CBD and Sleep: The Research So Far

Cannabinoids have been getting a lot of buzz lately for their potential in treating sleep disorders (Babson, Sottile, & Morabito, 2017). With the increasing legalization of medicinal cannabis and the fact that cannabinoids have been shown to have soporific effects, more and more people are curious about their potential therapeutic benefits. These compounds are being investigated as a possible treatment option for a variety of common and less common sleep disorders such as insomnia, sleep disordered breathing, restless legs syndrome, narcolepsy, and parasomnias (Kuhathasan et al., 2019).

Limitations of Studies

There are limitations in the amount and consistency of studies on CBD. New data is being released all the time, and scientists move closer to consensus each year – but policy makers like the FDA require strong evidence before approving something to be intended to treat illness. While anecdotal stories abound about how CBD helped with sleep – they are just that, anecdotal. Scientific studies are shedding actual light into how CBD and THC. And with some positive and negative effects recorded, more research is needed before any conclusions can be made, or recommended to policymakers. Our purpose in this article is to collect and summarize notable existing research – not to make claims of any products efficacy. As strong believers in CBD, Utah Cannabis Co wants to keep the newest findings in the forefront of the stage.

Cannabinoids and Sleep Disorders

Keeping the limitations in both pre-clinical and clinical studies in mind, the studies in this article do point to cannabinoids having some potential therapeutic effects on sleep disorders. The research referenced here has shown promising results, with some preliminary studies indicating that CBD could be an effective treatment for insomnia – where THC might help with reducing sleep latency, it could also have negative effects on sleep quality over the long term (Russo, Guy, & Robson, 2007). Additionally, some studies have investigated the use of synthetic cannabinoids like nabilone and dronabinol for sleep apnea, which show that they may provide some short-term benefits by modulating serotonin-mediated apneas (Babson et al., 2017).

The Potential Therapeutic Effects of Cannabinoids on Sleep Disorders:

CBD looks like it could be a promising option for treating other sleep disorders like REM sleep behavior disorder and excessive daytime sleepiness. On the other hand, nabilone might be able to reduce nightmares associated with PTSD and improve sleep for those with chronic pain (Russo et al., 2007). While there are clinical trials underway to test the efficacy of cannabinoids in managing insomnia and obstructive sleep apnea, what we really need are some large multicenter studies that are rigorous enough to thoroughly assess the dose, efficacy, and safety of the different types of cannabinoids when used to treat sleep disorders (Kuhathasan et al., 2019).

Let’s be honest here: research on cannabis and its effects on sleep is still in its early stages, and the results so far have been somewhat mixed (Babson et al., 2017). However, it’s pretty clear that cannabinoids do have the potential to modulate sleep physiology and impact various sleep disorders. That being said, it’s absolutely crucial that we conduct more controlled and longitudinal research to further our understanding of both the research and clinical implications of using cannabinoids to treat sleep disorders. In this article, we’ll take a look at some studies and their results that specifically examine the use of CBD to treat sleep-related issues.

The Effects of CBD on Sleep:

Let’s talk about a study called “Cannabidiol, a constituent of Cannabis sativa, modulates sleep in rats” (Murillo-Rodríguez et al., 2006). Basically, the goal of this study was to see what would happen when rats were given CBD directly into their brain ventricles (intracerebroventricular administration) and how it would affect their sleep patterns. The results were pretty interesting: when CBD was given to the rats during their “lights-on” period, it actually increased their wakefulness and reduced their rapid eye movement (REM) sleep. However, no changes in sleep were observed when the CBD was given during the “dark phase.” What this suggests is that CBD has the ability to modulate waking activity by activating neurons in two specific regions of the brain – the hypothalamus and dorsal raphe nucleus (DRD) – both of which play a role in generating alertness. The study also discovered that the icv injections of CBD led to an enhancement of c-Fos expression in these areas of the brain that are associated with wakefulness.

