Why You Might Want to Use CBD for Sleep — and How to Do Just That
Trouble catching some zzz's? Maybe your sleep hasn't been great lately? Either way, it's time to do something about it.
"Sleep quantity is as important as sleep quality," says Alex Dimitriu, M.D., double board-certified psychiatrist and sleep medicine physician and founder of Menlo Park Psychiatry & Sleep Medicine. And while many substances (looking at you, wine) might help you feel sleepy, they can actually reduce your deep and REM sleep — two stages of sleep that are particularly beneficial to your brain and body's overall wellbeing.
But that doesn't seem to be the case with CBD. "Some recent research has suggested that CBD may be beneficial to sleep, without negatively impacting sleep architecture [aka what determines the quality and restorative ability of sleep]," according to Dr. Dimitriu.
So should you try using CBD to catch a few more winks? Perhaps. Ahead, experts weigh in on the potential pros of using CBD for sleep, explain the available research, and more.
First, What Is CBD?
By now, you've likely heard plenty about CBD, but let's review what it is so you can understand how it works. Ready? Let's go.
CBD comes from the cannabis plant (aka hemp or marijuana), which is chock-full of compounds called phytocannabinoids, such as tetrahydrocannabinol (THC), cannabinol (CBN), and — the star of this article — cannabidiol (CBD). While THC is known as the stuff that gets you high, "CBD is generally a non-intoxicating cannabinoid," says Smita Patel, M.D., a triple board-certified physician in neurology, sleep medicine, and integrative medicine and founder of iNeuro Institute. (Related: Drug, Medicine, or Something In Between? Here's What You Should Really Know About Weed)
CBD is "believed to produce beneficial effects such as anti-inflammatory, analgesic, anxiolytic [anti-anxiety], anti-nausea, and anti-epileptic effects, without causing the psychoactive or 'high' effects seen with THC," she explains. "In fact, CBD counteracts the psychoactive effect of THC by reducing anxiety and other negative effects of THC."
So, How Can CBD Be Beneficial for Sleep — If At All?
As with so many components of marijuana, there is a rather limited amount of scientific evidence on CBD for sleep. That being said, current research suggests that CBD may help with those zzz's due largely thanks to its ability to reduce anxiety and pain. The logic is somewhat simple: The calmer you are and the more comfortable you feel as you hit the hay, the more likely you are to drift off to dreamland successfully.
"Because of the way CBD interacts with the endocannabinoid system [a part of the nervous system that's designed to receive cannibinoids], it can help calm down the brain and body, making sleep more refreshing [as well]," says Melanie Bone, M.D., physician and cannabis specialist. "CBD interacts with receptors in the central nervous system (brain) as well as in other parts of the body. Biochemical reactions take place that increase certain neurotransmitters in the brain that encourage relaxation and sleep. This is a bit simplified, but it's the essence of how it works."
Similarly, CBD has also been shown to help with insomnia, which typically involves chronic difficulty falling asleep, staying asleep, or both. Because of their history of poor sleep, folks with insomnia might suffer from sleep anxiety, which can, in turn, increase their nighttime sleeplessness. CBD, however, might be able to help patients conquer this vicious cycle, thanks to its ability to reduce anxiety, according to the Sleep Foundation. As for research on the topic? A study looking at the use of CBD and THC in humans clinically diagnosed with insomnia is underway. (See more: Could Sleep Anxiety Be to Blame for Your Tiredness?)
The compound might also have the power to help manage REM sleep behavior disorder (RBD), a condition in which a sleeping person physically acts out and vocalizes their dreams, often with sudden, potentially violent arm and leg movements, according to the Mayo Clinic. For example, a 2014 study found that CBD (75 to 300mg per day for six weeks) reduced the frequency and symptoms of RBD. But (!!) it only involved four patients.
All that being said, "some patients find that taking an evening dose of CBD makes them feel awake, but when they lie down and close their eyes, they sleep deeper and longer than they do without the CBD," says Dr. Patel. "Other patients simply report that their CBD use in the morning or early afternoon helps them to relax and sleep more at night. CBD may disturb sleep in a small number of people when it's taken in the evening before bed."
