- According to research, CBD may have a calming effect on the nervous system(1). CBD may offer beneficial effects on an individual’s mood due to its impact on the serotonin system depending on the CBD product type and dose(2).
- Sleep deprivation is prevalent among Americans. Sleep issues are among the most common medical complaints in the United States and pose a serious health concern(3).
- CBD is a phytocannabinoid. It helps the endocannabinoid system maintain homeostasis or balance in the human body(4). This cannabinoid compound has purported antiemetic, analgesic, anxiolytic, antioxidant, and anti-inflammatory properties(5).
- CBD’s anxiolytic and calming effects may help individuals relax better by relieving stress and anxiety, resulting in improved sleep quality(6).
Benefits of CBD: Does CBD Help an Individual Sleep?
Clinical studies indicate that CBD has anxiolytic potential, which may help reduce anxiety and contribute to relaxation and better sleep quality(7).
According to research, CBD may have a calming effect on the nervous system(8). CBD may also offer beneficial effects on an individual’s mood due to its impact on the serotonin system depending on the CBD product type and dose(9).
Sleep deprivation is prevalent among Americans. Sleep issues are among the most common medical complaints in the United States, posing a serious health concern(10).
Sleep deprivation is linked to various serious ailments. Those who receive less than seven hours of sleep in 24 hours are more prone to acquire chronic illnesses such as obesity, heart disease, diabetes, arthritis, stroke, and depression(11).
Among the 70 different types of sleep disorders, the following are the most common(12):
- Insomnia is the inability to fall or stay asleep(13). This disorder impairs daytime wakefulness, concentration, and mood. Individuals who have insomnia may experience anxiety about getting inadequate sleep, which can exacerbate nighttime sleeplessness(14).
- Sleep apnea is a condition in which one who is asleep suddenly stops breathing. This condition is a life-threatening sleep disease where breathing stops and begins repeatedly. An individual may have sleep apnea if one snores loudly and fatigues even after a whole night’s sleep(15).
- Narcolepsy is a long-term disorder marked by excessive daytime sleepiness and sleep episodes. Regardless of the circumstances, people with narcolepsy find it challenging to stay awake for long periods. Narcolepsy causes persistent tiredness during the day(16).
- Circadian rhythm sleep disorders result from desynchronization between internal sleep-wake rhythms and the light-darkness cycle. Insomnia, excessive daytime sleepiness, or both are common symptoms, which usually go away as the biological clock adjusts(17).
- Restless legs syndrome (RLS) is a condition that causes an insatiable desire to move one’s legs, usually in response to a tingling, discomfort, and even pain in the legs that worsens when an individual is seated or lying down in the evening or at night(18).Â
- Parasomnias refer to people’s odd behaviors before falling asleep, while asleep, or during the arousal interval between sleep and alertness(19). Sleepwalking and nightmares are examples of this condition. These actions’ characteristics, severity, and frequency vary greatly(20).
- Fibromyalgia, commonly known as fibromyalgia syndrome (FMS), is a long-term condition that causes chronic pain that affects the entire body(21). Its symptoms include widespread pain, extreme tiredness (fatigue), difficulty sleeping, muscle stiffness, problems with mental processes, headaches, and irritable bowel syndrome (stomach pain and bloating)(22).
- Chronic fatigue syndrome (CFS) is a complex disorder marked by chronic exhaustion that lasts at least six months and is not fully explained by an underlying medical condition(23). The fatigue worsens with physical or mental exertion and does not get better with rest(24).
CBD may offer potential benefits with its anxiolytic and calming properties. The experience of improved sleep with CBD is not related to drowsiness. CBD instead presents components that may help with anxiety alleviation for a restful sleep(25).
Recent breakthroughs have enabled the isolation of the active ingredients in cannabis and the manufacture of cannabinoid medicines that are practically psychoactive-free, possibly giving relief to conditions such as chronic pain(26).
CBD has alerting and sedative effects at low to medium doses and sedative and sleep-inducing effects at high concentrations. This action relates to CBD’s biphasic properties, which means low and high-dose administration may have opposing effects(27).Â
Narcoleptics, or individuals who sleep excessively during the day, may benefit from low to moderate dosages of CBD that have an alerting impact. High doses of CBD (160 milligrams) were proven to increase the length and quality of sleep in one insomnia trial(28).
