Can CBD Help With Sleep? A Look at the Evidence

By | last updated January 27, 2023

Evidence Based 32

We all know how important sleep is to our overall health. Lack of proper rest leads to negative physical and mental health effects, decreasing your cognitive performance and increasing the risk of serious health issues (1).

The good news is that cannabidiol, commonly known as CBD, may have beneficial effects on sleep. Many people are choosing CBD over prescription sleep aids because it’s natural and has mild side effects.

Research suggests that CBD may help by improving the underlying causes of poor sleep like anxiety and chronic pain, as well as directly making you more sleepy. 

Read more to learn how CBD might help with sleep, how to best use it, and other helpful tips.

What Does the Research Say?

Although further high-quality clinical research is needed, multiple studies show the potential of CBD in helping people sleep better. The evidence suggests that CBD may help by improving problems that lead to poor sleep, such as anxiety and pain, as well as directly affecting sleep. 

CBD’s Indirect Sleep Benefits

On one hand, CBD can help by addressing the common causes of poor sleep, namely anxiety, stress, chronic pain, and depression. 

In a 2019 study, 97 patients with chronic pain who have been taking opioids were given CBD-rich hemp extract capsules. CBD not only reduced their opioid intake but also resulted in improvements in sleep quality (2). 

Another Colorado study from the same year found that adults suffering from anxiety and poor sleep experienced improvements in both, although the sleep benefits seemed to only last for a month (3).

Yet another 2019 study of people with post-traumatic stress disorder reported that 38% of the 21 participants had better sleep after CBD treatment (4). Meanwhile, a 2020 review paper concluded that CBD may help with anxiety and depression (5).

All these findings show that cannabidiol may be useful in improving poor sleep indirectly, by tackling its underlying causes.

CBD’s Direct Effects On Sleep

CBD has also been demonstrated to directly affect sleep, with high doses working as a sedative (a compound that slows brain activity and induces sleep), whereas small doses may actually make you more awake.

In one older study, people with insomnia slept longer after taking 160 mg of CBD (6). Additionally, multiple studies of CBD reported sedation and tiredness as side effects (7).

In contrast, a low dose of CBD (~15 mg) was found to increase wakefulness in healthy volunteers (8). 

CBD and RBD

CBD has also been shown to help with REM sleep behavior disorder (RBD). RBD is a sleep disorder characterized when people physically act out their dreams.

In a 2014 study, 4 patients with Parkinson’s disease and RBD were treated with CBD. The researchers found that the individuals had a “prompt and substantial reduction in the frequency of RBD-related events without side effects (9).” 

Meanwhile, a 2021 clinical trial in people with RBD reported improved sleep satisfaction from 300 mg doses of CBD (10).

In summary, CBD may promote better sleep in a variety of ways, including addressing the underlying causes of insomnia and other sleep problems and directly making you feel more sleepy or awake.

cbd oil for sleep

How Does CBD Help With Sleep?

Although further research is needed to understand the mechanisms behind CBD’s sleep effects, we do have a general picture. 

CBD seems to work in two major ways: interacting with our endocannabinoid system (ECS), and affecting other receptors and systems involved in anxiety, pain, sleep, depression, and other processes.

CBD and the Endocannabinoid System

One way that CBD can affect sleep is by interacting with the body’s endocannabinoid system (ECS). This key system is made up of specialized cannabinoid receptors, endocannabinoids (cannabinoids made inside our bodies), and the enzymes that build and break them down (11). 

The ECS regulates a wide array of vital functions, including pain, metabolism, immunity, anxiety, stress, and sleep to maintain hemostasis: a healthy state of balance in the body. 

There’s a good deal of evidence that the ECS plays a role in sleep. For one, it may regulate the sleep-wake cycle by interacting with the suprachiasmatic nucleus, a part of the brain involved in regulating the 24-hour circadian rhythms (12).

Additionally, studies show that the levels of endocannabinoids, related enzymes, and even cannabinoid receptors change throughout the day, with major differences between day and night (13).