Some good news? CBD probably isn't bad for your sleep cycle. Meaning, unlike wine, it likely won't change your sleep architecture (reminder: this is what determines the quality and restorative nature of the sleep you're getting). Case in point: A 2018 study that found that "CBD does not seem to interfere with the sleep cycle of healthy volunteers," explains Dr. Dimitriu. (And, TBH, just the fact that research like this exists is really exciting!)
How Much CBD Do You Need To Sleep?
If you're thinking, "wait, I tried this stuff, and it didn't work for me at all!" know that such a situation is pretty normal. "Because each person has a unique endocannabinoid system, each person may have a somewhat different reaction to a particular cannabinoid," says Dr. Bone. It could also come down to the dose; you just might not be taking enough. "Doses can range from 10mg to 500mg before people feel any effect," says Perry Solomon, M.D., a cannabis expert and board-certified physician. (Quite the range, no?)
"The key to achieving successful results with CBD is using an appropriate amount tailored to your individual needs," says Dr. Patel. "First, try CBD during the morning and in the middle of the day for three to five days before trying it right before bedtime. If you find CBD energizing and want to try it at bedtime, you may find that increasing your dose by two to four times may help with relaxation and sleep." (Related: I Tried 4 CBD Products for Sleep and Here's What Happened)
The universal advice from the experts: Start low and go slow. Begin by taking a small amount, and gradually scale up until you find what works best for you and helps you nod off. And if you're just getting started on your CBD for sleep journey, consider keeping tabs on your trials and errors. "You need to keep a sleep journal to record what you took, when you took it, and how you felt the next morning," advises Dr. Solomon. "You might need to adjust the time and dosage accordingly."
Dr. Patel shares a similar piece of advice: "Be sure to check in with your body and mind before taking [CBD] and one hour after taking the product so you can track its effectiveness." You can jot down how you feel right before you take your CBD and then 20, 40, 60 minutes later. Doing a body-scan meditation at these points can help you determine if any tensions have been released in your body (thereby telling you that the product's kicked in).
What Are the Forms of CBD?
There are plenty of options when it comes to the delivery of CBD, such as capsules, gummies, chocolates, oil droplets, tinctures, and more. But don't start stocking up on a veritable smorgasbord of products just yet. It helps to first identify your specific shut-eye struggles to best determine which, if any, CBD products could be a fit for you. "There are two issues with difficulty sleeping: falling asleep and staying asleep," says Dr. Solomon.
If you have trouble falling asleep, you'll typically want something fast-acting, such as a vape pen (but proceed here with extra caution given the recent health scares associated with certain pens), tincture (or oil) or dissolving under-the-tongue strips — all of which provide deliveries with the fastest efficacy, says Dr. Solomon. (Sound up your alley? You might want to check out these organic CBD oils, too.)
As for how long it takes for your dose of cannabidiol to kick in? It totally depends — and the experts don't have a formula. It depends on your body, the delivery, what you've recently eaten, and many other factors (those are just the ones experts know of right now). A rough range would be 15 to 90 minutes, with inhalation providing the fastest delivery (as little as 15-30 minutes). Research, however, is still scant on this.
Now, if you're having trouble staying asleep the whole night, you likely "need to take something that takes longer to begin to work and lasts longer," says Dr. Solomon. This means an edible method (including capsule) is your best bet. "An edible, such as a gummy, can take one to one and a half hours to kick in, and lasts four to six hours," says Dr. Solomon. "If taken before bed, it will start to work when you are asleep — and help keep you asleep." (Related: Are Edibles the Key to Better Sleep?)
CBD Products that Help With Sleep
"There are many products with varying ranges of CBD, CBN, and THC that some [patients] find effective, but others find don't work at all," says Dr. Solomon. "I might stay away from products that have a high amount of THC (the product that gets you 'high') since some people don't like that feeling. The exact amount can range from 5-10mg of THC, but again, it varies from person to person." (Related: What's the Difference Between CBD, THC, Cannabis, Marijuana, and Hemp?)
