Are you considering using CBD oil for sleep? Do you have questions about safety, effectiveness, and legality?
There’s been a lot of buzz about CBD and cannabis thanks to the passing of the 2018 Farm Bill1 that legalized hemp-derived CBD with less than 0.3 percent tetrahydrocannabinol (THC) at the federal level. According to a 2023 survey2 of 1,169 adults, 21.1 percent of participants said they used CBD within the past year.
What Is CBD?
Cannabidiol (or CBD for short) is one of hundreds of known cannabinoids that are derived from the Cannabis sativa plant. Unlike THC, this cannabinoid doesn’t produce the same “high” that is associated with cannabis plants. In the United States, CBD in hemp oil is legal as long as it is derived from hemp and contains less than 0.3 percent THC.1
Cannabidiol is available as a crystalline isolate, meaning it has been purified to contain only CBD, or as a full-spectrum oil containing a variety of compounds including cannabinoids, terpenes, and essential oils.
It was originally thought that the ‘isolate’ form was the best choice, but researchers have been investigating something called the “entourage effect3”, where it is believed that properties found within the whole plant work synergistically to create an amplified effect.
Walking into your local gas station or pet store, you’ll likely notice the wide range of CBD oil products available as pure oils, tinctures, gummies, vapors, and more. Quality and concentration can vary from product to product, so be sure to do your research before buying and check the label for the recommended dosage.
Looking to learn more? Check out our top-rated CBD oil guide here.
What Do People Use CBD For?
CBD for Pain
Certain types of pain, including cancer-associated pain, neuropathic pain, and central pain states (associated with multiple sclerosis) are often difficult to treat with traditional opiates, anti-seizure drugs, and antidepressants. Medical cannabis is available in some states with a prescription and is commonly used for treating chronic pain, back pain, and several other conditions.
Certain research4 has supported the use of cannabis for treating pain from a variety of conditions, and one study5 of 177 cancer patients found that patients who used a combination of CBD/THC had a 30 percent greater reduction in pain compared to placebo, whereas those who used THC alone saw no effect.
Learn More: How to Cope With Pain and Sleep
CBD for Anxiety
A 2019 study6 conducted at a psychiatric clinic looking at the use of CBD for anxiety and sleep found a reduction in anxiety scores in 79.2 percent of patients and an improvement in sleep scores in 66.7 percent of patients within the first month of treatment.
Want to know more? Read our full guide for sleeping through anxiety.
CBD for Mental Health
A systematic review7 looking at a total of 1,629 patients with conditions including Alzheimer’s disorder/dementia, schizophrenia, and others found that treatment with THC- and CBD-based medicines were associated with improvements in several symptoms of mental disorders, but not complete remission. For example, among those with generalized social phobia, medication with CBD significantly reduced anxiety, cognitive impairment, and speech performance discomfort.7
How Does CBD Work to Make You Drowsy?
In the 1900s, scientists discovered the existence of a biochemical communication system in the body known as the endocannabinoid system8. This complex network of cannabinoid receptors is found throughout the body and in the central nervous system, where sleep is primarily regulated.
We have also learned that the body can manufacture endogenous cannabinoids that act as chemical messengers, and using cannabis-based products have similar effects. Research9 has found that people may experience an endocannabinoid deficiency that results in many different symptoms, including difficulty with sleep.
Scientists are still researching exactly how cannabinoids improve sleep, but initial findings suggest that it has to do with how endocannabinoids interact with proteins, receptors, and chemicals in the brain. This signaling is thought to influence the activity of various hormones, neurotransmitters, and other cells that affect things like the sleep-wake cycle, emotional regulation, and pain.
Another possible contributor is a terpene called myrcene, which is found naturally occurring in certain types of the cannabis plant10. Terpenes are aromatic compounds found in plants and fruits and are the basis of aromatherapy. Myrcene has been found to have sedative effects and is also found in high levels in the sleep-inducing herb, hops (the same flower found in beer).10
Some medical professionals believe that CBD improves rest by reducing anxiety and pain, allowing people to relax and, in turn, fall asleep more easily.