In addition, it is theorized that CBD may also help with insomnia-related anxiety(29). A new pilot study is underway to investigate the use of CBD and THC in humans with physician-diagnosed insomnia(30).Â
In the REM (rapid eye movement) phase of sleep, patients with REM sleep behavior disorder verbalize and make aggressive movements(31). The condition is most prevalent among older patients suffering from neurodegenerative diseases, such as Alzheimer’s or Parkinson’s disease(32). Â
In a limited study of individuals with Parkinson’s disease, CBD has shown promise in managing REM sleep disorder symptoms. Further research is necessary. However, the preliminary findings suggest that CBD may be a potential therapeutic agent for REM sleep behavior disorder(33).
A study from Current Neuropharmacology hypothesized that CBD may be used as a wake-promoting agent(34). Still, additional research is necessary to confirm the effect of CBD on wakefulness and sleepiness at various doses and delivery methods.
Sleep is a critical nervous system activity that helps maintain brain and body homeostasis, energy levels, cognitive abilities, and other essential processes in various organisms(35).Â
As a result, it is critical to learn more about the neurological underpinnings of cannabis medication’s effects on sleep and the involvement of the endogenous cannabinoid system in sleep physiology(36).
The endocannabinoid system (ECS) has substantial involvement in sleep. The ECS directly impacts sleep as the master regulator of the most basic human activities(37). ECS controls eating, relaxing, sleeping, forgetting, and protecting ourselves through the immune system.Â
Endocannabinoids like anandamide and 2-AG fluctuate with the natural circadian rhythms. The anandamide levels in the brain are higher at night when combined with oleamide and adenosine to induce sleep. During the day, 2-AG levels in the brain are more elevated, increasing alertness(38).
The ECS and endocannabinoids are essential components in sleep and sleep neurophysiology. Notably, cannabinoid medications appear to modify sleep physiology(39). Studies examine how phytocannabinoids interact with the ECS with a thorough investigation of the therapeutic nature of these compounds(40).Â
CBD may affect various biological functions, although it does not bind to the CB1 cannabinoid receptor and has no psychotropic and psychotomimetic effects (the onset of psychotic symptoms after administration of a specific drug)(41). According to current experimental findings, CBD appears to be a viable therapeutic candidate for certain conditions.
More clinical research and back-translational efforts are necessary to elucidate cannabinoid-mediated sleep alterations and the molecular mechanisms of cannabinoid actions in sleep-related neurons and circuits. An in-depth explanation of how cannabinoids influence sleep, as well as the basic biology of sleep-wake states, is also warranted(42).
How to Use CBD for Tiredness
The type of CBD used, the dosage, and body composition all have a role in how difficult it is to forecast when CBD will kick in and how CBD effects will manifest.
The delivery methods are classified according to the pathway or route CBD enters the body(43). Inhalation, ingestion, sublingual (under the tongue), topical, or transdermal (application onto the skin) are all possible routes of administration.Â
Users may optimize the therapeutic effect of the CBD product using various delivery methods(44).
Inhaling or vaping activated cannabinoid extracts requires producing a thick visible vapor cloud. CBD in vape products usually takes effect between 2 to 15 minutes(45). Vaping, however, creates a greater risk for respiratory symptoms indicative of lung injury(46).
On the other hand, the sublingual delivery method of CBD oil is done by placing CBD oil drops or tinctures under the tongue(47). The onset time of CBD via this administration route is within 5 to 30 minutes, similar to the topical application of CBD.
Likewise, ingesting CBD edibles like gummies or capsules takes a more prolonged onset of action. CBD infused in these products usually takes effect within 30 to 90 minutes as food or beverages still have to pass through the stomach and the liver enzymes(48).
CBD options are provided through the three types of CBD made available for users. A full-spectrum CBD extract contains all of the naturally occurring compounds of the cannabis plant, including the psychoactive THC.Â
Meanwhile, although broad-spectrum CBD oil is comparable to a full-spectrum CBD oil, the broad-spectrum CBD variant undergoes a process to eliminate THC. Lastly, CBD isolate contains only cannabidiol(49).
