What You Need to Know About Using CBD for Better Sleep
There's anecdotal evidence for CBD as a sleep aid, but the science is still unclear. Here's what you need to know about CBD for sleep.
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Of course you want to fall into a deep, quality sleep every night, the kind that leaves you feeling rested and alert the next morning. Sadly, this isn’t the norm for many people.
According to a study in the journal Sleep, about one in three Americans don’t get enough sleep. That means they get six or fewer hours of sleep per night. In fact, more people have been reporting less sleep since 2013. Another disturbing finding: The sleep deficit seemed to disproportionately affect Hispanic and non-Hispanic Blacks.
Chronic lack of sleep is more than just a nuisance; it’s linked to a greater risk of health problems like type 2 diabetes, stroke, depression, and heart disease, as well as the more immediate danger of an accident.
While there are a number of medications and behavioral therapies to help you sleep, interest has recently started focusing on cannabidiol or CBD as a possible remedy. (Here’s how to improve sleep habits in one day.)
Here’s what you need to know about the potential benefits, side effects, and the legal status of using CBD for sleep.
What is CBD?
CBD is not the same as marijuana and CBD cannot make you high. It’s found in medical marijuana and is one of two main active ingredients in marijuana (cannabis). The other is delta-9-tetrahydrocannabinol (THC). That’s the ingredient that can lead to that “high” sensation.
“The marijuana plant makes two major chemicals, THC and CBD, which do totally different things,” explains Steven H, Feinsilver, MD, director of the Center for Sleep Medicine at Lenox Hill Hospital in New York City.
You can also extract CBD from the hemp plant, which is a Cannabis sativa plant that has much lower levels of THC than marijuana. (Here’s more on the differences between CBD vs. THC.)
The 2008 Farm Bill granted farmers permission to legally grow hemp as long as the THC content does not exceed 0.3 percent. However, CBD was not legalized in the bill.
Is CBD legal?
That depends, both on where you live and exactly what product you’re talking about. Laws governing CBD vary from state to state while the federal government considers it marijuana, which is still illegal.
The U.S. Drug Enforcement Administration (DEA), in fact, has classified marijuana (and its components) as a Schedule 1 substance, meaning it has no medical benefit and has a high risk of being abused.
According to the National Conference of State Legislatures, 36 states along with the District of Columbia, Guam, Puerto Rico, and the U.S. Virgin Islands have medical marijuana/cannabis programs in place. To make it more confusing, 11 states allow a different category of products: those that are low in THC while high in CBD.
What is CBD used for?
CBD has been used for centuries if not millennia to treat different ailments including, in ancient China, gout, malaria, and constipation. But because it has only recently become legal in various jurisdictions, researchers are just now learning about its benefits using modern scientific research.
The strongest evidence for the effectiveness of CBD lies with epilepsy. In fact, the only CBD-derived medication approved by the Food and Drug Administration (FDA) is Epidiolex. It’s approved to treat Lennox-Gastaut syndrome and Dravet syndrome, two rare and difficult-to-treat forms of epilepsy. (Here’s what you need to know about using CBD for seizures.)
“CBD has borne through clinical trials and has been approved for different kinds of epilepsy,” says Martin A. Lee, co-founder and director of Project CBD, a California nonprofit that promotes CBD research, and author of Smoke Signals: A Social History of Marijuana–Medical, Recreational, and Scientific. “That’s the only legal way to use it according to the FDA but, as we all know, millions and millions of people are taking CBD products and not necessarily taking them for epilepsy.”
There is some evidence that CBD may help ease pain, anxiety, and a number of other conditions, although the evidence here is less extensive. (Here’s what you need to know about CBD oil for anxiety.)
Does CBD work for sleep?
The evidence here is still early. “There is very little scientific evidence and, in my opinion, a great deal of misinformation promoted by the CBD industry,” says Lee.
One 2017 review paper in Current Psychiatry Reports points to studies showing that CBD may have some use in treating sleep apnea, REM sleep behavior disorder, excessive daytime sleepiness, PTSD nightmares, and sleep issues in people with chronic pain.
