CBD vs. THC for Sleep - April 2024

How Do CBD and THC Affect Sleep?

According to an expert, sleep is known to serve multiple functions. Proper sleep is essential for survival and healthy functioning⁽¹⁴⁾.

Thus, interest in studies of THC and CBD has been circulating on how these compounds can affect sleep.

The cannabis plant of various cannabinoids. The most prevalent are

CBD (cannabidiol) and tetrahydrocannabinol (THC)⁽¹⁵⁾. The effects of THC produce a euphoric “high”⁽¹⁶⁾. In contrast, cannabidiol does not have psychoactive effects. 

Medical marijuana is one of the most popular drugs in the United States⁽¹⁷⁾. 

Marijuana comes in various strains in Cannabis sativa and Cannabis indica plants. Some marijuana is stimulating, while others are soothing and sedating. 

According to the National Center for Drug Abuse Statistics,  around half of Americans, or over 78 million individuals, reported smoking marijuana at least once⁽¹⁸⁾.

Despite the therapeutic benefits of cannabis in medical conditions such as pain, insomnia, and anxiety⁽¹⁹⁾, chronic use of marijuana may increase the risk of stroke⁽²⁰⁾. The mechanism by which this connection occurs is not yet precise. Studies suggest that a combination of factors may cause the risk of stroke.

However, through the isolation of the active components of marijuana, the plant’s active substances may be used as a sleep aid, such as CBD⁽²¹⁾ and THC⁽²²⁾.

CBD and Sleep

According to a study, CBD may be effective in managing symptoms of sleep disorders⁽²³⁾, owing to the compound’s potential to reduce anxiety levels⁽²⁴⁾ and chronic pain⁽²⁵⁾.

Anxiety makes it difficult for individuals to fall asleep⁽²⁶⁾. CBD may affect the body’s serotonin⁽²⁷⁾, explaining CBD’s potential in managing depression and anxiety disorders. 

The chemical serotonin is a vital part of our body’s system that carries messages between different nerve cells⁽²⁸⁾. Serotonin also plays a role in various functions such as mood and sleep. 

Meanwhile, pain may have various effects on sleep, depending on discomfort⁽²⁹⁾. The role of CBD in pain management has been shown that the compound’s effects may be regulated through the interactions between various components, including the endocannabinoid system (ECS)⁽³⁰⁾. 

The ECS plays a critical role in regulating several bodily systems, including metabolism and hunger, mood, anxiety, and pain perception⁽³¹⁾.

THC and Sleep

Clinical studies show that THC, which is the psychoactive component of cannabis, has been demonstrated to inhibit rapid eye movement or REM sleep and reduce sleep latency⁽³²⁾. Sleep latency is the time interval between turning out the lights and the onset of the first cycle of any stage of sleep⁽³³⁾.

The study’s objective is to compare the effects of cannabis usage on sleep quality and anxiety on objective sleep measurements⁽³⁴⁾.

Dream vividness is increased in abstinent cannabis users but not in active users⁽³⁵⁾. 

The cycle between two forms of sleep throughout the sleep cycle at night is known as non-rapid eye movement (non-REM) sleep and rapid eye movement (REM) sleep. During each stage, the brain and body behave differently⁽³⁶⁾.

Non-REM sleep is a form of sleep that lasts 8-10 hours. It is hard to get out of this stage⁽³⁷⁾. In contrast, REM sleep lasts for an hour to one and a half hours after falling asleep. During these hours, individuals experience vivid dreams. 

In addition, THC in medical marijuana may assist patients with specific conditions such as chronic pain⁽³⁸⁾, post-traumatic stress disorder (PTSD)⁽³⁹⁾, and obstructive sleep apnea⁽⁴⁰⁾.

Individuals suffering from chronic pain may experience worse symptoms with inadequate amount of sleep⁽⁴¹⁾. Also, post-traumatic stress disorder (PTSD) usually co-occurs with sleep difficulties. Insomnia and nightmares are considered to be key PTSD symptoms⁽⁴²⁾. 

However, using marijuana to aid with sleep is a short-term solution. To sleep well, individuals may practice proper sleep hygiene and other activities that encourage a sleep-promoting lifestyle⁽⁴³⁾.

Sleep and the Endocannabinoid System

The sleep and waking patterns may be influenced by the endocannabinoid system and the internal circadian rhythms⁽⁴⁴⁾. 

The circadian rhythm influences sleep and arousal patterns⁽⁴⁵⁾.

The presence of endocannabinoid signaling is widely acknowledged in the body, and it supports a wide range of physiological processes⁽⁴⁶⁾.

