I have found the subject of sleep and sleep medications to be a difficult one through the years. Prescription drugs have been found to be effective in providing improved sleep quality or quantity, but users may pay a heavy price from side effects such as sleep walking, nightmares, addiction, and hangovers. Over the counter remedies do little to support the cause either.
This discussion on sleep is important and difficult to address no matter the modality you choose. Some statistics to back this up:
- 35% of adults get less than 7 hours sleep per day.
- Between 10-30% of adults struggle with insomnia.
- 50-70 million adults have a diagnosed sleep disorder
- 38% of adults report falling asleep during the day during the last month
Not getting enough sleep is linked with many chronic diseases such as diabetes, heart disease, depression, and anxiety. 5% of people report falling asleep while driving, which is a crazy — and scary — number to me. 5%!!! Getting enough sleep is not a luxury but is often treated as an afterthought in today’s stressed-out non-stop lifestyle.
According to a 2018 study of over 10,000 adults, the body’s ability to function declines if not consistently getting 7-8 hours of sleep. Those 35% of adults who get less than 7hours of sleep on a regular basis run a higher risk for developing diabetes, heart disease, and increased risk of early death. We all have experienced this reduction in our functioning from a poor night’s sleep, but when it gets to be chronic in nature, we suffer.
Good sleep hygiene (making changes to your sleep schedule and environment to promote better sleep habits) is definitely a part of a successful solution. Just taking a pill without adjusting any other risk factors or behavioural changes sets you up for failure, no matter the medication. But the purpose of this article is to look at a natural, homeopathic method to give us tools in the battle versus insomnia. Some of the terpenes and cannabinoids have been specially formulated to help improve our sleep with minimal side effects. I have heard personal and anecdotal stories that speak of glowing results when looking to CBD to improve sleep. So, hang on tight, hopeful reader, and let’s see what the hemp plant has to say in this category.
The problem as we look at possible options below to help you sleep is that the reasons for a poor night of sleep are varied and complicated. With most people there are multiple factors to consider so we have to tread quietly as we enter the sleep arena. I think if we can find temporary relief from a supplement that will not make things worse, then we have a starting point. The hope is that we can find some relief so that you, the problematic sleeper, can get some rest and think more clearly about possible solutions.
There are lots of OTC options but none are too exciting. I will mention some possibilities below, but this article is being written more from the lens of the CBD Pharmacist and is not meant to be exhaustive in the list of options. Lots of CBD companies out there talk about sleep and many manufacturers add terpenes or melatonin to their CBD to increase the potential effects on sleep. Keep in mind that most homeopathic medications do not have official FDA approval to make health claims but that doesn’t stop companies or the people selling their products from doing so.
Despite the longevity of popular over-the-counter medications (OTCs) such as Tylenol PM or Sominex, there are not any options that you the consumer can count on. The majority of OTCs use antihistamines as their main ingredient which has the side effect of making you drowsy, but also cause dry mouth and play havoc with glaucoma and/or your prostate. I have never been a fan of these options and most benefits are short lived.
There have been various prescription drug options over the years. The old guard medications have been Temazepam or Ambien, with some newer players like Lunesta or Belsomra trying to make a splash. The newer prescription medications tend to be less harmful to the body than the OGs in the category. These medications can cause nightmares, vivid dreams, and drowsiness the next day. Some of these are habit forming, especially medications such as Ativan or Xanax which are sometimes used to promote relaxation or sleep, or for people who are on them for other disorders such as anxiety.
So let’s talk about our naturopathic options. I think there is more credibility when you start to look at terpenes to give you therapeutic relief from poor sleep quality. I’ll list some options that you will routinely find in your CBD but I don’t feel that one is superior to another. Each person has to experiment with each formulation to see what works best for you. I still feel that your broad-spectrum and full-spectrum formulations are the best and that the terpene profile is complementary to the effectiveness of CBD and other cannabinoids.
I will supply you with a list of the most common terpenes and supplements you will see added to CBD to help you sleep. None of these additions are a slam dunk when it comes to sleeping. Results will vary quite a bit with each person and I still consider CBD to be the heavy hitter in this category.
