How Does CBD Oil Help With Sleep?
- A 2019 experiment demonstrated how adults experienced sedative effects after taking cannabidiol (CBD) (1).
- ADAA (Anxiety and Depression Association of America) mentioned how anxiety could lead to sleeping problems (2). A study has shown how CBD reduced the anxiety of 79% of human subjects (3).
- A 2019 study has shown that CBD was reported to improve sleep issues 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).
- A study published in FEBS Letters has found that CBD modulated sleep cycles among animal subjects. The authors mentioned how CBD might have therapeutic value in daytime sleepiness (6).
Why People Are Turning to CBD for Sleep
Sleep Disorders published a 2015 study that discussed the residual side effects of sleep medication. Prescription hypnotic drugs, such as benzodiazepine, chronobiotic agents, and low-dose hydrochloride, produce adverse effects that may interfere in the quality of life (7).
Also, access to prescribed sleep medications may be challenging for some, while others may have treatment-resistant insomnia.
These difficulties are why CBD is increasingly popular among individuals looking for alternative approaches to better sleep.
A study posted in the Neuropsychiatric Diseases and Treatment shared that the prevalence of sleep disorders has risen due to increased work hours, night shifts, and lifestyle conditions. Prolonged wakefulness can lead to a decline in cognitive function and the impairment of the immune system (8).
A study has shown that 33% of adults worldwide suffer from sleep disorders every year (9).
Sleep problems may be caused by factors, like sleep apnea, restless leg syndrome, insomnia, chronic pain, and narcolepsy (a condition that causes an individual to fall asleep during the day) (10).
Many studies have shown how CBD might potentially affect some of these conditions.
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 healthy sleep cycle experiences all four stages of sleep. NREM stages account for 75-80% of sleep time, while 20-25% is spent on REM sleep (11).
An individual with insomnia will have trouble maintaining the sleep cycle. Some may even have difficulty getting to the first two stages of sleep.
The disruption of this cycle can lead to many health issues, such as hypoxemia (low oxygen) and dyspnea (shortness of breath), pain conditions, and neurodegenerative diseases (12).
A 2017 study published in Current Psychiatry Reports mentioned that CBD might have therapeutic potential for treating insomnia. The study continued by acknowledging that CBD may hold promise for excessive daytime sleepiness and REM-sleep behavior disorder (13).
A crossover study compared CBD with nitrazepam (a hypnotic drug). The authors found that a CBD dose of 160 mg increased the duration of sleep among human subjects (14).
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 2 to 4 in the sleep cycle. This condition often involves confusional arousal (disorientation of time and place), sleep terrors, loss of muscle atonia, and sleepwalking (15).
RBD is prevalent among men over 50 years old and among patients with Parkinson’s disease (PD). A study has described the beneficial effects of CBD in reducing RBD symptoms among PD patients (16).
During the study, four patients with PD were treated with CBD. The clinical trial resulted in the reduced frequency of RBD-related events. Upon discontinuation of the treatment, RBD complex movements and symptoms returned (17).
The study stated that although positive results have been observed among patients, the mechanism of therapeutic action remains a hypothesis. More research is needed to confirm the efficacy and implications of CBD.
For more information on how CBD helps with insomnia, click here.
CBD Oil vs. Anxiety-Related Sleep Disorders
Psychiatrist and cannabis researcher, Scott Shannon, M.D., led a clinical study on 71 adult patients with anxiety and sleep disorders. The study entitled Cannabidiol in Anxiety and Sleep: A Large Case Series was published in The Permanente Journal in 2019.
After conducting the 12-week study, they have found that 57 out of the 72 of the patients who had anxiety experienced improvements during the first month of taking CBD (18).
Post-traumatic stress disorder (PTSD) develops after a traumatic event. PTSD is frequently associated with night terrors and disturbed sleep (19).
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 (20).
The study showed examples of how CBD dosings of 12mg (oral) and 32 mg (inhalation) have decreased the anxiety symptoms and sleep disturbances on patients.
Also, the Frontiers of Pharmacology 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% (21).
Based on the previous studies mentioned, CBD might have the potential to improve sleep quality and reduce anxiety among human subjects. However, more studies are needed to verify the observations and hypotheses presented.