While both THC and CBD have been demonstrated to induce good sleep, these two compounds operate somewhat differently. 

CBD is found in both medical and fiber-type Cannabis sativa plants, but unlike THC, CBD is totally nonpsychoactive⁽⁴⁷⁾.

Phytocannabinoids include the psychoactive cannabinoid THC and nonpsychoactive cannabinoids such as CBD⁽⁴⁸⁾.

The ECS significantly impacts many physiological systems in humans and other animals⁽⁴⁹⁾. This system is involved in practically every element of homeostasis (body balance) and acts as a self-regulating harm-reduction mechanism.

Cannabinoids, notably THC and CBD, are increasingly used to manage sleep disorders⁽⁵⁰⁾. THC and CBD may affect anxiety, mood, autonomic function, and the circadian sleep/wake cycle through the endocannabinoid system. 

Meanwhile, many plants and fruits include phytochemicals, and secondary metabolites that interact with the endocannabinoid system are called cannabimimetic⁽⁵¹⁾.

Cannabinoids for Sleep: Is CBD or THC Better?

Both CBD and THC may have sleep-related benefits. For instance, THC has shown promise in managing the symptoms of obstructive sleep apnea⁽⁵²⁾ and improving sleep in patients who suffer from chronic pain⁽⁵³⁾. 

Likewise, CBD may be effective in managing symptoms of sleep disorders⁽⁵⁴⁾, owing to CBD‘s capacity to lower anxiety⁽⁵⁵⁾ and chronic pain⁽⁵⁶⁾.

A study suggested that a Sativex extract formulation containing equal amounts of both CBD and THC may help sleep quality in subjects with chronic pain^(57).

While THC and CBD are each beneficial on their own when combined, they form the ideal team for better sleep. 

However, the therapeutic effectiveness and safety of CBD as sleep aid therapy are unknown. 

Further studies are needed on the safety, effectiveness, and health benefits of cannabis therapy for managing sleep problems.

Thus, individuals who dislike the high feeling caused by THC and the psychoactive effect of medical marijuana may go for CBD as an alternative for better sleep.

CBD and THC Usage

Cannabis products, like CBD, with less than 0.3% THC concentrations, are available in the dispensary or CBD market. 

Cannabis routes of administration are the following⁽⁵⁸⁾:

• Smoking and vaping
• Oral administration (oil, capsules, edibles)
• Topical administration

Individuals may use marijuana by smoking it in a joint or pipe. Suppose consumers detest smoking, want to protect their lungs, or dislike marijuana’s distinctive odor. In that case, users may consider vaping devices or sublingual THC-rich tinctures.

On the other hand, CBD products may come in various forms, such as the following⁽⁵⁹⁾: 

• Ingestible: CBD oil capsules, gummies, cookies, or chews
• Sublingual products: CBD sprays or tinctures
• Smoked or inhaled products: CBD vapes and smokes 
• Topical products: CBD lotions, creams, balms, and salves 

CBD and THC‘s side effects on individuals vary, as every individual reacts differently to these two compounds. 

Several cannabis strains must be evaluated for terpene levels to verify that the cannabis plant is safe.

Terpenes are the active components in cannabis essential oils. They produce the unique scent of cannabis plants.

Therefore, before using CBD and THC-infused products, consumers need to consult healthcare experts to know how these compounds may have an adverse effect on them.  

Should Individuals Take CBD or THC Before Bed?

Users may need to experiment with the right amount and time to take CBD or THC-infused products. 

THC from cannabis strains may affect individuals differently⁽⁶⁰⁾. Some users may find THC helps induce sleep before bedtime, while others may feel “high”. 

Users may need to experiment with the right amount and time to take CBD or THC-infused products. 

What Is the Best CBD: THC Ratio for Sleep?

The particular THC/CBD ratios vary according to the three varieties of cannabis being compared 

• Cannabis sativa has the following characteristics: lower THC level and greater CBD content.
• Cannabis indica has the following characteristics: higher THC level and lower CBD content.
• Hemp has a small amount of THC and a significant amount of CBD.

Thus, these ratios are critical since both THC and CBD work in distinct ways to enhance sleep.  

Dosing Tolerance of CBD vs. THC

With the increasing availability of pharmaceutical-grade cannabis-based therapeutics and the advent of tetrahydrocannabinol (THC) and cannabidiol (CBD) derivatives, the lack of knowledge about their pharmacology has become an issue⁽⁶¹⁾.