In one study, healthy participants had three times the levels of the endocannabinoid anandamide upon waking up versus going to bed. Also, when they were sleep deprived, this normal fluctuation was disrupted (14). 

We also know that compounds that activate the CB1 receptor can promote sleep, which is precisely how THC makes you drowsy (15).

In summary, there’s a good deal of evidence that the ECS is involved in sleep regulation. CBD can interact with this system by changing the function of its receptors, suppressing the enzyme that breaks down anandamide, and other effects, which may explain how it can help with sleep problems (16).

Other Ways CBD Can Affect Sleep

Another way CBD works to improve sleep is indirect, through interacting with systems involved in anxiety, stress, pain, depression, and other issues. Since these conditions are linked to insomnia and other sleep disturbances, CBD can indirectly improve your sleep by relieving them.

For example, research has consistently shown that CBD interacts with the 5-HT1A serotonin receptor, which is involved in anxiety, stress, sleep, and other cognitive processes (17, 18). We also know that CBD affects many receptors involved in pain, inflammation, and cognitive function (17).

cbd gummies

How to Best Use CBD for Sleep? 

First and foremost, we recommend using a full-spectrum CBD product instead of one made with isolate (pure CBD). 

Research has shown that full-spectrum CBD extracts are as much as 4 times more effective than CBD isolate, likely because of the synergy between its many active ingredients (19). If you’re sensitive to THC, you can also consider taking a broad-spectrum product.

There are various types of CBD products to choose from, including CBD oil tinctures, gummies, capsules, and vapes. Each has its strengths and weaknesses, which are important to consider to find the best option for your sleep needs.

You should take CBD about 30 to 60 minutes before going to bed to give it time to kick in. For capsules and gummies, 60 minutes is better since they take longer to kick in, whereas vapes and oils work faster so 30 minutes or less is enough. 

CBD Oil Tinctures

CBD oil is by far the most popular way of taking CBD because it’s absorbed well by the body, has long-lasting effects, and makes it easy to change the dosage. CBD oil takes about 15-40 minutes to take effect, which lasts for about 4-6 hours (20).

The key advantage of CBD oil, and the reason it’s more popular than CBD capsules and gummies, is that it bypasses the digestive tract. When you take CBD sublingually (under the tongue), it’s absorbed directly into your blood vessels, allowing for far greater absorption (21).

We recommend using full-spectrum CBD oil as your go-to option for better sleep.

CBD Capsules & Gummies

Consuming CBD through capsules or edibles like gummies is the most convenient method. It’s also discreet and makes it easy to use CBD on the go and boasts the longest average duration: about 6 hours (22). But it does have one major downside. 

CBD has low oral bioavailability — a fancy term for absorption; think of it as the percent of the CBD you took that is actually absorbed by the body (23). That’s because CBD and indeed most cannabinoids experience what’s called the first-pass effect — a large reduction in the concentration of the active ingredient in the digestive tract and liver before it’s absorbed. 

Research suggests that CBD’s oral bioavailability is only about 6 to 24%, which means you’re losing over 75% of the original amount you took (24).

Vaping CBD

Consuming cannabidiol through vaping is the best option when you’re looking for immediate relief. Having said that, its biggest downside is the shorter duration — its effects will only last about 1 to 4 hours (22).

Another thing to consider is the safety concerns of vaping. Although research is still in its early stages, current evidence suggests that vaping carries certain health risks and that inhaling anything other than good old air is likely to harm your health (25). 

Additional Sleep Ingredients

Many CBD products designed specifically for sleep include other beneficial ingredients, such as melatonin and l-theanine, as well as popular sleep-supporting herbs like chamomile, lemon balm, and passionflower.

Although it’s not required, we recommend choosing products with these added ingredients for greater effectiveness.

A Word on CBN Products

Cannabinol (CBN) is a non-intoxicating minor cannabinoid that’s believed to promote sleep, which is why it’s frequently included in CBD sleep aid products. However, there isn’t that much scientific evidence that CBN actually enhances sleep or has sedating effects (26).

