Introduction to Using CBD Oil for Sleep
Cannabis plants produce numerous compounds (also referred to as cannabinoids) of which delta-9-tetrahydrocannabidiol and cannabidiol are the most abundant and well recognized. Delta-9-terahydrocannabidiol, commonly known as THC, is a psychoactive and causes euphoric effects, also known as a “high” sensation. Cannabidiol, or CBD, unlike THC, does not produce these euphoric effects. Additionally, according to the World Health Organization (WHO), CBD does not exhibit indications of any abuse or dependence amongst users. CBD is generally well tolerated and considered safe. The WHO also states that, to date, there is no evidence of any public-related safety-issues associated with the use of CBD products.
Studies are underway to help explain the science and provide supporting evidence for how and why CBD works so well for people who are suffering from chronic pain, sleep deprivation and more. In this article we are going to focus on how and why it makes sense to consider using CBD oil for sleep.
CBD and Your Endocannabinoid System
Broadly, it is understood that CBD works primarily in conjunction with the body’s endocannabinoid system (ECS) which helps regulate physiological processes such as hormones, inflammation, stress, pain and more. Additionally, CBD is thought to have physiological mechanisms as well, such as interacting with serotonin receptors in the brain.1,2 Serotonin is a chemical that is considered a mood stabilizer within the body. This chemical is naturally produced within the body and when levels dip below a normal level, it can lead to feelings of depression and anxiety which, in turn, can negatively impact sleep. While CBD does not necessarily boost serotonin levels, a study has shown that CBD, through its interactions with serotonin receptors, is able to help reduce feelings of depression.
In addition to interacting with serotonin receptors, CBD is also believed to play a role in reducing cortisol levels in the body that may spike due to stress, trauma or pain. Studies have attributed this reduction in cortisol levels to indirectly improving sleep disorders.
So, How and Why Does CBD Help You Sleep?
As touched on above, sleep disorders can be caused by a variety of factors including anxiety, stress, trauma, or pain. And while there are plenty of medications and over-the-counter supplements available to help people contend with sleep deprivation, many of these options can cause undesired side effects. CBD can indirectly help resolve the inability to sleep by working on the issues that contribute to sleep disorders.
CBD and Stress
Stress is a condition often associated with an increase in a hormone called cortisol. In the short-term, when cortisol is released due to a stressful circumstance, this will cause altered immune system responses and suppression of systems in the body. Eventually, when the stressful circumstance is resolved or gone, cortisol levels drop and the systems within the body return to normal function. However, when cortisol is consistently released in the body due to long-term stress, it can disrupt the body’s natural processes and lead to issues such as sleep disorders. Managing the excess release of cortisol in individuals can thereby help improve the symptoms that accompany stress, specifically, sleep disorders such as insomnia.
CBD can be helpful in managing stress-related sleep disorders by contributing to the lowering of cortisol levels in the body.4 This can indirectly improve the ability to sleep by allowing for the reestablishment of normal system functions within the body.
Anxiety is often correlated with increased stress and cortisol levels as well. This can eventually lead to sleep disorders such as insomnia. To this, CBD has also been shown to be beneficial in improving symptoms of anxiety-related insomnia as well. A retrospective study conducted to see the correlation between CBD use and anxiety-associated insomnia showed that there was a decrease in anxiety scores within the first month of CBD use for a majority of patients.5 The study also an improvement in sleep scores within the first month of CBD.
CBD and Pain
Like stress, pain can be caused by a variety of factors, and can contribute to numerous issues including sleep disorders, discomfort, debilitation, and decreased quality of life. Short-term pain is caused by a reaction of the nervous system. For example, if an individual sprains their ankle, there is short-term pain and inflammation. This pain only lasts a few days to weeks until the ankle has fully healed. Chronic pain is long-term and can last anywhere from months to years. This type of pain is typically the result of inflammation, nerve weakening or nerve damage. Individuals that suffer from either short-term or long-term pain can also suffer from sleep disorders due to the discomfort that accompanies the pain.
For these individuals, CBD can be an alternative option for managing the pain and associated sleep disorders. Various studies have demonstrated an association between CBD use and improvements in pain management.6-12 CBD use has also been correlated with individuals who no longer needed an increase in the dose of their respective current pain management drug therapies.7,8 Accordingly, individuals suffering from an inability to sleep due to pain issues, may find improvements from the potential therapeutic advantages of CBD.
CBD and Trauma
Trauma is another issue that can contribute greatly to sleep disorders. The stress from a traumatic event will often lead to the inability to sleep, or insomnia. This is because when the body is over-stimulated (often a result of the trauma), certain neurotransmitters in the brain, such as epinephrine (also known as adrenaline), will keep us awake.13 This can not only lead to insomnia, but also flashbacks to the traumatic event, nightmares, increased anxiety and even depression. Trauma can also cause cortisol levels to rise due to the associated stress, which in turn, also contributes to sleep disorder.
As mentioned above, CBD can play a role in controlling cortisol levels which can indirectly help resolve the inability to sleep. Additionally, when it comes to trauma, it is thought that CBD may help by working on the serotonin receptors in the brain to improve mood. A case report done on a female with post-traumatic stress disorder (PTSD) showed that there was a correlation between daily CBD oil use and reduced insomnia or sleep disturbances in the patient. 14
For individuals who are seeking a way to improve their sleep without suffering the side effects of sleep medications, CBD products may be an attractive natural alternative. CBD oil has gained much interest as a safe and natural remedy that seems to interact well with the body’s endocannabinoid system while providing relief for various ailments including anxiety management and sleep deprivation. It is recognized as an attractive option for people who don’t want to take pharmaceutical drugs or contend with the mind-altering effects of THC.
