A good night's sleep has incontestable benefits for general health and wellbeing. For 30% of the general population, however, sinking into an effortless slumber doesn't come easily, according to a national poll by the Sleep Foundation. To make matters worse, sleeping pills and medications commonly used to induce sleep are often accompanied by side effects.
One possible alternative to these medications is cannabidiol (CBD), a non-intoxicating cannabis compound. It is currently trending as a sleep aid as many are discovering that it promotes drowsiness by removing obstacles to sleep, such as anxiety. But are there scientific grounds to believe that CBD can actually support and bolster more healthful sleep? Weedmaps spoke with four experts to find out.
What is CBD and how does it work?
While we have some understanding of how CBD interacts with the body, there is still much to learn.
“CBD itself doesn't do a lot of heavy lifting when it comes to binding to CB1 and CB2 receptors but instead promotes the binding of the endocannabinoids already in our systems,” Drew Ford, Chief Science Officer at Kase Manufacturing, a cannabis extraction facility, told Weedmaps. “It ensures they bind to the receptors that they're supposed to go to.”
Endocannabinoid receptors affect the entire body. According to Dr. Thinh Vo, Director of Quality and Compliance at Koi CBD, cannabidiol indirectly has an impact on receptors that send information between “the cells in the nervous, immune, and circulatory systems to regulate biological processes.”
Evidence from a study published in Translational Psychiatry also suggests that CBD inhibits the uptake of anandamide, which is an endocannabinoid that is often referred to as the “bliss molecule.” Anandamide binds to CB1 receptors in the body's endocannabinoid system, just like CBD. When CBD occupies those receptors instead, anandamide's pleasant effects may last longer.
How does CBD make you feel?
When it comes to how CBD products will make you feel, the answer will depend largely on individual-specific factors.
“Each person's reactions to CBD are unique,” Vo told Weedmaps News. “Reactions to CBD are also affected by other variables such as delivery method, whether the person is taking existing medications/supplements, and whether the product is an isolate or a spectrum oil.”
Vo points out that terpenes present in CBD oil also influence the individual's response. “We know that terpenes play an essential role in determining the strain and influencing a sedative effect, energetic effect, or combination of both,” he explained.
Per a study published in the Brazilian Journal of Psychiatry, when administered at different doses, CBD may provoke distinctive responses. Low doses may cause someone to feel energized and alert, while higher doses may be relaxing and encourage drowsiness. CBD is frequently anecdotally reported to alleviate anxiety.
“CBD is an anxiolytic, which means that it reduces anxiety and is calming,” explains Dr. Elaine Burns, a naturopathic doctor who is CEO and founder of Dr. Burns' ReLeaf. “In addition, it helps to relax the muscles. These two properties both contribute to a feeling of relaxation in the mind and body.”
Does CBD oil make you tired?
As to whether CBD oil can cause tiredness, expert opinions appear to be mixed. “There is no true clinical evidence to support CBD as a sleep aid. CBD oil itself should not make a person drowsy,” Ford said.
That being said, Ford also acknowledges that CBD may diminish the anxiety that can inhibit sleep and “could be effective as a sleep aid for people who need to calm down and relax their mind.”
Dr. Patricia Frye, a board-certified cannabis clinician and Chief Medical Officer at HelloMD, pointed out that there is evidence that high doses of CBD can modulate adenosine pathways in the brain. “Adenosine is the substance that accumulates during the day and deactivates the sensory neurons in the area of the brain that keeps us awake.”
CBD may also trigger tiredness or a sleep response through its reported effects on the 5-HT1a serotonin receptors, as observed in a study published in the medical journal Pain. “When binding to the 5-HT1a receptors, CBD essentially blocks those receptors from other agonists binding to them,” Ford explained. “Depending on the individual's body chemistry, when CBD binds to these receptors it can essentially block the anxiety or depression-causing molecules, leading to immediate relief.” As a result, some individuals may feel a sensation of sleepiness.
CBD vs. THC for sleep
THC, the cannabis plant's most abundant and intoxicating cannabinoid, is reputed to induce sleepiness. Ford believes any feelings of drowsiness associated with CBD oil can most likely be attributed to THC. “If CBD oil is making you feel drowsy, it's probably due to a fraction of THC being left in the product,” he said.
THC isn't necessarily more effective than CBD as a sleep aid. An individual's body chemistry affects how he or she responds to THC, and for some, it may be counterproductive if they're looking for deep slumber. Ford explained that while the “psychoactivity of THC” can lead to drowsiness, it can also cause the mind to race, ultimately concluding that “it really depends on what symptoms you are trying to overcome and what works best for your own body.”
Burns agrees, adding that THC can also cause anxiety and restlessness at doses higher than 10 milligrams. “Because of this, I would say that CBD is a better sleep aid for most people; however, dosing less than 10 milligrams of THC along with 20 milligrams or more of CBD could be a great combination.”
CBN, the cannabinoid into which THC transforms when exposed to heat and light, may have more sedative effects. One analysis by Steep Hill Labs found that five milligrams of CBN was as effective as a 10-milligram dose of diazepam, a member of the “benzo” family used to treat muscle spasms, seizures, and anxiety. Thus, it's likely that consuming older cannabis will have more sedative, sleep-inducing effects than fresher flower with less CBN present.
What effect does CBD oil have on sleep disorders?
Although more studies on CBD and sleep disorders need to be conducted, Vo pointed to the U.S. National Institutes of Health's National Library of Medicine, which returns more than 100 results for a search of CBD and sleep. The articles include studies and reviews of previous research, mostly conducted on animal models, which may overlap. A 2019 review of the use of CBD and THC for sleep indicates that cannabinoids may improve sleep quality, decrease sleep disturbances, and reduce the time it takes to fall asleep.
Many of the studies reviewing CBD, however, examined sleep as a secondary outcome in the context of another illness. Frye highlighted a 2019 study published in Frontiers in Pharmacology that investigated the use of CBD oil for children with autism spectrum disorder to treat related conditions such as sleep disturbances. “Patients with autism typically have sleep disturbances,” she explained. “The study showed that CBD improved sleep in 71.4% of patients.”
What are the other potential benefits of CBD?
As CBD interacts with the nervous, immune, and circulatory systems, it may also offer benefits for a gamut of conditions. An in-vitro study published in the European Journal of Pain suggests that CBD reduced evidence of pain and inflammation behaviors in rats, while another study published in Ingenta Connect found that CBD exhibited anti-anxiety and anti-depression effects in animal models. Too, CBD shows promise in reducing epilepsy-induced seizures and some types of muscle spasms, as shown in this in-vivo study published in The Lancet Neurology and this pilot patient study published in the International Journal of Neuroscience.
Per an in-vitro study published in the British Journal of Clinical Pharmacology, there is also evidence that CBD may potentially improve heart health and, as seen in this scientific review published by CNS Neuroscience & Therapeutics, may offer protective benefits for neurodegenerative disorders such as Parkinson's disease.
There is some evidence that CBD may reduce anxiety and promote feelings of calm and relaxation, which could lead to better sleep in some people.
However, there is presently little clinical research on human subjects specifically investigating the effects of CBD on sleep disorders. Possibly, future studies will enhance our understanding of CBD, its mechanisms, and its role in sleep regulation.
Major contributions from Dr. Adie Rae.