other medications. Individuals must first consult with a licensed physician before taking CBD, which might create an interaction with pharmaceutical drugs.
There are many different hypotheses on CBD’s potential effects on sleep. Some studies said that CBD might induce wakefulness, while other studies suggested CBD might cause sleepiness(27-28). Generally, higher amounts of CBD cause sedation.
CBD vs. Other Alternative Sleep Aids
Melatonin is a popular sleep aid that is marketed as a dietary supplement. Melatonin is a natural hormone in the brain responsible for the body’s sleep response to darkness. The body’s ability to produce melatonin is crucial in maintaining the circadian rhythm.
Although highly marketed, melatonin has produced conflicting results in clinical studies(29).
The American Academy of Sleep Medicine did not include melatonin in the list of treatments for insomnia, although they’ve acknowledged that the dietary supplement produced better results compared to placebo(30).
CBD is considered a natural alternative approach in treating insomnia. Like melatonin, CBD’s health benefits with regards to insomnia remain a hypothesis.
Around 40% to 80% of individuals with autism spectrum disorder (ASD) may present with sleep problems. In 2019, doctors conducted an experiment on children and adolescents with ASD. They have found that melatonin improved sleep problems in 60% of the patients, while CBD improved sleep in 71.4% of the patients(31-32).
Chamomile tea is another alternative treatment for insomnia. The traditional herb has been a staple among wellness enthusiasts. However, there is a lack of study on chamomile’s effectiveness in treating insomnia.
CBD teas are also recommended for individuals who wish to widen their options and achieve overall wellness.
Cannabinoids and CBD
Cannabinoids are naturally occurring compounds present in the cannabis plant. According to research, the cannabis plant contains roughly 80 to 100 cannabinoids and 300 non-cannabinoid compounds(33).
Cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC) are two of the main cannabinoids in the cannabis plant. CBD is non-psychoactive, while THC is the main psychoactive compound of the plant.
Other cannabinoids present in the cannabis plant include cannabinol (CBN), cannabigerol (CBG), and cannabidiolic acid (CBDA).
CBD has gained popularity over the years after medical researchers found that it possesses medicinal properties.
Research posted on the National Institutes of Health (NIH) website discussed that CBD had analgesic properties and helped treat chronic pain in adults(34). Another research found that CBD might help improve the health of patients with panic disorder, obsessive-compulsive disorder (OCD), social anxiety disorder, and post-traumatic stress disorder (PTSD)(35).
Meanwhile, a 2016 study concluded that CBD helped reduce pain and inflammation in arthritis patients(36).
Another research discovered that CBD might help prevent seizures in animals(37).
Some CBD brands infuse their CBD products with terpenes and flavonoids. CBD brands provide CBD in the forms of gummies, tinctures, hemp extracts, vapes, and hemp oils.
Most brands also offer their CBD gummies or CBD tinctures in various flavors to attract more customers.
Individuals looking for joint or muscle pain relief may opt for a transdermal approach, such as CBD topicals, CBD creams, CBD lotions, or CBD patches.
CBD brands use different extraction methods to extract CBD from industrial hemp plants. Some brands use solvent-based extraction methods, while others use the Supercritical Fluid Extraction (SFE) or the CO2 extraction process.
Most CBD brands offer high-quality CBD products in three forms: whole-plant or full-spectrum CBD, broad-spectrum CBD, and CBD isolate.
Full-spectrum CBD or whole-plant CBD contains the full chemical profile of the raw hem plant material. Full-spectrum hemp products contain various phytocannabinoids, including CBD and THC.
Other compounds retained in whole-plant CBD products include terpenes, flavonoids, and fatty acids.
Most customers purchase full-spectrum CBD extracts for the “entourage effect,” an effect caused by the cannabis compounds working synergistically with each other for better results.
Meanwhile, broad-spectrum CBD contains various cannabinoid compounds from hemp plants. However, it is different from full-spectrum hemp extracts because THC is removed from broad-spectrum CBD products.
CBD vs. Marijuana
Marijuana defines the flowers of cannabis plants derived from strains high in cannabinoids, especially THC. Meanwhile, the term hemp is the fibrous, seed-bearing plants that possess a high amount of CBD.
To avoid confusion between CBD and marijuana, remember that marijuana is a cannabis plant harvested for its high THC content. Meanwhile, CBD is a non-psychoactive cannabinoid usually derived from hemp plants.
Although hemp and marijuana are both cannabis species, they are genetically different. Hemp plants are rich in CBD, while marijuana plants are rich in THC.
Is CBD Safe?
Some CBD brands use organic and non-genetically modified organism (non-GMO) ingredients to ensure product safety. Some brands also have gluten-free or vegan options.
Most brands also offer CBD oils with measured droppers for accurate and safe dosing.