Explore our picks for the Best CBD Oil for Sleep.
Can CBD Impact Sleep Quality?
In a systematic review11 of cannabidiol and insomnia management, research suggests that CBD (either on its own or with THC) could help with insomnia symptoms. Additional research12 notes that high-dose CBD can have a sedating effect. They pointed to a study in which people with insomnia were given 160 milligrams a day of CBD. They found an increase in total sleep time and a decrease in the amount of nighttime awakenings.12
When to Take CBD Oil for Sleep
There is no definitive research on the ideal time to take CBD oil for sleep as it depends on the product composition and the dose. However, you’ll want to give the CBD time to work its way into your system. With this in mind, consider taking your CBD oil about an hour or so before your planned bedtime and see how that timeline works for you.
Can CBD Treat Insomnia?
The impact of cannabidiol on sleep may be dose-dependent. Studies13 have found that lower doses have a stimulating effect, increasing wakefulness, whereas higher doses have a sedative effect.
One study14 involving patients with insomnia found that a moderate dose of 160 mg/day increased the total amount of sleep time and decreased the number of awakenings during the night. Another retrospective study15 looking at two cannabis clinics found that patients with and without sleep as their primary concern noticed a significant decrease in the amount of time it took to fall asleep.
Short-term use of CBD may improve insomnia by decreasing the amount of time it takes to fall asleep and increasing NREM, slow-wave sleep. However, it is important to note that chronic use may lead to habituation.
Will CBD Stop Snoring?
Research16 has found that endocannabinoids may protect the brain from symptoms related to obstructive sleep apnea (OSA), a condition that causes abnormal patterns of breathing while asleep. One of the common symptoms of OSA is loud snoring17.
CBD Safety and Regulation
Although CBD use is growing in popularity, more research is still needed to discern its safety and optimal dosage. Until recently, this plant-based substance was classified in a way that made research difficult due to a lack of federal funding. Products are not regulated by the FDA as strictly as prescription medications, so despite labels and claims, it is difficult to know exactly what is in each bottle.
Issues with Regulation
A 2017 study21 of 84 online CBD products revealed that more than one-fourth of the products contained less cannabidiol than what is listed on the label and THC was found in 18 products.
Potential Danger to Employment
One of the most common side effects is drowsiness, which could impact job performance and safety, and impair driving to and from your place of work. Depending on the amount of THC in the product you choose, it is possible to fail drug testing that your employer may require as conventional drug tests look for the presence of THC in the urine, not CBD. If you take a product without THC in it, this should not show up in a drug test as long it’s from a reputable brand that does third-party testing.
Medical Side Effects of CBD
CBD may interact with other medications including blood thinners, antidepressants, and cholesterol-lowering statins. Other possible side effects include diarrhea, dry mouth, drowsiness, fatigue, and reduced appetite.
Long-Term vs. Short-Term Use
When it comes to sleep, CBD appears to work for short-term use and in higher doses. Long-term use could lead to dependency and a diminished effect over time.
CBD vs. Other Sleep Aids
Compared to other sleep aids, cannabidiol may be safer and more effective than prescription or over-the-counter options. If your sleeping difficulties are due to anxiety or pain, CBD may provide relief from your symptoms so you can fall asleep faster and stay asleep longer. Like many other natural sleep aids, more research is needed to know exactly which types of sleep disorders could benefit the most.
CBD vs. THC
CBD and THC are cannabinoids that both come from the cannabis plant. THC mainly acts on CB1 receptors18 (a part of the endocannabinoid system) which are most abundant in the brain and impact things like sensory perception, emotion, and cognition.
According to research, lower doses of THC are linked to reduced sleep onset latency (the time it takes to fall asleep after the lights turn off), more deep sleep, and longer sleep duration. In the case of CBD, lower doses were linked to a more stimulating effect, whereas higher doses were linked to a more sedating effect.18
Get More Info: Cannabis and Sleep
Ask Your Healthcare Provider About CBD
Can CBD work for my sleep disorder?