Unfortunately, THC still is not federally legal — so this author's personal favorite sleep gummy, Plus Dual Action Sleep Lychee Gummies, is only available in California. They have 3mg CBD, 2mg CBN, 1mg THC, and are like a FastPass to sleepy town, sans high.
Everything You Need to Know About Cannabis
Here’s the tea on CBD, THC, and the plant formerly known as marijuana.
You can smoke it, vape it, sip it, or spritz it. You can bake it into brownies. You can find it in lotions and potions to rub on your skin, tinctures to drop under your tongue, capsules to swallow, or oils that have been added to your latte or ice cream. Cannabis is everywhere these days, and to hear its proponents talk, it’s the fix for everything that might ail you. But is it? And do you need a degree in medicinal plant studies (yes, that exists) to know your CBD from your THC?
What exactly is cannabis?
The cannabis plant contains more than 100 chemical compounds, known as cannabinoids, some of which can affect how we feel and think. The most famous are tetrahydrocannabinol (THC), which produces a euphoric feeling and alters sensory perception, and cannabidiol (CBD), which is non-intoxicating but may be potent in other ways. Both hemp and marijuana are varieties of cannabis, but hemp has a very low concentration of THC, while marijuana’s is, no pun intended, much higher. The type and amount of cannabinoids in any given plant vary widely depending on the plant’s strain and how it’s grown; they help determine whether a cannabis product will perk you up, settle you down, or land you somewhere in between.
How do you consume cannabis?
Smoking pot leads to an almost- immediate high; in edible form, effects are delayed for 30 minutes to an hour but may be more intense, longer lasting, and, in some cases—especially if you overindulge—decidedly unpleasant (nausea, paranoia, even hallucinations).
Of course, cannabis has the potential to do much more than alter your consciousness. Yet because the plant’s longtime illegal status (see “Canna-Busted?,” right) stunted medical research, there’s still a lot to learn about its effectiveness. We’ve rounded up some of the most common cannabis claims to see which are solid and which may be as wispy as smoke.
Does cannabis actually relieve chronic pain?
The facts: When no less an authority than the National Academies of Sciences, Engineering, and Medicine (nasem) released a 2017 report reviewing the health effects of cannabis, it included evidence to validate the plant’s efficacy in treating several health conditions; chronic pain was in the top three.
A comprehensive review published in JAMA in 2015, analyzing 79 trials with 6,462 patients, found evidence that cannabis worked for chronic pain—which is “encouraging,” says Raphael Mechoulam, PhD, head of the medicinal chemistry lab at Hebrew University of Jerusalem and one of the world’s foremost cannabis researchers.
There is real promise that cannabis could help adults with chronic pain.
Daniele Piomelli, PhD, co-director of the Center for the Study of Cannabis at the University of California, Irvine, is also optimistic: “There is real promise that cannabis could help adults with chronic pain, though we need a few more studies to say that conclusively.” Because cannabis has a negligible risk of overdose, experts have suggested that medical cannabis could even be a way to help address the country’s opioid problem.
We have less evidence for the CBD-only panaceas we’re seeing everywhere from bars to bodegas to boutiques: the oils, vapors, topicals, and tinctures. There are tantalizing studies on CBD for pain, but they’ve been done on lab animals, and a rat needs a far lower dose of a drug to see effects than a 150-pound woman.
Medical cannabis could be a way to help address the country’s opioid problem.
Furthermore, the amount of cannabidiol that your body can get from an oil is relatively low. “My feelings on CBD products isn’t that they don’t work, but that they can’t be effectively used by humans because the dose would need to be so high,” says Jordan Tishler, MD, a Harvard Medical School–trained internist who’s president of the Association of Cannabis Specialists.
The caveats: An October 2018 paper found that more than one in ten frequent marijuana smokers who gave up their habit experienced cannabis withdrawal syndrome, which could include symptoms such as feelings of anger, irritability, or aggressiveness; abdominal pain; fever; chills; sweating; headache; or tremors or shakiness.
Is cannabis legal?
The laws regulating cannabis—and their enforcement—are changing by the day. Here’s where things stand right now.
Marijuana has been effectively illegal under federal law since 1937. Today it’s still federally prohibited, but individual states have their own laws regarding growth, sale, and possession (for instance, 46 states permit some form of medical use of marijuana; ten of them also permit recreational use).