CBD brands rely on third-party testing to gain the confidence of customers. With third-party lab tests, customers may be informed whether the products are free from contaminants, including pesticides, additives, and residual solvents.
However, CBD is still unregulated by the US Food and Drug Administration (FDA). Under FDA regulations, CBD companies are not allowed to make health claims or sell CBD as a food supplement.
Currently, there is only one pharmaceutical drug that contains CBD. Epidiolex is the first FDA-approved CBD drug used to treat rare forms of epilepsy(38).
Is CBD Legal?
Derived from agricultural or industrial hemp, CBD is legal at the federal level in the US under the 2018 Farm Bill(39).
Manufacturers are allowed to transport, produce, and sell CBD as long as the concentration contains 0.3% or lower THC levels.
However, it is recommended to read up on state laws before purchasing CBD products. CBD is still illegal under state laws in Idaho and South Dakota as of 2020(40).
Studies have shown that CBD might hold therapeutic benefits in achieving restful sleep by improving mental health, such as reducing anxiety and PTSD symptoms among human subjects(41-42).
Existing studies have shown promising results. However, more studies are needed to confirm CBD’s effectiveness in achieving better natural sleep.
Experts advise that whatever treatments or medications have been chosen, a good sleeping habit is still essential in achieving a healthy circadian rhythm and better sleep pattern.
- Maintain a healthy sleep schedule.
- Stay active by exercising, doing yoga, hiking, or bicycling.
- Avoid or limit caffeine, alcohol, and nicotine use.
- Avoid large meals before bedtime.
- Do not drink too much before bedtime.
- Avoid naps.
- If one is experiencing pain, do not tolerate it. Consult a medical professional about getting proper medication for the pain.
Individuals are advised to consult with a licensed physician before taking CBD into their daily regimen. Interested buyers may also read up on the published research about CBD on NIH’s PubMed Central (PMC) or National Center for Biotechnology Information website, www.ncbi.nlm.nih.gov.
- Shannon, S., Lewis, N., Lee, H., & Hughes, S. (2019). Cannabidiol in Anxiety and Sleep: A Large Case Series. The Permanente Journal, 23, 18–041. https://doi.org/10.7812/TPP/18-041
- Anxiety and Depression Association of America. Sleep Disorders. Retrieved from https://adaa.org/understanding-anxiety/related-illnesses/sleep-disorders
- Shannon, S (2019)., Op cit.
- Barchel, D., Stolar, O., De-Haan, T., Ziv-Baran, T., Saban, N., Fuchs, D. O., Koren, G., & Berkovitch, M. (2019). Oral Cannabidiol Use in Children With Autism Spectrum Disorder to Treat Related Symptoms and Co-morbidities. Frontiers in pharmacology, 9, 1521. https://doi.org/10.3389/fphar.2018.01521
- M. H. N. Chagas MD PhD, A. L. Eckeli MD PhD, A. W. Zuardi MD PhD, M. A. Pena-Pereira MD, M. A. Sobreira-Neto MD, E. T. Sobreira PhD, M. R. Camilo MD, M. M. Bergamaschi PhD, C. H. Schenck MD, J. E. C. Hallak MD PhD, V. Tumas MD PhD and J. A. S. Crippa MD PhD., (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. https://doi.org/10.1111/jcpt.12179
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- The Mayo Clinic. Sleep Disorders Overview. Retrieved from https://www.mayoclinic.org/diseases-conditions/sleep-disorders/symptoms-causes/syc-20354018
- Institute of Medicine (US) Committee on Sleep Medicine and Research; Colten HR, Altevogt BM, editors. Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. Washington (DC): National Academies Press (US); 2006. 2, Sleep Physiology. Available from: https://www.ncbi.nlm.nih.gov/books/NBK19956/
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- Minnesota Department of Health. (2017) Medical Cannabis Program to Add Autism and Obstructive Sleep Apnea as Qualifying Conditions. Retrieved from https://www.health.state.mn.us/news/pressrel/2017/cannabis113017.html
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- Kogan, R., Schoenfeld-Tacher, R., Hellyer, P., & Rishniw, M. (2018) US Veterinarians’ Knowledge, Experience, and Perception Regarding the Use of Cannabidiol for Canine Medical Conditions. Frontiers in Veterinary Science, 5: 338. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6338022/
- FDA Approves First Drug Comprised of an Active Ingredient Derived from Marijuana to Treat Rare, Severe Forms of Epilepsy. Retrieved from https://www.fda.gov/news-events/press-announcements/fda-approves-first-drug-comprised-active-ingredient-derived-marijuana-treat-rare-severe-forms
- The 2018 United States Farm Bill. Retrieved from https://www.usda.gov/farmbill
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- Elms, L., (2019)., Op cit.