If you are considering using a CBD-based product for your sleep disorder, speak with your primary care provider or sleep specialist about whether there is any research about its effectiveness in regulating your condition.
How much CBD should I use for sleep?
Research on the most effective dosage for sleep has varied, but most studies have agreed that higher doses seem to work better.18
Unfortunately, there are still no widely accepted guidelines on the most optimal dosage for sleep, and concentrations can vary widely between products. Many authorities say dosing should be based on body weight, so speak to a healthcare provider with experience using medicinal cannabis about what dosage may be best for you.
Can it interfere with my prescriptions?
Highly concentrated CBD oils may impact certain liver enzymes responsible for the metabolism of medications and could cause interactions with prescription drugs, either by increasing or decreasing their effectiveness. It is important to speak with a healthcare provider if you are currently taking any prescription or over-the-counter medications.
Is there a better alternative?
Because research is still limited, there may be other solutions that have been well-studied for the treatment of sleep-related difficulties that work better for you. Your healthcare provider may recommend things like cognitive behavioral therapy, improving sleep hygiene, or investigating the underlying cause of your troubles with sleep; the best is likely a combination of multiple modalities as listed rather than one on its own.
Natural Alternatives to CBD
After doing your research and speaking with your healthcare provider, you may decide to pass on CBD. If it’s not right for you, there are some other natural alternatives for sleep that you can try. Keep in mind that the effectiveness of any supplement or prescription medication will depend on the reason you are struggling with poor sleep to begin with.
Melatonin
Melatonin is a natural hormone produced in the brain in response to sunlight and darkness and helps to regulate the sleep-wake cycle known as the circadian rhythm. Research19 has found that supplementing with melatonin may help to improve sleep, especially for shift workers or those suffering from jet lag.
Explore our top picks for the Best Melatonin Supplements for Sleep.
Herbal Medicine
Many herbs have been researched for their safety and effectiveness as natural sleep remedies. Some of the most popular and widely used herbs known for their sedative effects include valerian root, chamomile, passionflower, St. John’s wort, Ginkgo biloba, lemon balm, and kava.
Homeopathy
Homeopathic remedies use a process of sequential dilution and succussion (shaking) and work on the principle of “like treats like.” This treatment involves taking a substance that causes symptoms of disease in a healthy individual and using it to treat similar symptoms in sick individuals. Homeopathic remedies come in different ratios of dilution such as 200x or 400x and can be found as single remedies or blends that target certain symptoms.
Aromatherapy
The use of essential oils has been increasing in popularity, especially for sleep. Many people use essential oils like lavender, chamomile, blue tansy, and cedarwood to help them fall asleep. Essential oils can be used by inhaling directly from the bottle, placing a few drops on a pillow, or using an aromatherapy diffuser.
Magnesium
This mineral may help to boost certain levels of neurotransmitters in the brain that influence sleep. Magnesium, particularly magnesium glycinate, is well-known for its calming properties and is often lacking in the diet of most Americans. Magnesium can be taken as an oral supplement or be used topically in a lotion or cream.
Explore the Best Magnesium Supplements for Sleep
Exercise
Getting moderate exercise on a daily basis may help to improve sleep. Vigorous activities tend to have a stimulating effect and are best done in the morning or afternoon hours so they don’t interfere with falling asleep at night. Yoga and light stretching are calming and can be performed in the evening hours.
Sleep Hygiene
Practicing good sleep hygiene is an often overlooked lifestyle modification that can be extremely helpful for many people. Going to bed and waking at the same time every day may help to establish regular patterns and regulate the circadian rhythm. Performing a calming bedtime routine is also a great way to signal the body and brain that it is time for rest.
CBT-i
Cognitive behavioral therapy for insomnia (CBT-i) is a form of treatment that involves working with a therapist to focus on changing behaviors that may be negatively impacting sleep. Therapists can also help to uncover any psychological factors and suggest certain techniques that may be helpful.
