How CBD Affects Sleep
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As a clinical psychologist specializing in sleep, I've been excited about the benefits of cannabidiol for sleep for a long time.
All cannabinoids interact with specific receptors in our endocannabinoid system, and in doing so, may influence our circadian functioning. The brain's master circadian clock is primarily responsible for synchronizing circadian rhythms, regulating sleep-wake cycles and many other physiological functions, including appetite, metabolism, and immunity.
Research indicates that CBD and other cannabinoids may affect the timing of circadian clocks.
Studies have also shown that CBD can affect specific "clock genes" that regulate the timing of circadian clocks, leading some researchers to suggest CBD as a possible treatment for circadian-clock-related disorders.
Disruptions to circadian sleep-wake cycles are a cause of poor sleep and irregular sleep patterns. Some research in animal models shows that CBD may help strengthen sleep-wake cycles and increase sleep amounts.
Related: Can CBD Combat Sleep Disorders?
CBD and REM
CBD can also address abnormalities of REM sleep, a sleep stage that's critical for refreshing the brain's cognitive and emotional processing centers. CBD has been shown effective in treating REM behavior disorder in patients with Parkinson's syndrome.
REM sleep behavior disorder is a condition that causes people to act out physically during dreaming and REM sleep. Typically, during REM, the body is largely paralyzed, a state known as REM atonia. This immobilization keeps sleepers from acting out their dreams. In REM sleep behavior disorder, this paralysis doesn't occur, leading to disruptive sleep and injuring themselves or their sleeping partners. REM sleep behavior disorder is linked to neurological and neurodegenerative conditions, including Parkinson's disease and narcolepsy, and can occur with PTSD.
CBD and pain relief
CBD has both analgesic (pain-relieving) and anxiolytic (anxiety-reducing) properties. CBD also has shown anti-depressant effects in animal models and can increase serotonin levels in the brain. These capabilities make CBD a possible source of relief for sleep problems. Why do I say "possible"? Because researchers have not done these studies with poor sleepers, which means these effects may only be produced in normal sleepers.
Physical pain and dysregulation of mood (including stress, anxiety disorders, and depression) are some of the most common underlying causes of insufficient, poor-quality rest and often contribute to insomnia.
CBD can effectively treat certain types of chronic pain, including pain associated with medical conditions such as multiple sclerosis and cancer and pain associated with inflammation. Chronic inflammation is a root cause of many diseases—and unhealthful inflammation is disruptive to sleep itself. CBD functions as an anti-inflammatory agent, making it a promising therapy for treating inflammation and offering protection from inflammation-related disruptions to sleep. In one pharmaceutical form, Sativex, CBD (combined with THC) has been shown to improve sleep patterns and subjective measures of sleep quality in people who have some forms of chronic pain. In this situation, we can hypothesize that when pain reduces, it no longer influences sleep negatively, and the sleeper can rest more soundly. But this is very different than CBD directly helping sleep.
There's a growing body of evidence supporting CBD's power to calm the central nervous system, which has profound implications for sleep. This soothing, mood-stabilizing cannabinoid has demonstrated effectiveness in both animal and human models in improving some forms of anxiety.
A 2019 survey looked at the impact of CBD on a group of people with both anxiety and sleep problems. This was not a comparison or experimental study but rather a subjective retrospective survey using validated questionnaires. Researchers found a 25mg daily dose of CBD reduced self-reported anxiety in 79 percent of participants after one month of use and improved self-reported sleep in 66 percent. (Important: we have no data showing if study patients were compliant with the dose.) Anxiety levels stayed low over time, but sleep returned to baseline levels in 2-3 months for most problem sleepers.
Also of note was the timing of CBD dosing: people who reported anxiety as their primary issue took CBD in the morning, and those that said sleep was their primary complaint took CBD in the evening. We don't talk enough about the timing of taking medication and supplements, which can have a significant impact on therapeutic effectiveness and sleep.
Circadian rhythms influence the body's biological responses to medications and supplements —just one of the many physiological processes that take powerful cues from these rhythms. My book, The Power of When, shares how to optimize your daily routine according to your individual circadian rhythms and chronotype.
CBD may have a role in treating some sleep disorders, mood disorders, and pain disorders that affect sleep. However, the science is still too early to tell. Here's what we know now:
- CBD may affect the timing of circadian clocks, which control sleep-wake cycles
- CBD can help treat some forms of chronic pain, which may make it easier to sleep
- CBD can treat disturbances to REM sleep
- CBD can reduce anxiety and may help sleep for some people with anxiety