In addition to what we just talked about, the study also looked at the effects of CBD on the release of dopamine (DA) in the nucleus accumbens – a region of the brain that’s involved in reward processing and motivation. To do this, they used microdialysis in unanesthetized rats. What they found was that when CBD was given via icv administration, it actually caused an increase in the release of DA in this area of the brain. The study then went on to test whether the sleep-inducing endocannabinoid anandamide (ANA) could block the wakefulness-inducing properties of CBD, but it turns out that it couldn’t. What this all means is that CBD might actually be helpful in treating sleep disorders that involve excessive somnolence (i.e. sleepiness), since it seems to promote wakefulness and increase dopamine levels in the brain.

CBD for Improving Sleep Quality:

While there haven’t been a ton of studies on how CBD affects the sleep-wake cycle in humans, the research that does exist suggests that CBD could be a helpful tool for improving sleep quality and reducing dream recall without any negative side effects. Additionally, CBD has shown some potential for treating REM sleep behavior disorder (RBD) – a condition that causes people to act out their dreams during the rapid eye movement (REM) phase of sleep – which is often seen in patients with Parkinson’s disease (PD) (Chagas et al., 2013). Currently, the main treatment for RBD is a benzodiazepine called clonazepam, which can have some serious side effects, especially in older patients. So, CBD might be a viable alternative to traditional treatments for RBD.

CBD and the Brain

There’s an interesting case report that suggests CBD could be a potential treatment option for patients with Parkinson’s disease who suffer from rapid eye movement sleep behaviour disorder (RBD). Apparently, a recent case series found that CBD led to a significant reduction in the frequency of RBD-related events in these patients, and the effects were both quick and long-lasting. Although we’re still not entirely sure how CBD works to improve sleep and RBD, some experts believe that it may have something to do with its ability to modulate CB1 receptors in certain parts of the brain that are involved in regulating the sleep-wake cycle, like the basal prosencephalon and the pedunculopontine and laterodorsal nuclei.

CBD, Sleep, and Anxiety

CBD might have some promising benefits for people dealing with anxiety and sleep issues. There was a retrospective case series done at a psychiatric clinic, called “Cannabidiol in Anxiety and Sleep: A Large Case Series,” (Shannon et al., 2019) that looked at how CBD could be used as an adjunct to usual treatment for these complaints. They followed 103 adult patients and tracked their anxiety and sleep quality monthly while using CBD. Turns out, most patients were totally cool with it and didn’t experience any negative effects. Only three patients reported adverse effects.

Out of the 72 adults who finished the study, 47 were mainly concerned about anxiety and 25 were struggling with poor sleep. Within the first month, about 80% of patients saw a decrease in their anxiety scores, which stayed low throughout the rest of the study. As for sleep, 2 out of 3 patients (around 67%) showed improvement in their sleep scores within the first month, but there were some fluctuations over time. It seems like CBD might have some potential as a treatment for anxiety-related disorders and improving sleep quality. But to really know for sure, we need more controlled clinical studies to investigate the therapeutic possibilities of CBD in these areas.

CBD and Age

In another study, “Cannabis use and sleep: Expectations, outcomes, and the role of age” (Winiger et al., 2021) included 152 moderate cannabis users with different ages, and the results were a mixed bag. Basically, people who were currently using cannabis and using it more often tended to expect that it would improve their sleep. But interestingly, the frequency of recent use and the concentration of THC or CBD in the cannabis didn’t really have much of an impact on sleep outcomes. Here’s the weird part: people who said they were currently using cannabis actually reported worse subjective sleep quality. Plus, the more often they ate cannabis-infused edibles, the worse their overall sleep was, with lower sleep efficiency, shorter sleep duration, and higher PSQI scores (which means worse overall sleep).

Here’s what the study found: age played a role in how CBD concentration affected sleep duration and quality. Even though the overall effects of cannabis use on sleep outcomes didn’t hold up after multiple comparisons correction test, some of the results were still worth noting. For example, people who used cannabis tended to have higher expectations that it would help them sleep, but there weren’t many clear connections between cannabis use and actual sleep outcomes. On the other hand, the concentration of CBD in cannabis did seem to have a positive effect on sleep duration, especially when age was factored in. So, age might be an important factor in how CBD concentration can affect sleep in a positive way.