CBD Oil vs. Daytime Sleepiness
The circadian rhythm involves an individual’s physical, mental, and behavioral changes. These changes respond to light and dark environments, thus influencing one’s sleep-wake cycle.
There are several challenges in maintaining circadian rhythms, such as night shift work, improper eating behavior, prolonged wakefulness, and other lifestyle disorders (22).
The Journal of Clinical Psychology released a study demonstrating how CBD (15 mg) increased wakefulness among healthy young adults (23). The dose used in the clinical trial also contained tetrahydrocannabinol (THC).
Moreover, a study posted in Current Neuropharmacology demonstrated how CBD acted as a wake-inducing agent to mice during the “lights-on” period. The hypothesis was that CBD might influence the increase of dopamines in the brain of animal subjects (24).
Dopamines are neurotransmitters in the body that regulates bodily functions. Dopamines are also in charge of the reward system in the brain and promote wakefulness. The study also found that an increase in dopamine in rat models led to alertness (25).
The study hypothesized that since CBD induced alertness among animal and human subjects, it might hold a therapeutic value in sleep disorders caused by daytime sleepiness (26).
CBD Oil vs. Sleep Apnea
For individuals experiencing treatment-resistant insomnia, they may be experiencing an underlying condition called sleep apnea.
Sleep apnea is a disorder wherein throat muscles block the airway, making it difficult to breathe while sleeping.
There are currently three types of sleep apnea. Obstructive sleep apnea involves the throat muscles blocking the airway, while central sleep apnea occurs when the brain does not send proper signals to the muscles. Complex sleep apnea is when an individual experiences both central sleep and obstructive sleep apneas (27).
Obstructive sleep apnea (OSA) is the most common among the three types of sleep apneas. A study had mentioned that sleep-disordered breathing is common among patients with treatment-resistant insomnia (28).
Currently, there is a lack of study on how CBD affects individuals who have sleep apneas.
A 2018 study posted in the Journal of Clinical Sleep Medicine mentioned that early animal studies have demonstrated that cannabinoid agonists, such as dronabinol (a synthetic form of the psychoactive-causing cannabinoid, THC), provided respiratory stability. The authors of the study acknowledge that this might hold therapeutic value for OSA (29).
The authors also called for “increased funding and further research on the use of synthetic medical cannabis extracts to treat OSA.”
However, the American Academy of Sleep Medicine (AASM) holds a strong position against the use of medical cannabis, cannabinoids, and its synthetic extracts in treating OSA. AASM stated the opposition is due to unreliable delivery methods, insufficient evidence, and safety (30).
This statement from AASM came after the Minnesota Department of Health announced in 2017 that they are adding OSA into the qualifying conditions for their medical cannabis program (31).
Individuals with sleep apneas are strongly advised to consult with a licensed medical practitioner at accredited sleep facilities before taking any treatment.
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 can temporarily relieve the pain.
There are not enough scientific studies that directly address how CBD may affect individuals with RLS. However, some studies have linked the improvement of RLS symptoms with cannabis use.
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 (32).
The author continued by proposing more clinical trials to study the effect and implications of cannabis use for RLS symptoms.
CBD Oil vs. Chronic Pain
Chronic pain can be associated with insomnia in some individuals. A review published in the Journal of American Pain Society mentioned that individuals with chronic headaches, migraine, and arthritis had reported poor sleep quality or sleep disturbances (33).
A 2017 study published in the Physiological Reviews showed that migraine headaches might partially be caused by intense sensory nerve stimulation. The stimulation is caused by the release of inflammatory agents, creating a migraine attack (34).
CBD is becoming a popular alternative approach in treating chronic pain. Many studies have recognized the pain-relieving effects of phytocannabinoids, such as CBD and THC.
A study posted in Proceedings of the National Academy of Sciences of the United States of America acknowledged the inflammatory and analgesic effects of CBD (35). The research discussed CBD’s ability to enhance adenosine signaling leading to decreased inflammation.
Another study published in the Journal of Experimental Medicine also reported how CBD has potentially suppressed neuropathic pain and inflammation on animal subjects (36).