Terpenes are aromatic compounds found in plants that create a characteristic scent such as pine, lavender, and an orange peel. Terpenes play a key role in plant development attracting pollinators and repelling predators. They also can play a part in the plant’s natural immune system and help recover from injuries. In humans, terpenes have many potential benefits in such areas as aroma therapy but also are the subject of bigger claims like anti-inflammatory and antiviral properties.
- Caryophyllene: the only terpene that binds directly to cannabinoid receptors in the body. Its predominant effects are to ease anxiety, lessen inflammation, and help promote restful sleep. You will also find it in cinnamon, black pepper, and cloves.
- Myrcene: the most abundant terpene found in cannabis. Studies have shown that it helps to relax your muscles and has a mild hypnotic effect. You will also find it in mangoes, thyme, and hops.
- Linalool: famous for its lavender scent. It has been reported to lessen stress or depression and has a mild hypnotic effect. You can find this in lavender, clary sage, and sweet basil.
- Pinene: famous for the scent you smell from pine trees. This also has mild hypnotic effects along with anti-anxiety and a unique mechanism that helps increase non-REM sleep. You can also find this in rosemary, orange peels, and parsley.
Another common addition to your CBD for sleep is the supplement melatonin. You can take melatonin as a supplement and it has gained some popularity over the years. But it is actually a hormone secreted by your body at night and plays a critical role in your sleep-awake cycle. It has gained popularity by those people trying to adjust from jet lag or for people with sudden changes in their work/sleep cycle.
Melatonin secretion increases at night and decreases when the light of morning begins to shine in. There is much still to learn about this supplement but it is safe and non-toxic. The biggest struggle for most people is the feeling of being drowsy or “hung-over” in the mornings. Most OTC forms are in the 5-10 mg range but you will find it in much lower quantities when given with CBD, which is a good thing. We want melatonin to be an additive agent that helps CBD work better, not the other way around!
CBN or cannabinol is a cannabinoid found in the hemp plant, similar to CBD. THC will turn into CBN when exposed to heat and light. So while there are some similarities they are actually quite different. THC binds to our CB1 receptors in our Endocannabinoid System (ECS) and so does CBN but at about 1/10th the strength.
While we are focusing on CBN for sleep for this article, it has also been shown to have anti-anxiety and anticonvulsant properties. This multi-faceted approach that CBN has on your body adds to its luster because it not only causes sedation but can help reduce pain and discomfort.
The clinical results on the effectiveness of CBN are mixed, so it is best to try it yourself and observe the results. It is best in a full-spectrum product so that you can take advantage of the whole plant and all of the cannabinoids.
Sleep results for CBD are similar to CBN, with lots of anecdotal evidence but mixed reviews clinically. Some studies conducted have found the 0.3% THC full spectrum version to have more of an impact than the 0% THC broad spectrum formulations.
What we do know is that raised levels of Anandamide (AEA) have been known to promote sleep, which is a primary effect of CBD. AEA is unique in that it impacts certain areas of the brain to help with staying awake and works in other areas at night to promote sleep. This shouldn’t be a surprise since there are CB1 receptors located in the sleep-inducing areas of the brain. CB1 and AEA also can lead to increased amounts of acetylcholine which is a neurotransmitter that is found in higher levels when we sleep.
CBD also increases the levels of adenosine which helps with the wake-sleep cycle. Adenosine is a really interesting neurotransmitter and has some similarities to AEA. Adenosine regulates the arousal of our body, helping us to wake up in the mornings and promote wakefulness. But it also has this effect at night to suppress our nerve cell activity and make us drowsy. It is postulated that adenosine increases throughout the day and gets stronger at night which leads to more suppression of our brain cells and more sleepiness. Caffeine also targets adenosine and reduces its potency which is a factor in increasing our wakefulness.
