Cannabidiol (CBD) is a nonpsychoactive phytocannabinoid (plant-based cannabinoid) naturally present in cannabis plants. Rather than altering thoughts, CBD may interact with the endocannabinoid system (ECS) to help increase sleep time and improve sleep quality(1).
The ECS plays a role in maintaining homeostasis in the body and ensuring that different internal systems work properly. The ECS has cannabinoid receptors throughout the body, with CB1 and CB2 receptors being the most common(2).
The receptors are how the ECS regulates daily bodily functions and processes, including pain sensation, stress or anxiety response, energy levels, mood, and sleep(3).
The human body produces endogenous cannabinoids (endocannabinoids), which can bind to ECS receptors and influence the body’s functionality(4).
Similarly, phytocannabinoids, such as CBD and tetrahydrocannabinol (THC), may influence cannabinoid receptors to trigger specific responses.
A study suggested that CBD binds with CB1 receptors in the ECS and modulates their response to certain stimuli(5). The researchers hypothesized that CBD may help treat medical conditions associated with the central nervous system, such as sleep disorders(6).
A 2020 review also noted that CB1 receptors may be involved in promoting sleep(7). Additionally, a study showed that activating CB1 receptors may induce sleep and modulate sleep generation(8).
CB1 receptors are mostly found in the central nervous system(9). They are particularly abundant in the hippocampus, cerebellum, and basal ganglia regions of the brain.
The basal forebrain is one of the seven parts of the brain involved with sleep. This portion of the brain promotes sleep and wakefulness through the release of adenosine, a chemical that supports sleep drive(10).
When activated, CB1 receptors influence cognitive functions, such as memory processing, movement, mood, and pain sensation(11). A study in PLOS One showed that activated CB1 receptors may also increase the stability of non-rapid eye movement (NREM) sleep(12).
NREM sleep has three stages, including the deepest sleep period necessary to feel refreshed upon waking up(13). NREM sleep is also sometimes referred to as dreamless sleep, as rapid eye movement (REM) sleep is the stage when dreams occur.
The researchers hypothesized that triggering CB1 receptors may be necessary for stable NREM sleep, though not for sleep homeostasis (the balance between sleep and wakefulness)(14).
Meanwhile, CB2 receptors are abundant in the immune system. These receptors affect immune cell functions and trigger anti-inflammatory responses(15).
Benefits of Using CBD for Sleep
A review that appeared in Current Psychiatry Reports suggested that CBD may offer therapeutic benefits for people with insomnia(16). The review also stated that CBD shows promise as a treatment for REM sleep behavior disorder and excessive daytime sleepiness.
Sufficient hours and good quality of sleep are vital for maintaining optimal physical and mental wellness. According to the US Centers for Disease Control and Prevention, adults need at least seven hours of sleep each day(17).
However, researchers from the University of Pennsylvania found that nearly 25% of Americans experienced acute insomnia per year(18).
Acute insomnia is characterized by difficulty falling or staying asleep multiple times a week for at least a fortnight.
Findings published in the Journal of Clinical Pharmacy and Therapeutics also acknowledged CBD’s potential in treating REM sleep behavior disorder (RBD) events.
The study noted that patients who were given daily doses of CBD exhibited a rapid and significant reduction in the recurrence of RBD events(19). Moreover, patients who stopped taking CBD saw a return of the frequency and intensity of their RBD symptoms.
Consumer Reports found that one-third of Americans who had sleep problems also used sleeping aids or pills(20). Over-the-counter (OTC) and prescription sleep medications may help with RBD and other sleep problems, though they do not always produce good results.
Almost six out of ten people who took sleep aids experienced drowsiness, confusion, and forgetfulness upon waking up the following day(21).
One study also suggested that OTC sleep aids may be linked to a 52% increased risk for stroke among middle-aged and older men and women(22).
According to a study published in Sleep Disorders, prescription sleep medications, like benzodiazepines or other hypnotic drugs, may also cause residual side effects(24).
These side effects include daytime sleepiness or drowsiness, oversleeping, difficulty concentrating, headaches, and even periods of amnesia.
A crossover trial done on insomnia patients compared the effects of CBD with nitrazepam, a hypnotic medication and type of benzodiazepine drug. The findings showed that a high dose of CBD (160mg) helped improve sleep duration significantly(25).
A clinical study also observed the effects of CBD on adult patients with anxiety and sleep disorders.