Adverse effects associated with cannabis compounds are mainly related to the psychoactive effects of THC, which should be limited to 30mg/day (milligrams per day) or less⁽⁶²⁾. 

The CBD or THC dose may be initiated in low doses to minimize the risk of adverse effects.

Safeness of CBD and THC

The only approved product for use with cannabidiol, or CBD, is Epidiolex, a prescription drug used to treat epilepsy⁽⁶³⁾. 

Despite CBD’s potential to manage sleep issues, there is currently no conclusive pieces of evidence supporting CBD use in humans.

Meanwhile, the Food and Drug Administration (FDA) has approved using two pharmaceutical products, Syndros and Marinol, for treating anorexia and cancer chemotherapy-induced nausea in the United States⁽⁶⁴⁾. These drugs contain the active ingredient dronabinol, which is a synthetic version of tetrahydrocannabinol.

Note that only prescription drugs approved by the FDA are available to patients. The agency has not approved any other types of marijuana or cannabidiol products⁽⁶⁵⁾.

CBD and THC Side Effects and Other Risks

Despite CBD‘s potential benefits for sleep, CBD may interact with other medications, which may cause side effects⁽⁶⁶⁾.

Higher doses of CBD may also cause long-term adverse effects on the brain⁽⁶⁷⁾. According to Mayo Clinic, other side effects of CBD are⁽⁶⁸⁾: 

• Dizziness
• Diarrhea
• Appetite changes
• Fatigue

Marijuana usage for medical purposes is usually regarded as safe. However, various strains of marijuana have varying quantities of THC. The Mayo Clinic also cited some side effects of medical marijuana, such as⁽⁶⁹⁾:

• Increased heart rate
• Drowsiness
• Fatigue
• Dry mouth and dry eyes
• Hallucinations
• Disorientation
• Increased appetite

Therefore, for individuals considering CBD and THC for their medical condition, it is prudent to see a healthcare practitioner first before using CBD and THC-infused products.

How Much Sleep Are Americans Getting?

A study from the CDC (Center for Disease Control and Prevention) noted that about a third of Americans do not get enough sleep (7 or more hours)⁽⁷⁰⁾. The study, conducted in all 50 states, is the first to estimate the healthy sleep duration of individuals.

According to one of the findings, individuals who reported being unable to work or jobless had significantly shorter healthy sleep durations (51% and 60%, respectively) than employed respondents (65%).

Meanwhile, sleep experts recommend that adults get at least 7 hours each night to improve their health and wellbeing⁽⁷¹⁾. Not getting sleep less than seven hours a day is linked to an increased risk of chronic conditions.

Serious Problem of Sleep Deprivation

Several of the most severe consequences of chronic sleep deprivation include high blood, diabetes, heart attack, heart failure, and stroke⁽⁷²⁾. Other possible complications include obesity, depression, impaired immunological function, and decreased sexual desire.

Sleep deprivation can even affect appearance, which may cause premature wrinkles and dark circles beneath the eyes over time⁽⁷³⁾. Additionally, there is a relationship between sleep deprivation and an increase in the stress hormone cortisol in the body. Cortisol is capable of degrading collagen, the protein that maintains the skin’s smoothness. 

Meanwhile, CBD may boost wakefulness⁽⁷⁴⁾. Cannabidiol may help not make consumers feel daytime sleepiness. Rather than working as a sedative, CBD has been studied to operate as a wake-promoting agent.

Serious Problems With Sleeping Pills

A sleeping pill is a sedative used to treat insomnia and other sleep disorders⁽⁷⁵⁾. Although sleeping pills have legitimate uses, these drugs can also lead to abuse and addiction. 

Some individuals are not aware of the potential risks and side effects of taking sleeping pills.

Some individuals experience seizures while taking sleep medications, while others have allergic reactions to sleeping pills⁽⁷⁶⁾.

Moreover, although it is rare for individuals to develop parasomnias due to sleeping pills, they can still experience these disorders. Parasomnias can manifest in behaviors such as sleep-walking and sleep-eating⁽⁷⁷⁾.

A comprehensive review was performed to analyze the evidence supporting melatonin as an agent to increase sleep quality. Melatonin may reduce fatigue for military personnel, civilians, and active adult males⁽⁷⁸⁾.

Anyone who believes they are using an excessive amount of sleep aids or are experiencing ill effects from a sedative should see a physician for medical advice. 

