Poor sleep is, unfortunately, all too common among Americans. Problems with sleeping are among the top medical complaints in the United States, and they are a major health concern. There are 70 different sleep disorders, the most common including:
- Insomnia: the inability to fall asleep or stay asleep
- Sleep apnea: impaired breathing while sleeping
- Restless leg syndrome: tingling, discomfort, and even pain in the legs that increases at night and is relieved by movement
- Circadian rhythm disorders: the disturbance of the internal clock and sleep patterns
- Parasomnias: abnormal movements and activities while sleeping, including sleep walking and nightmares
- Excessive daytime sleepiness: persistent drowsiness during daylight hours from narcolepsy or another medical condition
Poor sleep is also a risk factor for many serious illnesses, and adults who get less than seven hours of sleep in a 24-hour period are more likely to develop chronic health conditions like obesity, heart disease, diabetes, arthritis, stroke, and depression. According to a 2016 study by Dr. Daniel Kripke, prescription sleep medications come along with increased risk for death, cancer, depression, and infection, not to mention the negative side effects associated with them, like excessive drowsiness the next day and dependence.1
The role of the ECS in sleep is clear: As the master regulator of our most basic human functions, the ECS has a direct impact on sleep. (Remember, the ECS umbrella includes eat, relax, sleep, forget, protect.) In fact, our own endocannabinoids, anandamide and 2-AG, fluctuate with our natural circadian rhythms. Anandamide levels in the brain are higher at night, where it works with oleamide and adenosine to generate sleep. 2-AG levels in the brain are higher during the day, and it seems to promote wakefulness.
The ability of cannabis to help with sleep has been known and appreciated for hundreds of years, but CBD has impacts on sleep that are only beginning to be understood scientifically. People will often claim that CBD helps them sleep, and yet we’ve seen scientifically that at low to moderate doses, CBD promotes alertness and wakefulness.2 So how does CBD help with sleep?
Because CBD has effective anti-anxiety and calming effects, the experience of better sleep with CBD is not because CBD is causing drowsiness, but rather because the anxiety relief and relaxation it provides allows for better quality of rest.
That being said, because of its biphasic properties (see What Does “Biphasic” Mean?, below), CBD can have both alerting effects at low to medium doses and more sedating and sleep-producing effects at high doses. Low to moderate doses of CBD that create an alerting effect might be helpful for narcoleptics, or people suffering from excessive sleepiness during the day. In one insomnia study, high doses (160 milligrams) of CBD were shown to improve the length and quality of sleep.3
Several terpenes found most potently in cannabis-derived products, and to some extent, in hemp-CBD products, can also work both on their own and with cannabinoids to help promote sleep: terpinolene, linalool, and myrcene all work as sedatives .
What Does “Biphasic” Mean?
This means that low and high doses of the same substance can have opposite effects. Many cannabinoids have biphasic effects. THC is known for having euphoric effects at lower doses, but can cause anxiety and paranoia at higher doses. CBD can have alerting effects at moderate doses, and sedating effects at high doses. The biphasic effects of cannabinoids underscore the fact that using cannabis therapeutics is an extremely personal process, and finding the right dose for you is part of the process.
- Daniel F. Kripke, “Hypnotic Drug Risks of Mortality, Infection, Depression, and Cancer: but Lack of Benefit,” F1000Research 5, (May 2016): 918, doi:10.12688/f1000research.8729.1.
- Ethan B. Russo, “Cannabidiol Claims and Misconceptions,” Trends in Pharmacological Sciences 38, no. 3 (2017): 198–201, doi:10.1016/j.tips.2016.12.004.
- Elisaldo A. Carlini and Jomar M. Cunha, “Hypnotic and Antiepileptic Effects of Cannabidiol,” The Journal of Clinical Pharmacology 21, S1 (1981), doi:10.1002/j.1552-4604.1981.tb02622.x.