Dosing of CBD to Impact Sleep
Dosing for sleep is the #1 area of confusion in regards to CBD. The critical concept to understand is that CBD is not a sleeping medication. I know, I realize that I am writing this blog about CBD and sleep, but CBD does not act like those medications I mentioned in the first few paragraphs. CBD does not make you sleepy until taking very high doses (over 100 mg at a time) which I do not recommend. CBD works with your body’s own internal balancing system that helps to get us back to homeostasis. So yes, there are effects on anandamide and dopamine which are both neurochemicals that aid us in our sleep, but that isn’t all they do. Think of CBD like a smart pill, it helps our body know what to do, at the right time, to achieve the maximum result. I don’t recommend taking CBD at bedtime, at least not right away. You can take a dose in the morning and afternoon and it can still help you sleep.
The effect, as I like to put it, is that CBD helps you go to bed, when it is time for bed. If you listen to your body, you will notice more drowsiness when your body says it is time to call it quits. Do not compare it to a sleeping pill like Ambien that literally shuts your body down. But CBD acts gradually and sometimes subtly, unlike its splashy cousin marijuana.
The one identifiable effect from CBD, and I think it’s the most prevalent and easily identifiable, are the vivid dreams. The higher the dose of CBD and the closer it is to bed the higher the likelihood of this side effect. These dreams are not like nightmares but are just very realistic, and you find yourself waking up just to get them to stop!
I recommend starting CBD in the morning, no matter the reason for using it. Once you build up to a therapeutic dose, split it up morning and afternoon and see how things go. You can slowly start to transition the second dose to the evening as you observe its effects on your sleep. After 30-45 days you can try it at night if still not getting your desired effect. You just want to build slowly and observe the results.
And as an aside, I have found formulations with CBG to have a stronger effect on dreams than CBD. I don’t totally understand this mechanism but I have seen it myself and, in a couple, other people.
Otherwise, consistent every day dosing is the way to go. Give CBD a chance to work in your body and realize that it is gradual in nature and most often will not create dramatic results. Keep with the low and slow philosophy and build up to the 75 mg-100 mg range per day for most people. Chronic conditions may require a higher dosage, but I don’t recommend topping out much over 150 mg-200 mg. There is not any kind of set maximum dosage limit for CBD, but we do know that eventually it stops working when given at high doses. Think of CBD effectiveness like a bell curve, with the top of the bell being the most effective at say, 75 mg-125 mg per day, and doses that go much higher start to get less return on the CBD investment. The higher the dosage the more likely you are to feel dizziness or fatigue.
I recommend starting at 0.25-0.5 mg/kg of CBD per day for those that are new to CBD.
Increase gradually over the next 30 days to 1 mg/kg of CBD and you can start to gauge how effective CBD will be. With anxiety and depression, you have to give at least 2-3 months to observe your own behavior and response. I don’t recommend going over 2-3 mg/kg per day of CBD but everyone has to find their own limit. Don’t go thinking that just because you are having success at 100 mg per day that the results will be twice as good if you up your dose to 200 mg per day. CBD doesn’t work like that, more is not always better!
There are many CBD formulations and theories by manufacturers for what works best for sleep. I’m here to say that there are no home runs, at least not yet. I’m sure that we will see more cannabinoids that are isolated and increased for their effect on our sleep, but it is going to be a work in progress for a long time.
Now, with that being said, I personally know lots of people that have gained a positive effect on their sleep. Not only does CBD affect our dopamine and anandamide, but it also helps reduce our anxiety by increasing our serotonin levels. There are many prescription drugs that are used for sleep that are anti-depressants. They often have a side effect of making you drowsy but also help with the anxiety and nerves that can make sleep difficult. There are times when we just need to quiet down our brain to allow our body to sleep, and I think this is something that CBD can do for us.
I do like when higher levels of terpenes are added since those are also naturally present in the hemp plant. Melatonin is a solid option but I don’t recommend adding to CBD unless you have tried it before. CBN is still a bit of a mystery with some positive anecdotal stories and some negative ones too.
I’ve written about CBD and the effects it has on pain and anxiety in recent blog articles, and they are much easier subjects to write about than CBD for sleep. I would say to keep your expectations moderate and be observant of how your dosing affects your sleep. Tweak your CBD as best fits your needs and try different formulations before writing it off. CBD is by far the safest of all the options for your sleep and is worth taking the time to figure it out.