A good night’s sleep is essential to your overall health and wellbeing. Experts recommend adults sleep seven to nine hours1 each night. Proper sleep ensures you feel well-rested and have energy for the next day2. A good night’s rest also contributes to memory formation, helps grow and repair muscle and tissue, and prevents sickness.
Unfortunately, falling asleep or staying asleep can be difficult for certain types of sleepers. As many as 70% of Americans3 report not sleeping the recommended hours, and nearly one-third of American workers sleep less than six hours per night4. Solutions for better sleep and avoiding sleep debt vary. Possible approaches include improved sleep hygiene, prescription sleep aids, and natural sleep aids.
One increasingly popular strategy for sleeping better is taking cannabidiol (CBD), a derivative of cannabis. CBD is commonly used to improve sleep and decrease anxiety. However, the regulation of CBD in the United States is limited, and much more research must be done to determine the exact effects CBD has on sleep and other physical and mental health concerns.
About Cannabis and Cannabinoids
While there are many different slang terms for the green, narrow-leafed plant you may recognize, the plant is scientifically called Cannabis sativa5. The word “cannabis” can be used to describe any products made from the plant. Cannabis plants contain multiple chemical compounds, including a group referred to as “cannabinoids.” Out of more than 100 cannabinoids, researchers have primarily studied two that appear to have the greatest impact on humans: tetrahydrocannabinol (THC) and CBD.
What Is Tetrahydrocannabinol (THC)?
Most commonly known effects of cannabis, such as “getting high,” are caused by the cannabinoid, THC6. The term “marijuana” specifically refers to parts of the Cannabis sativa plant that contain THC.
Cannabis plants and derivatives that contain less than 0.3%7 THC are classified as “hemp.” As of 2018, hemp is no longer defined as a controlled substance by the U.S. federal government. As a result, there has been an influx of hemp-related products in the American market. These products are generally marketed as CBD products.
What Is Cannabidiol (CBD)?
CBD, the other commonly known cannabinoid, can be legally sold in the U.S. when extracted from hemp8 and marketed according to relevant regulations. CBD does not have psychoactive properties9 and does not bring about the same effects as THC. Also, CBD does not have effects that would lead to potential dependency10 or risk of abuse.
CBD is an increasingly popular substance in the U.S. While many health benefits have been attributed to CBD, in most cases, scientific validity of its effectiveness is still unclear.
Is CBD FDA-Approved?
Only a few cannabis-derived or cannabis-related drug products are FDA-approved in the U.S.:
- Epidiolex. This oral CBD solution11 was the first drug containing a purified cannabis-derived substance approved by the FDA12. The drug is approved for seizure treatment in rare and severe forms of epilepsy, Dravet syndrome, Lennox-Gastaut syndrome, and tuberous sclerosis complex for patients ages two and up. Although Epidiolex has been shown to reduce other types of seizures, it has not yet been FDA-approved for treating those seizures.
- Marinol and Syndros. These two drugs contain dronabinol, a synthetic form of THC13. They come in capsules or oral solutions14. Dronabinol affects the part of the brain that controls appetite, nausea, and vomiting, so the drugs have several therapeutic uses. These uses include the treatment of nausea and vomiting in chemotherapy patients and treatment of weight loss in patients with HIV.
- Cesamet. Cesamet contains nabilone, a synthetic compound with a chemical structure similar to THC. Like dronabinol, this capsule also affects the part of the brain that controls vomiting and nausea15. The drug is prescribed to patients receiving chemotherapy who have not responded to other nausea and vomiting treatments.
The FDA has not approved any other CBD drug products. The agency has not determined the safety and effectiveness of cannabis or CBD in the treatment of any particular conditions or disease.
What Forms Does CBD Come In?
- Pills and capsules
- Topical solutions, including lotions, creams, patches, gels, and ointments
What Are Common Doses of CBD?
Outside of Epidiolex, the FDA doesn’t regulate dosing of non-drug CBD products. As a result, the amount of CBD in products varies widely among forms.
Research shows 300-mg oral doses of CBD can be taken safely on a daily basis for up to six months. One scientific review showed that taking up to 1,500 mg daily17 was well-tolerated by participants. A subsequent review confirmed that use of 1,500 mg daily for four weeks18 showed no negative effects.
Unfortunately, the indicated CBD content on a product label is not necessarily the amount that the product actually contains, which may lead people to take more or less CBD than intended. One analysis of 84 CBD products sold online showed that 26% of the products contained less CBD than the label said19. The same analysis showed nearly 43% of the products were underlabled, meaning they contained substantially more CBD than the label said.