The Bottom Line
Before using any new supplement, be sure to speak with your healthcare provider about your particular situation and any current medications you may be taking. Like many other natural sleep remedies, CBD appears to be the most effective for short-term use for some people.
The jury is still out on what the best form and dosage is for sleep, so for now, follow the recommended guidelines on the bottle you are taking and be sure to confirm that the type you are using is legal in your area. Working with a healthcare provider with expertise in using medical cannabis would be helpful to guide your therapy. If you do decide to give CBD a try, it could take 60 minutes before bed so it has time to take effect.
Raina Cordell
RN, RHN, Certified Health Coach
About Author
Raina Cordell is a Registered Nurse, Registered Holistic Nutritionist, and Certified Health Coach, but her true passion in life is helping others live well through her website, www.holfamily.com. Her holistic approach focuses on the whole person, honing the physical body and spiritual and emotional well-being.
References:
- “Farm Bill”. U.S. Department of Agriculture. Webpage accessed January 25, 2024.
- Wilson-Poe PhD, Adrianne R., et al. “Past-Year Use Prevalence of Cannabidiol, Cannabigerol, Cannabinol, and Δ8-Tetrahydrocannabinol Among US Adults”. JAMA Network. 2023.
- Russo, Ethan B. “The Case for the Entourage Effect and Conventional Breeding of Clinical Cannabis: No “Strain,” No Gain”. Frontiers in Plant Science. 2018.
- Russo, Ethan B. “Cannabinoids in the management of difficult to treat pain”. Therapeutics and Clinical Risk Management. 2008.
- Johnson, Jeremy R., et al. “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”. National Library of Medicine. 2010.
- Shannon MD, Scott., et al. “Cannabidiol in Anxiety and Sleep: A Large Case Series”. The Permanente Journal. 2019.
- Hoch, Eva., et al. “How effective and safe is medical cannabis as a treatment of mental disorders? A systematic review”. European Archives of Psychiatry and Clinical Neuroscience. 2019.
- “The Discovery of the Endocannabinoid System”. Medical Cannabis Handbook. Webpage accessed January 25, 2024.
- Russo, Ethan. B. “Clinical Endocannabinoid Deficiency Reconsidered: Current Research Supports the Theory in Migraine, Fibromyalgia, Irritable Bowel, and Other Treatment-Resistant Syndromes”. Cannabis and Cannabinoid Research. 2016.
- Surendran, Shelini., et al. “Myrcene—What Are the Potential Health Benefits of This Flavouring and Aroma Agent?”. Frontiers in Nutrition. 2021.
- Ranum, Rylea M., et al. “Use of Cannabidiol in the Management of Insomnia: A Systematic Review”. National Library of Medicine. 2023.
- Babson, Kimberly A., Sottile, James., Morabito, Danielle. “Cannabis, Cannabinoids, and Sleep: a Review of the Literature”. Current Psychiatry Reports. 2017.
- Murillo-Rodríguez, Eric., et al. “Potential Effects of Cannabidiol as a Wake-Promoting Agent”. Current Neuropharmacology. 2014.
- Carlini, E.A., Cunha, J.M. “Hypnotic and antiepileptic effects of cannabidiol”. National Library of Medicine. 1981.
- Tringale MD, Rolando., Jensen MD, Claudia. “Cannabis and Insomnia”. O’Shaughnessy’s. 2011.
- Jumpertz, R., et al. “Circulating endocannabinoids and N-acyl-ethanolamides in patients with sleep apnea–specific role of oleoylethanolamide”. National Library of Medicine. 2010.
- “Obstructive Sleep Apnea”. Penn Medicine. Last modified January 9, 2023.
- Ferracioli-Oda, Eduardo., Qawasmi, Ahmad., Bloch, Michael H. “Meta-analysis: melatonin for the treatment of primary sleep disorders”. PLoS One. 2013.