Limitations

There’s a lot of interest in using cannabinoids to treat sleep disorders, but we need more research to understand how safe and effective they really are, and how different doses might affect people differently. While some studies have shown promise, there are some issues with how they were done, like small sample sizes, inconsistent methods, and possible biases. Plus, we still don’t know enough about how different cannabinoids interact with other medications or underlying medical conditions, so more research is definitely needed.

Conclusion

While there are some limitations to the research on cannabinoids and sleep, it has given us some important clues about how they might help treat sleep disorders. For example, CBD seems to be promising for reducing anxiety and improving sleep quality, while THC might help people fall asleep faster but could harm sleep quality in the long run. Researchers have also looked at synthetic cannabinoids like nabilone and dronabinol for sleep apnea, and found that they can help reduce serotonin-mediated apneas in the short term.

In addition, cannabinoids may also be useful for treating other sleep disorders, such as REM sleep behavior disorder and excessive daytime sleepiness. However, we need more research to fully understand how cannabinoids work in these disorders and to identify any potential risks associated with their use.

To summarize, using cannabinoids for managing sleep disorders is an ongoing area of research, and early studies have shown encouraging results. However, we need more research to fully understand the safety, effectiveness, and optimal dosages of different cannabinoids for various sleep disorders. As more states legalize cannabis for both medical and recreational use, it becomes even more critical to have a clearer understanding of how cannabinoids affect sleep, so we can provide better guidance for clinical practice and public health policies.

References

Babson, K. A., Sottile, J., & Morabito, D. (2017). Cannabis, cannabinoids, and sleep: A review of the literature. Current Psychiatry Reports, 19(4), 23.

Chagas, M. H. N., Crippa, J. A. S., Zuardi, A. W., et al. (2013). Effects of acute systemic administration of cannabidiol on sleep-wake cycle in rats. Journal of Psychopharmacology, 27(3), 312-316. 

Kuhathasan, N., Dufort, A., MacKillop, J., Gottschalk, R., Minuzzi, L., & Frey, B. N. (2019). The use of cannabinoids for sleep: A critical review on clinical trials. Experimental and Clinical Psychopharmacology, 27(4), 383–401. 

Moltke, J., & Hindocha, C. (2021). Reasons for cannabidiol use: A cross-sectional study of CBD users, focusing on self-perceived stress, anxiety, and sleep problems. Journal of Cannabis Research, 3, 5. 

Shannon, S., Lewis, N., Lee, H., & Hughes, S. (2019). Cannabidiol in anxiety and sleep: A large case series. The Permanente Journal, 23, 18-041. 

Chagas, M. H. N., Eckeli, A. L., Zuardi, A. W., Pena-Pereira, M. A., Sobreira-Neto, M. A., Sobreira, E. T., Camilo, M. R., Bergamaschi, M. M., Schenck, C. H., Hallak, J. E. C., Tumas, V., & Crippa, J. A. S. (2014). Cannabidiol can improve complex sleep-related behaviours associated with rapid eye movement sleep behaviour disorder in Parkinson’s disease patients: A case series. Journal of Clinical Pharmacy and Therapeutics, 39, 564–566.  

Murillo-Rodríguez, E., Millán-Aldaco, D., Palomero-Rivero, M., Mechoulam, R., & Drucker-Colín, R. (2006). Cannabidiol, a constituent of Cannabis sativa, modulates sleep in rats. FEBS Letters, 580(18), 4337–4345. 

Russo, E. B., Guy, G. W., & Robson, P. J. (2007). Cannabis, pain, and sleep: Lessons from therapeutic clinical trials of Sativex®, a cannabis-based medicine. Chemistry & Biodiversity, 4(8), 1729–1743.

Winiger, E. A., Hitchcock, L. N., Bryan, A. D., & Bidwell, L. C. (2021). Cannabis use and sleep: Expectations, outcomes, and the role of age. Addictive Behaviors, 112, 106642.