46 states permit some form of medical use of marijuana; 10 of them also permit recreational use.
Hemp, on the other hand, was federally legalized last year. But as of press time, CBD, even if derived from hemp, is still federally prohibited. Although CBD is widely marketed as a health and wellness aid, the FDA considers it a drug, not a supplement, and does not allow the sale of CBD-laced products.
The FDA considers CBD a drug.
Some states, like Maine, have even started cracking down on the sale of CBD-infused food products. Does this mean the feds will come after you for your CBD gummies? Unlikely. In February 2017, then–Attorney General Jeff Sessions said in an interview that the Justice Department wasn’t planning to take on “small marijuana cases”—like yours. True, Sessions is no longer AG, but federal policing of individual consumption is still unlikely to become a priority.
Does cannabis help with sleep?
The facts: There’s moderate evidence that cannabis can help some people snooze better, according to the nasem report. And a 2017 research review suggests that CBD may have therapeutic potential for the treatment of insomnia. THC may also help people nod off faster, says Mechoulam. But on the flip side, it might cause sleep to be less restful, canceling out some of its benefits.
The caveats: The way cannabis helps or hampers sleep depends on many factors, including the levels of CBD and THC, the dose, the method, the length of time you’ve been taking it, and the existing sleep issues. In addition, most of the studies on cannabis and sleep have been done on people with chronic pain issues. And even if THC does put you out, there’s a risk that the effects will wear off with regular use. But if you’ve tried everything else, talk to a doctor about cannabis. “Insomnia is, like pain, a condition for which conventional medications don’t work very well,” says Tishler, who notes that cannabis is a promising option with a low risk of negative side effects.
And how about gastrointestinal issues?
The facts: While a preliminary 2017 study showed that a non-intoxicating form of THC called THC-A had an anti-inflammatory effect when applied to cells taken from people with inflammatory bowel disease (IBD), experts are still uncertain whether cannabis can have the same effect in patients. Tishler says that cannabis use can improve IBD symptoms including the debilitating stomach pains IBD is known for, but it’s not a proven cure. “The evidence for treatment of symptoms of IBD is clear,” he says. “Whether that’s based on changes in how a patient perceives their symptoms or on improving the pathology of the disease is less than clear.”
The caveats: THC-A has been tested only in human tissue, not humans themselves. While Tishler has recommended the compound to some of his patients, he says that “most dispensaries aren’t hip to the medical value of THC-A” and don’t carry these types of products.
But cannabis can mitigate anxiety, right?
The facts: Studies have supported the stoner movie stereotype of the uptight worrywart who is mellowed out by a joint. But studies have also supported that other stereotype, of the paranoid pothead: Anxiety and panic reactions are the most commonly noted acute effects of being high. This is because THC appears to decrease anxiety at lower doses and increase anxiety at higher doses.
THC appears to decrease anxiety at lower doses and increase anxiety at higher doses.
There is less anecdotal and scientific evidence regarding CBD, though it appears to ease anxiety at all doses that have been tested. “My impression is that low levels of THC and high levels of CBD cause positive effects by enhancing mood,” notes Mechoulam. However, he adds, the therapeutic window for CBD and the precise mechanisms by which it works are yet to be determined.
The caveats: Considering the number of people who use marijuana to treat anxiety, there’s a surprising dearth of rigorous research on how it affects mental health conditions. Given the federal prohibition of cannabis, most studies looking at its effect on mood have involved little control or standardization of treatment type or dose. THC and CBD may help anxiety in the short term, but so do exercise and cognitive-behavioral therapy, and the evidence suggests long-term use isn’t recommended (the effects may wear off, or users could become dependent on this treatment).
Now for the biggest caveat of all. Use of marijuana is linked to an increased risk of schizophrenia in those with a genetic vulnerability, and the risk goes up the more you use. So if you’re going to partake, do so in moderation. And keep in mind that, as every expert will tell you, what we don’t yet know about cannabis far outweighs what we do. But if it turns out to have even half the therapeutic benefits it’s said to possess, it will prove to be a wonder drug indeed.