When to See a Doctor

Anyone who is having difficulty sleeping should see a physician and avoid self-medication. Individuals who have been experiencing any of the following on more than one night each week for many weeks in a row may see a physician about sleeping issues⁽⁷⁹⁾:

• Difficulty falling asleep or having a good night’s sleep
• Waking up earlier than the usual time
• Feeling excessively tired in the daytime 
• Trouble in performing daily activities due to sleep issues
• Falling asleep while driving, reading, watching TV, or doing other activities
• Snoring or gasping too loud

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1. The Extraordinary Importance of Sleep https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6281147/
2. Ibid.
3. Cannabis, Cannabinoids, and Sleep: a Review of the Literature https://pubmed.ncbi.nlm.nih.gov/28349316/
4. Cannabidiol as a Potential Treatment for Anxiety Disorders https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4604171/
5. CBD for chronic pain: The science doesn’t match the marketing https://www.health.harvard.edu/blog/cbd-for-chronic-pain-the-science-doesnt-match-the-marketing-2020092321003
6. Tips for beating anxiety to get a better night’s sleep https://www.health.harvard.edu/mind-and-mood/tips-for-beating-anxiety-to-get-a-better-nights-sleep
7. Chronic Pain https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/chronic-pain
8. 0159 Reduced REM Sleep Percent in Frequent Cannabis Versus Non-Cannabis Users https://academic.oup.com/sleep/article/43/Supplement_1/A62/5846891
9. Cannabis for Chronic Pain: Challenges and Considerations https://pubmed.ncbi.nlm.nih.gov/29637590/
10. Federal Study Finds Cannabis Beneficial for PTSD Treatment https://www.vfw.org/media-and-events/latest-releases/archives/2021/9/federal-study-finds-cannabis-beneficial-for-ptsd-treatment
11. Medical Cannabis and the Treatment of Obstructive Sleep Apnea: An American Academy of Sleep Medicine Position Statement https://jcsm.aasm.org/doi/10.5664/jcsm.7070
12. Chronic Pain https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/chronic-pain
13. Disturbed Sleep in PTSD: Thinking Beyond Nightmares to https://www.frontiersin.org/articles/10.3389/fpsyt.2021.767760/full
14. The Extraordinary Importance of Sleep https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6281147/
15. Cannabis, a complex plant: different compounds and different effects on individuals https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3736954/
16. Ibid.
17. Marijuana Addiction: Rates & Usage Statistics https://drugabusestatistics.org/marijuana-addiction/
18. Ibid.
19. Therapeutic Benefits of Cannabis: A Patient Survey https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3998228/
20. Harmful Effects of Smoking Cannabis: A Cerebrovascular and Neurological Perspective https://www.frontiersin.org/articles/10.3389/fphar.2019.01481/full
21. Cannabis, Cannabinoids, and Sleep: a Review of the Literature https://pubmed.ncbi.nlm.nih.gov/28349316/
22. Ibid.
23. Cannabidiol as a Potential Treatment for Anxiety Disorders https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4604171/
24. Ibid.
25. CBD for chronic pain: The science doesn’t match the marketing https://www.health.harvard.edu/blog/cbd-for-chronic-pain-the-science-doesnt-match-the-marketing-2020092321003
26. Tips for beating anxiety to get a better night’s sleep https://www.health.harvard.edu/mind-and-mood/tips-for-beating-anxiety-to-get-a-better-nights-sleep
27. Cannabidiol modulates serotonergic transmission and reverses both allodynia and anxiety-like behavior in a model of neuropathic pai https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6319597/
28. Serotonin https://my.clevelandclinic.org/health/articles/22572-serotonin
29. Chronic Pain https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/chronic-pain
30. CBD for chronic pain: The science doesn’t match the marketing https://www.health.harvard.edu/blog/cbd-for-chronic-pain-the-science-doesnt-match-the-marketing-2020092321003
31. Ibid.
32. 0159 Reduced REM Sleep Percent in Frequent Cannabis Versus Non-Cannabis Users https://academic.oup.com/sleep/article/43/Supplement_1/A62/5846891
33. Sleep Latency https://www.sciencedirect.com/topics/nursing-and-health-professions/sleep-latency
34. 0159 Reduced REM Sleep Percent in Frequent Cannabis Versus Non-Cannabis Users https://academic.oup.com/sleep/article/43/Supplement_1/A62/5846891
35. Ibid.
36. Sleep Basics https://my.clevelandclinic.org/health/articles/12148-sleep-basics
37. Ibid.
38. Cannabis for Chronic Pain: Challenges and Considerations https://pubmed.ncbi.nlm.nih.gov/29637590/