Only Epidiolex, a CBD product administered orally, has been approved by the FDA to help with rare and severe forms of epilepsy(50). State restrictions on CBD differ, and research into its possible health benefits continues(51). Â
Safeness
In the United States, only a few cannabis-derived or cannabis-related drug items have been approved by the FDA(52):
Epidiolex. The FDA authorized this oral CBD solution as the first medicine containing a refined cannabis-derived substance.Â
This FDA-approved CBD oral solution is used to treat seizures associated with two rare and severe forms of epilepsy, Lennox-Gastaut syndrome, and Dravet syndrome, in patients two years of age and older(53).
Syndros and Marinol. Dronabinol, a synthetic version of THC, is present in these two medicines. They are available in the form of capsules or oral solutions.Â
Because dronabinol affects the portion of the brain that regulates hunger, nausea, and vomiting, it has a variety of therapeutic applications. Treatment of nausea and vomiting in chemotherapy patients and weight loss in HIV patients are among these applications(54).
Cesamet. Nabilone, a synthetic molecule with a molecular structure similar to THC, is included in Cesamet. This pill, like dronabinol, affects the region of the brain that controls nausea and vomiting. The drug is given to chemotherapy patients who have not reacted to previous anti-nausea and anti-vomiting medications(55).
While numerous CBD products are available, other CBD medicinal products have not been approved by the FDA(56). The FDA has not determined the safety and efficacy of cannabis or CBD in treating any specific disease or condition(57).Â
Despite the rigorous research, not all CBD products are guaranteed to be of acceptable quality(58). Â
To date, the FDA does not regulate the purity and safety of dietary supplements and products, which may pose a significant health risk to individuals(59).
Meanwhile, the WHO (World Health Organization) indicated that CBD is generally well tolerated and has a favorable safety profile(60). However, drug-drug interactions may occur when CBD is used along with an individual’s prescribed medication(61).
Additionally, CBD may have adverse effects such as fatigue, drowsiness, nausea, and irritability(62). These side effects necessitate that potential users seek medical advice before consuming any CBD product for their wellness.
Risks and Side Effects: Does CBD Make One Feel Tired or Sleepy?
CBD in products like CBD oil may help with tiredness as it is believed to promote calmness and relaxation in both the body and the mind. Hence, the compound may not make an individual tired or sleepy(63).
CBD’s purported sleep-promoting effects may ease underlying medical conditions that cause sleep disruptions, like chronic pain and anxiety. This effect is associated with a good night‘s sleep(64). Â
At lower doses, CBD may not generate a sedative effect. Still, CBD may help an individual get much better sleep and prevent drowsiness throughout the day(65).Â
Furthermore, CBD appears to increase wakefulness and alertness by potentially reducing daytime sleepiness, which is essential for daytime performance and consistency of the sleep-wake cycle(66).
CBD is largely well tolerated with a good safety profile according to the WHO (World Health Organization)(67).Â
Still, CBD products may have minimal side effects. Hence, individuals must be careful when administering CBD. For instance, users of Epidiolex, a CBD-derived drug, may develop diarrhea or other gastrointestinal problems(68).Â
When taking CBD, some people may also experience sleepiness(69).Â
Adverse side effects of CBD may be associated with drug-drug interactions between CBD and an individual’s existing medications(70).
Hence, users must seek medical advice before using any CBD product, especially if utilizing medications, herbs, or supplements, to prevent negative interaction(71).Â
The Legality of CBD
CBD, found in all cannabis plants, may be extracted from either industrial hemp or high-quality medical marijuana. CBD products are only federally legal if derived from hemp and contain less than 0.3% THC concentration(72).
The Farm Bill of 2018 considered hemp legal in the United States, removing all hemp-derived products, including CBD items, from the Controlled Substances Act(73).Â
According to the FDA (Food and Drug Administration), studies are conducted to consider CBD as a new drug(74). Hence, a wide range of CBD products is available in various locations in the United States, though CBD’s legal status has remained uncertain.
The FDA has approved only one CBD product. Epidiolex is a prescription medication containing a refined form of CBD and is used to treat seizures in children with Lennox-Gastaut or Dravet syndrome(75). This FDA-approved medication is available only with a prescription from a licensed healthcare professional.
What Are CBD and THC?
CBD (Cannabidiol) is an organic substance derived from hemp plants. CBD does not contain the psychoactive component, tetrahydrocannabinol (THC). CBD is believed to be medicinally beneficial. Not to mention, this active chemical substance may also help maintain homeostasis or balance in the human body(76).