Moreover, a 2015 experiment published in the European Journal of Pain demonstrated how rats with induced-arthritis displayed reduced joint swelling and improved limb postures following transdermal CBD absorption (37).
How CBD Oil Works to Help With Sleep
The endocannabinoid system is made of G-protein receptors located throughout the human body, such as cannabinoid receptor 1 (CB1) and cannabinoid receptor 2 (CB2).
These receptors can be found mostly in the central nervous system, the immune system, and the peripheral nervous system (38).
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 (39).
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 (40).
According to a study, the activity of CBD on G-protein receptors might drive its neuroprotective, antidepressive, and anxiolytic benefits (41).
Moreover, a study released in Current Neuropharmacology discussed how microinjections of CBD into the lateral hypothalamus (next to the pituitary gland) led to the enhancement of dopamine to increase wakefulness during daylight hours (42).
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) (43).
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 (44).
Pros and Cons of CBD Oil for Sleep
- CBD may be beneficial in treating insomnia (45).
- The beneficial effects of CBD may include reducing REM-sleep behavior disorder symptoms among PD patients (46).
- CBD may potentially help in reducing anxiety and improve the quality of sleep among individuals with anxiety-related insomnia (47).
- CBD, in low doses, might help improve wakefulness during daylight. The reduction of daytime sleepiness may lead to healthy circadian rhythms (48).
- CBD may help alleviate inflammation and block neuropathic pain, such as headaches and migraines (49).
- Transdermal CBD application might help in alleviating joint inflammation and pain (50).
- CBD, unlike THC, does not induce psychoactive effects.
- The World Health Organization (WHO) has acknowledged that CBD is non-addictive and safe for daily use (51).
- Although legal in the United States, CBD remains highly unregulated. Individuals are encouraged to thoroughly research which brands are safe and legitimate.
- CBD may present a few side effects, such as dry mouth, diarrhea, sleepiness, and reduced appetite (52).
- It is not advisable to take CBD in conjunction with other medications. Individuals must first consult with a licensed physician before taking CBD, as this 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 (53), while other studies suggested CBD might cause sleepiness (54).
- A recent study published in Molecules has found that extremely high doses of CBD may cause liver injury (55).
How Does CBD Compare to Other Alternative Treatments?
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 (56).
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 (57).
CBD is considered a natural alternative approach in treating insomnia. Like melatonin, CBD’s health benefits with regards to insomnia remain a hypothesis.
Around 40-80% 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 (58), while CBD improved sleep in 71.4% of the patients (59).
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.
How to Choose the Right CBD Oil for Sleep
Before taking CBD, one must need to know the different types of CBD concentrations available. Full-spectrum CBD oil is a concentration that includes all the compounds present in the hemp plant.
These cannabinoids are CBD, THC, cannabinol (CBN), cannabigerol (CBG), and cannabichromene (CBC). When taken together, all these compounds produce the “entourage effect.”
The entourage effect means that an individual takes in all the supposed benefits of the cannabinoids.
The full-spectrum CBD oil may be a good option for individuals who suffer from sleep disruptions without the presence of anxiety.
Although THC content in full-spectrum CBD oil must be 0.3% or below, it is advised that one opts for a concentration without any traces of THC.
A 2018 study published in Lancet shared that high doses of THC have been linked to increased anxiety and paranoia among patients in a clinical study (60).
Broad-spectrum CBD oil is an ideal choice for individuals who do not want THC in their system.
Like the full-spectrum, the broad-spectrum may also produce the entourage effect without the presence of THC. This concentration usually contains only CBD, CBG, CBN, and CBC.
Lastly, CBD isolate is a concentration that contains 99% pure CBD extracts. This concentration is recommended to individuals who do not have the tolerance for other cannabinoids.
When choosing CBD brands, individuals must always look for a certificate of analysis (COA). The COA is a third-party laboratory result that verifies how much cannabinoids are present in the product. The COA is also crucial in determining if the product is free from heavy metals, pesticides, fungicides, and other harmful substances.
Additional tips on shopping for the best CBD oil
- One must be particular with their brand’s source of hemp. One must always choose brands that use organic and non-GMO hemp. Some brands also have gluten-free or vegan options.