39. ​​Federal Study Finds Cannabis Beneficial for PTSD Treatment https://www.vfw.org/media-and-events/latest-releases/archives/2021/9/federal-study-finds-cannabis-beneficial-for-ptsd-treatment
40. Medical Cannabis and the Treatment of Obstructive Sleep Apnea: An American Academy of Sleep Medicine Position Statement https://jcsm.aasm.org/doi/10.5664/jcsm.7070
41. Chronic Pain https://adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/chronic-pain
42. Disturbed Sleep in PTSD: Thinking Beyond Nightmares https://www.frontiersin.org/articles/10.3389/fpsyt.2021.767760/full Tips for Better Sleep
43. Tips for Better Sleep https://www.cdc.gov/sleep/about_sleep/sleep_hygiene.html
44. Endocannabinoid signalling: has it got rhythm? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2931554/
45. Ibid.
46. Ibid.
47. Cannabis sativa L. and Nonpsychoactive Cannabinoids: Their Chemistry and Role against Oxidative Stress, Inflammation, and Cancer https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6304621/
48. ​​Cannabidiol and Other Non-Psychoactive Cannabinoids for Prevention and Treatment of Gastrointestinal Disorders: Useful Nutraceuticals? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7246936/
49. Cannabis sativa L. and Nonpsychoactive Cannabinoids: Their Chemistry and Role against Oxidative Stress, Inflammation, and Cancer https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6304621/
50. Cannabinoid therapies in the management of sleep disorders: A systematic review of preclinical and clinical studies https://www.sciencedirect.com/science/article/abs/pii/S1087079220300824
51. Cannabimimetic plants: are they new cannabinoidergic modulators? https://link.springer.com/article/10.1007/s00425-019-03138-x
52. Medical Cannabis and the Treatment of Obstructive Sleep Apnea: An American Academy of Sleep Medicine Position Statement https://jcsm.aasm.org/doi/10.5664/jcsm.7070
53. Cannabis for Chronic Pain: Challenges and Considerations https://pubmed.ncbi.nlm.nih.gov/29637590/
54. Cannabis, Cannabinoids, and Sleep: a Review of the Literature https://pubmed.ncbi.nlm.nih.gov/28349316/
55. Cannabidiol as a Potential Treatment for Anxiety Disorders https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4604171/
56. CBD for chronic pain: The science doesn’t match the marketing https://www.health.harvard.edu/blog/cbd-for-chronic-pain-the-science-doesnt-match-the-marketing-2020092321003
57. Cannabinoids in the management of difficult to treat pain https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2503660/
58. Practical considerations in medical cannabis administration and dosing, page 8 https://www.utah.gov/pmn/files/480971.pdf
59. Page 190-193 of Healing With CBD https://drive.google.com/file/d/1AGlxnhS2SoFeOXEuysv75bd_C9pEnwsU/view
60. Cannabis affects people differently: inter-subject variation in the psychotogenic effects of Δ9-tetrahydrocannabinol: a functional magnetic resonance imaging study with healthy volunteers https://pubmed.ncbi.nlm.nih.gov/23020923/
61. Practical considerations in medical cannabis administration and dosing https://www.utah.gov/pmn/files/480971.pdf
62. Ibid.
63. 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
64. FDA and Cannabis: Research and Drug Approval Process https://www.fda.gov/news-events/public-health-focus/fda-and-cannabis-research-and-drug-approval-process
65. Ibid.
66. CBD and other medications: Proceed with caution https://www.health.harvard.edu/blog/cbd-and-other-medications-proceed-with-caution-2021011121743
67. Ibid.
68. 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
69. Marijuana https://www.mayoclinic.org/drugs-supplements-marijuana/art-20364974
70. 1 in 3 adults don’t get enough sleep https://www.cdc.gov/media/releases/2016/p0215-enough-sleep.html
71. Ibid.
72. Here’s What Happens When You Don’t Get Enough Sleep (and How Much You Really Need a Night) https://health.clevelandclinic.org/happens-body-dont-get-enough-sleep/
73. Ibid.
74. Potential Effects of Cannabidiol as a Wake-Promoting Agent https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4023456/
75. Signs Of Sleeping Pill Abuse https://www.addictioncenter.com/sleeping-pills/symptoms-signs/
76. Ibid.
77. Ibid.
78. The effectiveness of melatonin for promoting healthy sleep: a rapid evidence assessment of the literature https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4273450/
79. How to Talk to Your Doctor about Your Sleep https://www.sleepfoundation.org/sleep-studies/how-to-talk-to-your-doctor-about-sleep

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