That said, many people report anecdotally that CBD helps them and, says Lee, “reports from consumers and patients should not be discounted. If it’s helping them sleep, that’s great.”
(Here’s what happened when one woman used CBD oil for insomnia.)
CBD, sleep, and anxiety
To the extent that CBD does help sleep, it may be because it also mitigates anxiety, says Lee. In a 2019 study of 72 adults experiencing anxiety or poor sleep, published in The Permanente Journal, researchers found that CBD eased anxiety and kept anxiety levels down over a period of three months. However, it didn’t have a significant effect on sleep. The reason wasn’t clear.
(These are the best CBD oils for anxiety.)
Even if further studies do show that CBD is effective for sleep conditions, much depends on the dosage. One study published in Current Neuropharmacology found that CBD may actually make you more awake. Even if CBD proves effective for sleep, Lee emphasizes that it would not work like a sleeping pill. “If you take [CBD] before you go to sleep, you’re liable to be up all night,” says he says.
Is CBD safe?
This is another open question. CBD tends to be well-tolerated, but it can have side effects like nausea as well as make you feel tired or irritable. It may also interact with other medications, such as the blood thinner warfarin (Coumadin).
According to the FDA, it may also cause diarrhea, decrease your appetite, harm your liver over the long term, and, if you take it with alcohol or other drugs, make you drowsy.
What are the best forms of CBD for sleep?
Related to the issue of safety is the fact that CBD products are not regulated in the same way as drugs. That means you have tons of products out there with different ingredients, different dosages, and different claims—some of which may be entirely false. Whether or not any of these may offer a sleep benefit is unknown at this point.
Currently, formal guidelines on CBD for sleep do not exist. But if you choose to try CBD products for sleep, there are different forms of CBD, including CBD oil, CBD tinctures, CBD capsules, and CBD edibles. Consumption methods for CBD vary and depend on preference. (Here’s a buyer’s guide for finding the best CBD oil for pain.)
If you choose CBD oil, you can vape or ingest it orally. However, vaping has been linked to the EVALI (e-cigarette or vaping use-associated lung injury) outbreak, according to the Centers for Disease Control and Prevention. (Here are the risks and benefits of vaping CBD.)
Talk to your doctor if you’re considering using CBD for sleep (or anything else).
The last word
Sleep disorders are becoming increasingly common and considered a public health epidemic in the U.S. Treatment for sleep issues, like insomnia, may require changing lifestyle habits and sometimes taking prescription medications. CBD has been used as an alternative treatment for people with sleep disorders who choose to self medicate.
Although CBD is considered to be generally safe, there’s still very limited information (aside from anecdotal) on its long-term effects. Further research is needed to determine whether CBD should be recommended for sleep.
Next, here’s what you need to know about CBD edibles.
- Sleep: "Are U.S. adults reporting less sleep?: Findings from sleep duration trends in the National Health Interview Survey, 2004–2017"
- National Institutes of Health: "Sleep Deprivation and Deficiency"
- Steven H. Feinsilver, MD, director, Center for Sleep Medicine, Lenox Hill Hospital, New York City
- Food and Drug Administration: "FDA Regulation of Cannabis and Cannabis-Derived Products, Including Cannabidiol (CBD)"
- Drug Enforcement Administration: "Drug Scheduling"
- NORML: "State Medical Marijuana Laws"
- The Permanente Journal: "Cannabidiol in Anxiety and Sleep: A Large Case Series"
- FDA: "FDA Approves First Drug Comprised of an Active Ingredient Derived from Marijuana to Treat Rare, Severe Forms of Epilepsy"
- Martin A. Lee, co-founder and director, Project CBD, author of Smoke Signals: A Social History of Marijuana–Medical, Recreational and Scientific
- Current Psychiatry Reports: "Cannabis, Cannabinoids, and Sleep: a Review of the Literature"
- Current Neuropharmacology: "Potential Effects of Cannabidiol as a Wake-Promoting Agent"
- FDA: "What You Need to Know (And What We're Working to Find Out) About Products Containing Cannabis or Cannabis-derived Compounds, Including CBD"