- One must be particular with carrier oil due to possible allergies. Many brands use MCT oil (unrefined coconut oil), hemp oil, extra-virgin olive oil, and grapeseed oil. Carrier oils are always specified in the product description.
- Read testimonials and brand reviews from other customers. Check the rating of each product.
- Avoid toxic substances like propylene glycol and polyethylene glycol when buying CBD vape pens and CBD vape cartridges.
- Always research the extraction process of the CBD brand. The CO2 extraction process does not add any heat or solvents.
- Choose CBD brands that have a money-back guarantee.
CBD Dosage for Sleep
More studies are needed to determine the proper dosing of CBD. Many studies have produced conflicting results when researching the effects of CBD.
Studies have shown that low doses (10mg/kg) produced anxiolytic effects on rats compared to higher doses (100mg/kg) (61).
In a crossover study, researchers comparing CBD with nitrazepam (a hypnotic pharmaceutical drug used for insomnia) have found that a high single dose of CBD (160mg) on rats increased the duration of sleep (62).
The doses mentioned are considered high doses and not economically viable since CBD can be quite expensive.
However, a study has found that 25 mg to 75 mg of CBD per day would be enough to produce effects on human adults who presented with insomnia and anxiety (63).
A contrasting study demonstrated how CBD might work as a wake-promoting agent. The researchers gave 15 mg CBD (combined with 15 mg THC) dose, which resulted in increased wakefulness in young human adults (64).
Individuals who are taking CBD for the first time are advised to start with a low dose between 1 milligram per kilogram to 50 milligrams per kilogram of CBD per day (< 1 mg/kg to 50 mg/kg per day) (65).
They can gradually increase the dosage when the body gets used to the CBD in their system.
How to Take CBD Oil for Sleep
First time CBD users may take CBD products that have lower concentrations of cannabinoids in a single serving. These products may be in the form of sprays, capsules, oil drops, or edibles (gummies).
When using CBD gummies for sleep, one can take a serving around 30 minutes before bedtime.
For individuals who are used to taking CBD, they may opt for CBD oil tinctures or drops. These can be taken by using a dropper to put CBD oil under the tongue. For better sleep, it is recommended to take the CBD tincture before bedtime.
CBD companies have come up with ways to improve their tincture formulas by adding terpenes (for flavoring) or natural and artificial sweeteners.
Individuals looking for joint or muscle pain relief may opt for a transdermal approach, such as CBD balms, CBD creams, CBD lotions, or CBD patches.
Lastly, vaping is the fastest way to bring CBD into the system, but it is not as long-lasting compared to CBD tinctures. Individuals must be aware of the side effects of vaping before choosing this method to take CBD (66).
Is CBD Oil Legal?
Derived from agricultural or industrial hemp, cannabidiol (CBD) is now a legal compound In the U.S., Canada, and some countries in Europe.
The United States 2018 Farm Bill legalized hemp extraction, making CBD legal in the USA (67).
Manufacturers are allowed to transport, produce, and sell CBD as long as the concentration contains 0.3% or lower THC levels. Unlike THC, CBD does have any psychoactive effects.
Although CBD is currently unregulated, the U.S. Food and Drug Administration remains watchful. CBD companies are not allowed to make health claims or sell CBD as a food supplement.
CBD companies rely on third-party lab results to gain the confidence of customers.
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 (68).
Studies have shown that CBD might hold therapeutic benefits in achieving better sleep by improving mental health, such as reducing anxiety (69) and PTSD symptoms (70) among human subjects.
Moreover, a clinical experiment has demonstrated how CBD has improved the anxiety and sleep disturbances of children with ASD (71).
CBD has also been shown to reduce REM-sleep behavior disorder (RBD) events in patients with neurodegenerative diseases (72).
Lastly, a contrasting study has shown that CBD might help reduce daytime sleepiness, which may contribute to maintaining a healthy circadian rhythm (73).
Existing studies have shown promising results. However, more studies are needed to confirm CBD’s effectiveness in achieving better sleep.
Experts advise that whatever treatments or medications have been chosen, a good sleeping habit is still essential in achieving a healthy circadian rhythm.
- 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 put up with 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.
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