CBD is the nonpsychoactive phytocannabinoid component most prevalent in hemp(77).
On the other hand, THC is the principal psychoactive component of cannabis, which stimulates cells in the brain to release dopamine and creates euphoria(78). THC is a compound in the resin secreted by the Cannabis sativa plant(79).
THC, CBD, and other cannabinoid molecules, such as terpenes and flavonoids, are currently being evaluated for medicinal uses, separately and in combination(80).
Terpenes are the components of essential oils responsible for the aroma of cannabis(81). Meanwhile, flavonoids are active compounds found in cannabis that are believed to have antioxidant, anti-inflammatory, and antiviral actions(82).Â
Clinical studies examining the protective effects of CBD have shown that it may offset the harmful effects of THC(83). Combining CBD with THC may reduce the anxiolytic effect of THC by half. This result indicated that CBD could counteract THC‘s anxiety-inducing effects(84).
- Cannabidiol in Anxiety and Sleep: A Large Case Series https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6326553/
- Cannabidiol modulates serotonergic transmission and reverses both allodynia and anxiety-like behavior in a model of neuropathic pain https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6319597/
- The State Of Sleep Health In America
https://www.sleephealth.org/sleep-health/the-state-of-sleephealth-in-america/ - Endocannabinoids and the Control of Energy Homeostasis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2586261/p
- Antioxidative and Anti-Inflammatory Properties of Cannabidiol https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7023045/
- Healing with CBD page 177 https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view /
- Cannabidiol in Anxiety and Sleep: A Large Case Series https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6326553/
- Ibid.
- Cannabidiol modulates serotonergic transmission and reverses both allodynia and anxiety-like behavior in a model of neuropathic pain https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6319597/
- The State Of Sleep Health In America
https://www.sleephealth.org/sleep-health/the-state-of-sleephealth-in-america/ - Healing with CBD page 176 https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
- ibid
- Insomnia and Excessive Daytime Sleepiness (EDS) https://www.merckmanuals.com/professional/neurologic-disorders/sleep-and-wakefulness-disorders/insomnia-and-excessive-daytime-sleepiness-eds
- ibid
- Sleep apnea https://www.mayoclinic.org/diseases-conditions/sleep-apnea/symptoms-causes/syc-20377631
- Narcolepsy https://www.mayoclinic.org/diseases-conditions/narcolepsy/symptoms-causes/syc-20375497#
- Circadian Rhythm Sleep Disorders https://www.msdmanuals.com/professional/neurologic-disorders/sleep-and-wakefulness-disorders/circadian-rhythm-sleep-disorders#
- Restless legs syndrome https://www.mayoclinic.org/diseases-conditions/restless-legs-syndrome/symptoms-causes/syc-20377168#
- Parasomnias & Disruptive Sleep Disorders
https://my.clevelandclinic.org/health/diseases/12133-parasomnias–disruptive-sleep-disorders - ibid
- Fibromyalgia https://www.nhs.uk/conditions/fibromyalgia/
- ibid
- Chronic fatigue syndrome https://www.mayoclinic.org/diseases-conditions/chronic-fatigue-syndrome/symptoms-causes/syc-20360490#
- ibid
- Healing with CBD page 177 https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
- Cannabis and cannabidiol (CBD) for the treatment of fibromyalgia https://pubmed.ncbi.nlm.nih.gov/33004171/
- Healing with CBD page 177 https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
- ibid
- Cannabidiol (CBD) and Δ 9-tetrahydrocannabinol (THC) for chronic insomnia disorder (‘CANSLEEP’ trial): protocol for a randomised, placebo-controlled, double-blinded, proof-of-concept trial https://pubmed.ncbi.nlm.nih.gov/32430450
- ibid
- Parasomnias https://www.merckmanuals.com/professional/neurologic-disorders/sleep-and-wakefulness-disorders/parasomnias
- ibid
- ibid
- Potential Effects of Cannabidiol as a Wake-Promoting Agent
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4023456/ - Cannabinoids, Endocannabinoids and Sleep https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7388834/
- ibid
- Healing with CBD page 177 https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
- ibid
- Cannabinoids, Endocannabinoids and Sleep https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7388834/
- ibid