Still, if you’re curious, you can always try a CBN product and see how it works for you.

cbd oil dosage

How Much CBD Should You Take for Sleep?

At this time, there’s no official recommended dosage of CBD for sleep. It’s important to note that the ideal amount is going to be different for each individual, depending on your age, weight, genetics, and other factors. 

Clinicians suggest a ‘start low and go slow’ approach when taking CBD for the first time (27). Begin with a small dose like 10-15 mg and carefully observe the effects for at least two hours, slowly raising it over time until you feel the desired effects. 

You can also use your product’s recommended dosage as a useful starting point.

Potential Side Effects

In a 2018 safety review, the World Health Organization (WHO) concluded that “CBD is generally well tolerated with a good safety profile (28).”

Its most common side effects include drowsiness, fatigue, and low blood pressure (29), with most review papers concluding that it’s relatively safe and well tolerated (30), especially compared to the more serious potential side effects of common sleeping pills (31).

Still, we should mention that high doses of CBD could potentially interact with some medications. One review showed that it may interact with antiepileptic drugs, antidepressants, opioid analgesics, and other common medications (32).

It’s always best to consult your doctor before taking CBD, especially if you’re taking prescription medications.

CBD: A Promising Natural Sleep Aid

To sum up, studies suggest that CBD may help you sleep better both directly and by relieving common sleep disruptors such as anxiety, stress, and chronic pain. Small doses of CBD might also help you deal with daytime sleepiness — a common problem for people with sleep issues.

Nonetheless, in-depth research on CBD and sleep is still lacking. Until proper high-quality clinical trials are done, we can’t say anything for certain.

If you’re going to use CBD for sleep, we recommend taking a high-quality full-spectrum CBD oil about 30 minutes before bedtime. 