Although CBD is considered safe and generally well tolerated, it may cause adverse reactions in some individuals. Side effects that have been reported with the use of CBD include fatigue, diarrhea, changes in appetite and weight, jitteriness, and drowsiness. In addition, CBD can negatively interact with some medications.
If you are thinking of using CBD, it is important to know that CBD products are not regulated by the Food and Drug Administration (FDA). Always use caution and research the various CBD oil products to see which one is right for you. Also, remember to consult your doctor before starting the use of any CBD products, especially if you are currently taking any medications as CBD can interact negatively with certain drugs.
- Elms L, Shannon S, Hughes S, Lewis N. Cannabidiol in the Treatment of Post-Traumatic Stress Disorder: A Case Series. J Altern Complement Med. 2019;25(4):392-397. doi:10.1089/acm.2018.0437
- Zanelati TV, Biojone C, Moreira FA, Guimarães FS, Joca SR. Antidepressant-like effects of cannabidiol in mice: possible involvement of 5-HT1A receptors. Br J Pharmacol. 2010 Jan;159(1):122-8. doi: 10.1111/j.1476-5381.2009.00521.x. Epub 2009 Dec 4. PMID: 20002102; PMCID: PMC2823358.
- Serotonin: What You Need To Know. https://www.healthline.com/health/mental-health/serotonin#functions. Last Reviewed on May 18, 2017. Accessed on October 12, 2020.
- Zuardi AW, Guimarães FS, Moreira AC. Effect of cannabidiol on plasma prolactin, growth hormone and cortisol in human volunteers. Braz J Med Biol Res. 1993 Feb;26(2):213-7. PMID: 8257923.
- Shannon, Scott et al. “Cannabidiol in Anxiety and Sleep: A Large Case Series.” The Permanente journal 23 (2019): 18-041. 7 Jan. 2019. Accessed Oct. 5, 2020.
- Genaro K, Fabris D, Arantes ALF, Zuardi AW, Crippa JAS, Prado WA. Cannabidiol Is a Potential Therapeutic for the Affective-Motivational Dimension of Incision Pain in Rats. Front Pharmacol. 2017;8:391. Published 2017 Jun 21. doi:10.3389/fphar.2017.00391
- Hoggart B, Ratcliffe S, Ehler E, Simpson KH, Hovorka J, Lejčko J, Taylor L, Lauder H, Serpell M. A multicentre, open-label, follow-on study to assess the long-term maintenance of effect, tolerance and safety of THC/CBD oromucosal spray in the management of neuropathic pain. J Neurol. 2015 Jan;262(1):27-40. doi: 10.1007/s00415-014-7502-9. Epub 2014 Sep 30. PMID: 25270679.
- Johnson JR, Burnell-Nugent M, Lossignol D, Ganae-Motan ED, Potts R, Fallon MT. Multicenter, double-blind, randomized, placebo-controlled, parallel-group study of the efficacy, safety, and tolerability of THC:CBD extract and THC extract in patients with intractable cancer-related pain. J Pain Symptom Manage. 2010 Feb;39(2):167-79. doi: 10.1016/j.jpainsymman.2009.06.008. Epub 2009 Nov 5. PMID: 19896326.
- Johnson JR, Lossignol D, Burnell-Nugent M, Fallon MT. An open-label extension study to investigate the long-term safety and tolerability of THC/CBD oromucosal spray and oromucosal THC spray in patients with terminal cancer-related pain refractory to strong opioid analgesics. J Pain Symptom Manage. 2013 Aug;46(2):207-18. doi: 10.1016/j.jpainsymman.2012.07.014. Epub 2012 Nov 8. PMID: 23141881.
- Serpell M, Ratcliffe S, Hovorka J, Schofield M, Taylor L, Lauder H, Ehler E. A double-blind, randomized, placebo-controlled, parallel group study of THC/CBD spray in peripheral neuropathic pain treatment. Eur J Pain. 2014 Aug;18(7):999-1012. doi: 10.1002/j.1532-2149.2013.00445.x. Epub 2014 Jan 13. PMID: 24420962.
- Van de Donk T, Niesters M, Kowal MA, Olofsen E, Dahan A, van Velzen M. An experimental randomized study on the analgesic effects of pharmaceutical-grade cannabis in chronic pain patients with fibromyalgia. Pain. 2019 Apr;160(4):860-869. doi: 10.1097/j.pain.0000000000001464. PMID: 30585986; PMCID: PMC6430597.
- Vučković S, Srebro D, Vujović KS, Vučetić Č, Prostran M. Cannabinoids and Pain: New Insights From Old Molecules. Front Pharmacol. 2018 Nov 13;9:1259. doi: 10.3389/fphar.2018.01259. PMID: 30542280; PMCID: PMC6277878.
- Trauma and Sleep. National Sleep Foundation Organization. https://www.sleepfoundation.org/mental-health/trauma-and-sleep. Accessed on October 12, 2020.
- Suraev, Anastasia S et al. “Cannabinoid therapies in the management of sleep disorders: A systematic review of preclinical and clinical studies.” Sleep medicine reviews 53 (2020): 101339. 16 May 2020. Accessed Oct. 5, 2020.