- Potential Effects of Cannabidiol as a Wake-Promoting Agent https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4023456/
- ibid
- Healing with CBD page 189 https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
- ibid
- ibid
- Can vaping damage your lungs? What we do (and don’t) know https://www.health.harvard.edu/blog/can-vaping-damage-your-lungs-what-we-do-and-dont-know-2019090417734
- Healing with CBD page 192 https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
- ibid
- Healing with CBD Page 80 https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
- FDA Approves New Indication for Drug Containing an Active Ingredient Derived from Cannabis to Treat Seizures in Rare Genetic Disease https://www.fda.gov/news-events/press-announcements/fda-approves-new-indication-drug-containing-active-ingredient-derived-cannabis-treat-seizures-rare#:
- ibid
- FDA Regulation of Cannabis and Cannabis-Derived Products, Including Cannabidiol (CBD)
https://www.fda.gov/news-events/public-health-focus/fda-regulation-cannabis-and-cannabis-derived-products-including-cannabidiol-cbd - FDA Approves First Drug Comprised of an Active Ingredient Derived from Marijuana to Treat Rare, Severe Forms of Epilepsy https://www.fda.gov/news-events/press-announcements/fda-approves-first-drug-comprised-active-ingredient-derived-marijuana-treat-rare-severe-forms
- ibid
- ibid
- FDA Regulation of Cannabis and Cannabis-Derived Products, Including Cannabidiol (CBD) https://www.fda.gov/news-events/public-health-focus/fda-regulation-cannabis-and-cannabis-derived-products-including-cannabidiol-cbd
- ibid
- What Patients Guide to CBD
-https://american-safe-access.s3.amazonaws.com/Patients_Guide_to_CBD.pdf - CBD products are everywhere. But do they work?https://www.health.harvard.edu/newsletter_article/cbd-products-are-everywhere-but-do-they-work#
- World Health Organization Reports CBD Oil Is Generally Safe https://www.rtor.org/2019/07/05/who-report-on-cbd-oil/#
- ibid
- What are the benefits of CBD — and is it safe to use?
https://www.mayoclinic.org/healthy-lifestyle/consumer-health/expert-answers/is-cbd-safe-and-effective/faq-20446700 - Cannabidiol in Anxiety and Sleep: A Large Case Series
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6326553/ - A Balanced Approach for Cannabidiol Use in Chronic Pain https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7204604/
- Cannabidiol in Anxiety and Sleep: A Large Case Series https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6326553/
- Potential Effects of Cannabidiol as a Wake-Promoting Agent https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4023456/
- World Health Organization Reports CBD Oil Is Generally Safe https://www.rtor.org/2019/07/05/who-report-on-cbd-oil/#
- Epidiolex (Cannabidiol) Primer: Frequently Asked Questions for Patients and Caregivers
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6938286/ - Cannabidiol in Anxiety and Sleep: A Large Case Series
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6326553/ - World Health Organization Reports CBD Oil Is Generally Safe https://www.rtor.org/2019/07/05/who-report-on-cbd-oil/#
- CBD and other medications: Proceed with caution https://www.health.harvard.edu/blog/cbd-and-other-medications-proceed-with-caution-2021011121743
- Cannabidiol (CBD)-what we know and what we don’t https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476
- FDA Regulation of Cannabis and Cannabis-Derived Products, Including Cannabidiol (CBD) https://www.fda.gov/news-events/public-health-focus/fda-regulation-cannabis-and-cannabis-derived-products-including-cannabidiol-cbd
- Cannabidiol (CBD)-what we know and what we don’t https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476
- ibid
- Endocannabinoids and the Control of Energy Homeostasis https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2586261/
- Cannabidiol (CBD)-what we know and what we don’t
https://www.health.harvard.edu/blog/cannabidiol-cbd-what-we-know-and-what-we-dont-2018082414476 - What is THC? https://www.livescience.com/24553-what-is-thc.html
- ibid
- Clinical and Preclinical Evidence for Functional Interactions of Cannabidiol and Δ 9-Tetrahydrocannabinol https://pubmed.ncbi.nlm.nih.gov/28875990/)
- The Cannabis Terpenes
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7763918/ - Flavonoids as antioxidants
https://pubmed.ncbi.nlm.nih.gov/10924197/ - Does Cannabidiol Protect Against Adverse Psychological Effects of THC? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3797438/#
- ibid