References

  1. Karna, B., and V. Gupta. “Sleep Disorder.[Updated 2021 Nov 20].” StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing (2022).
  2. Capano, Alex, Richard Weaver, and Elisa Burkman. “Evaluation of the effects of CBD hemp extract on opioid use and quality of life indicators in chronic pain patients: a prospective cohort study.” Postgraduate medicine 132.1 (2020): 56-61.
  3. Shannon, Scott, et al. “Cannabidiol in anxiety and sleep: a large case series.” The Permanente Journal 23 (2019).
  4. Elms, Lucas, et al. “Cannabidiol in the treatment of post-traumatic stress disorder: a case series.” The Journal of Alternative and Complementary Medicine 25.4 (2019): 392-397.
  5. García-Gutiérrez, María S., et al. “Cannabidiol: a potential new alternative for the treatment of anxiety, depression, and psychotic disorders.” Biomolecules 10.11 (2020): 1575.
  6. Carlini, Elisaldo A., and Jomar M. Cunha. “Hypnotic and antiepileptic effects of cannabidiol.” The Journal of Clinical Pharmacology 21.S1 (1981): 417S-427S.
  7. Meissner, Hannah, and Marco Cascella. “Cannabidiol (CBD).” StatPearls [Internet]. StatPearls Publishing, 2022.
  8. Nicholson, Anthony N., et al. “Effect of Δ-9-tetrahydrocannabinol and cannabidiol on nocturnal sleep and early-morning behavior in young adults.” Journal of clinical psychopharmacology 24.3 (2004): 305-313.
  9. Chagas, Marcos HN, et al. “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 39.5 (2014): 564-566.
  10. de Almeida, Carlos MO, et al. “Cannabidiol for rapid eye movement sleep behavior disorder.” Movement Disorders 36.7 (2021): 1711-1715.
  11. Lu, Hui-Chen, and Ken Mackie. “An introduction to the endogenous cannabinoid system.” Biological psychiatry 79.7 (2016): 516-525.
  12. Babson, Kimberly A., James Sottile, and Danielle Morabito. “Cannabis, cannabinoids, and sleep: a review of the literature.” Current psychiatry reports 19.4 (2017): 1-12.
  13. Valenti, M., et al. “Differential diurnal variations of anandamide and 2-arachidonoyl-glycerol levels in rat brain.” Cellular and Molecular Life Sciences CMLS 61.7-8 (2004): 945-950.
  14. Vaughn, Linda K., et al. “Endocannabinoid signalling: has it got rhythm?.” British journal of pharmacology 160.3 (2010): 530-543.
  15. Murillo-Rodríguez, Eric. “The role of the CB1 receptor in the regulation of sleep.” Progress in Neuro-Psychopharmacology and Biological Psychiatry 32.6 (2008): 1420-1427.
  16. Britch, Stevie C., Shanna Babalonis, and Sharon L. Walsh. “Cannabidiol: pharmacology and therapeutic targets.” Psychopharmacology 238.1 (2021): 9-28.
  17. Mlost, Jakub, Marta Bryk, and Katarzyna Starowicz. “Cannabidiol for pain treatment: focus on pharmacology and mechanism of action.” International journal of molecular sciences 21.22 (2020): 8870.
  18. Rancillac, Armelle. “Serotonin and sleep-promoting neurons.” Oncotarget 7.48 (2016): 78222.
  19. Pamplona, Fabricio A., Lorenzo Rolim Da Silva, and Ana Carolina Coan. “Potential clinical benefits of CBD-rich cannabis extracts over purified CBD in treatment-resistant epilepsy: observational data meta-analysis.” Frontiers in neurology (2018): 759.
  20. Russo, Ethan B. “Cannabinoids in the management of difficult to treat pain.” Therapeutics and clinical risk management 4.1 (2008): 245.
  21. Hanssen, Arlen D., Douglas R. Osmon, and Robin Patel. “Local antibiotic delivery systems: where are we and where are we going?.” Clinical Orthopaedics and Related Research® 437 (2005): 111-114.
  22. Borodovsky, Jacob T., et al. “Smoking, vaping, eating: Is legalization impacting the way people use cannabis?.” International Journal of Drug Policy 36 (2016): 141-147.
  23. Millar, Sophie Anne, et al. “Towards better delivery of cannabidiol (CBD).” Pharmaceuticals 13.9 (2020): 219.
  24. Birnbaum, Angela K., et al. “Food effect on pharmacokinetics of cannabidiol oral capsules in adult patients with refractory epilepsy.” Epilepsia 60.8 (2019): 1586-1592.
  25. Burrowes, K., Lutz Beckert, and Stuart Jones. “Human lungs are created to breathe clean air: the questionable quantification of vaping safety “95% less harmful”.” NZ Med J 133.1517 (2020): 100-106.
  26. Corroon, Jamie. “Cannabinol and sleep: separating fact from fiction.” Cannabis and cannabinoid research 6.5 (2021): 366-371.
  27. Lucas, Catherine J., Peter Galettis, and Jennifer Schneider. “The pharmacokinetics and the pharmacodynamics of cannabinoids.” British journal of clinical pharmacology 84.11 (2018): 2477-2482.
  28. https://www.who.int/docs/default-source/controlled-substances/whocbdreportmay2018-2.pdf?sfvrsn=f78db177_2
  29. Huestis, Marilyn A., et al. “Cannabidiol adverse effects and toxicity.” Current neuropharmacology 17.10 (2019): 974-989.
  30. Larsen, Christian, and Jorida Shahinas. “Dosage, efficacy and safety of cannabidiol administration in adults: a systematic review of human trials.” Journal of clinical medicine research 12.3 (2020): 129.
  31. https://www.mayoclinic.org/diseases-conditions/insomnia/in-depth/sleeping-pills/art-20043959
  32. Balachandran, Premalatha, Mahmoud Elsohly, and Kevin P. Hill. “Cannabidiol interactions with medications, illicit substances, and alcohol: a comprehensive review.” Journal of general internal medicine 36.7 (2021): 2074-2084.

Leave a Comment