While CBD at higher doses does not appear to have serious negative consequences, these products may also contain higher levels of THC than reported on the label. Other CBD products may contain THC that is not reported on the label at all. The THC in these products can produce intoxicating effects, which may or may not be desired.
What Are the Effects of Taking CBD?
Research shows that CBD has a calming effect on the nervous system20. CBD can also alter mood because it affects the serotonin system. Outcomes vary among people and depend on the product type and dose.
Unlike THC, CBD does not induce a feeling of being “high.” Even large doses of CBD do not produce THC-like effects. Additionally, a few studies have demonstrated that CBD reduces the psychoactive effects of THC.
Studies of short-term CBD use show that patients do not experience withdrawal21.
What Health Conditions Can CBD Help With?
So far, CBD’s effectiveness in the treatment of epilepsy is well-supported by research. Other early research suggests that CBD may also help treat schizophrenia and substance use disorders.
Currently, there is insufficient research to determine the effectiveness of CBD in treating other health conditions. However, preliminary research suggests CBD can help with a number of sleep disorders, including insomnia22 REM sleep behavior disorder23, and excessive daytime sleepiness disorder24. Additional preliminary research suggests CBD can also help patients improve sleep and reduce anxiety.
What Are the Risks of CBD?
Most negative effects of CBD medications and products are mild. For example, patients who use Epidiolex may experience diarrhea or other gastrointestinal issues. Some people may experience drowsiness when they take CBD. Other negative effects experienced with CBD may be due to an interaction between the CBD and other medications the patient is taking. Get the latest information in sleep from our newsletter Your privacy is important to us.
How Can CBD Help With Sleep Disorders?
Research on the effects CBD has on sleep disorders is still preliminary. Some people who use CBD for chronic pain report sleeping better. Currently, it is unclear whether these patients sleep better because of the pain relief or because CBD directly affects their sleep.
Other initial studies of CBD and sleep disorders suggest positive outcomes. However, not everyone experiences the same sleep benefits with CBD use, and different doses might lead to different effects. Research suggests that low doses of CBD are stimulating, while high doses of CBD are sedating. Discrepancies in experience can also be attributed to the method of CBD administration and dose. Additional research is needed to deepen our understanding of CBD as an intervention for sleep disorders.
Anxiety and CBD
While not a sleep disorder itself, anxiety can contribute to poor quality sleep, insufficient sleep, and sleep disorders. Because CBD calms the nervous system, early research indicates that CBD can be used to treat anxiety-related disorders. One study showed that nearly 80% of participants who used CBD to treat their anxiety reported lower anxiety levels within a month. Sleep initially improved in more than 65% percent of participants, followed by fluctuating results.
Insomnia and CBD
People who suffer from insomnia experience difficulty falling asleep or staying asleep25 at night. This disorder affects daytime wakefulness, ability to concentrate, and mood. Because of their history of poor sleep, people with insomnia may suffer from anxiety about getting inadequate sleep, which can then increase sleeplessness at night26.
Given the potential positive outcomes of CBD treating anxiety, it is speculated that CBD may also help reduce the anxiety associated with insomnia. Additionally, a new pilot study27 of CBD and THC use in humans with physician-diagnosed insomnia is underway. The results of the study will offer more insight into the effects CBD has on insomnia.
REM Sleep Behavior Disorder and CBD
In REM sleep behavior disorder, patients verbalize and make aggressive movements28 during their rapid eye movement (REM) stage of sleep. The disorder is most common in older patients with neurodegenerative diseases, such as Alzheimer’s disease and Parkinson’s disease.
In a limited study of four patients with Parkinson’s disease, CBD helped manage the REM sleep behavior disorder symptoms. Before taking CBD, the patients experienced disorder symptoms 2–7 times per week. After taking CBD, the symptoms occurred 0–1 times in a week. Further studies are necessary, but these initial results suggest CBD as a possible treatment for REM sleep behavior disorder.
Excessive Daytime Sleepiness Disorder and CBD
Those who have excessive daytime sleepiness disorder struggle to stay awake during typical daytime hours. One solution for waking up on time and staying wake may be CBD. Initial research on animals shows that CBD functions as a wake-inducing drug. However, other studies suggest CBD functions as a sedating drug. Further research is needed to determine what doses and methods of CBD use affect wakefulness and sleepiness.
Does CBD Interact With Other Prescriptions?
CBD can interact with other prescriptions a person takes. In particular, CBD can slow the liver’s ability to break down certain medications. Additionally, using CBD as well as herbs or supplements can make the patient too sleepy.
Before using any CBD product, consult your doctor. Let your doctor know of any medications, herbs, or supplements you are taking, so they can assess if CBD might cause a negative interaction. Your doctor will be able to inform you if CBD is a viable option to meet your health goals.