The results indicated that 48 out of 72 patients with sleep-related concerns saw an improvement in their sleep scores in the first month of the study(26). On average, the patients had sustained improvements over three months of CBD treatment.
Moreover, researchers hypothesized that using CBD to reduce sleep-interrupting symptoms, like pain, may improve sleep quality.
This hypothesis aligns with the findings of various studies regarding CBD’s promising therapeutic effects for pain and anxiety.
Studies suggested that CBD treatments may provide relief for patients with multiple sclerosis and other conditions that cause chronic pain(27). In particular, CBD was observed to reduce chronic pain by more than 30% in fibromyalgia patients.
Risks of Using CBD for Sleep
CBD remains a highly unregulated product in the United States despite being legal on the federal level.
Moreover, the US Food and Drug Administration (FDA) has not approved CBD as a treatment for any medical condition. The FDA has only approved one CBD-based drug, Epidiolex, for treating rare forms of epilepsy(28).
A study published in the journal Molecules in 2019 indicated that extremely high doses of Epidiolex (2,460mg/kg of a person’s body weight) may cause CBD-induced hepatoxicity or liver injury(29).
Other possible side effects of taking CBD are(30):
- Reduced appetite
- Dry mouth
- Tiredness or fatigue
- Weight loss or weight gain
Additionally, CBD may cause a contraindication or drug interaction with some medications consumers may be taking, such as blood thinners(31).
Despite its possible side effects, CBD still has a good safety profile, according to the World Health Organization(32).
Additionally, it is better to consult a healthcare professional before buying or using any CBD product.
Buying top-quality CBD oil may help prevent unwanted adverse effects.
How Soon Can CBD’s Effects Be Felt
The chosen delivery method or way of taking CBD affects how fast patients may feel the product’s effects.
Moreover, different products’ potencies and carrier oils may also affect CBD bioavailability. Bioavailability is the speed and amount of the drug that gets absorbed into the bloodstream.
Additionally, studies suggest that vaping may cause lung issues or respiratory illnesses(37).
Users that let CBD sit under their tongue may feel its effects in as fast as 15 minutes, with the effects lasting up to eight hours(38).
Findings indicated that patients with sleep problems reported improved sleep within one month of taking CBD(39).
The researchers also noted that improved sleep scores were observed throughout the three months of CBD treatment(40).
However, sustained improvement and better results were observed only while the patients continued to take CBD. The patients who discontinued CBD treatments due to fatigue and mild side effects also stopped experiencing better sleep quality(41).
CBD Dosage for Sleep
A study in The Permanente Journal indicated that dosages of 25mg to 75mg of CBD per day may help improve sleep quality(42).
Researchers also noted that a participant who had schizoaffective disorder and a trauma history was given a 175mg per day dosage of CBD for better sleep(43).
Consumers should note that no official dosage guidelines or recommendations have been released by the FDA or any official organization.
Most CBD companies also give their dosage recommendations for each product.
However, it is better to talk with a physician familiar with CBD for a more precise dosage that accounts for other existing conditions and current medications.
How to Take CBD for Sleep
CBD oils and tinctures usually come with a marked dropper to make dosage measurement easier and more accurate.
Some CBD tinctures or oils may be used as substitutes for vape oils. Take note that CBD oils that use medium-chain triglyceride (MCT) or fractionated coconut oil as the carrier oil are not ideal for vaping.
According to a study, burning and inhaling MCT oil may cause inflammation and acute lung injury(45).
When to Take CBD for Sleep
Researchers noted that using CBD for sleep after dinner may help reduce sleep concerns and improve sleep quality(47). Some CBD brands recommend taking CBD gummies around 30 minutes before going to bed.
The same study noted that giving CBD to patients in the morning also aided in improving anxiety levels(48).
Where to Buy CBD for Sleep
Consumers may purchase CBD products at physical stores or online through company brand websites and third-party retailers.
How to Buy the Best CBD Oils for Sleep
Terpenes are aromatic compounds that may induce relaxation and therapeutic relief(53). Flavonoids are phytonutrients or plant chemicals that may offer antioxidant and anti-inflammatory benefits(54).
When taken together, all the compounds produce the entourage effect, wherein the compounds work in synergy to enhance their individual therapeutic benefits.
The entourage effect means that the individual takes in all the purported benefits of the cannabinoids.
Broad-spectrum CBD extracts are ideal for consumers that want the advantage of all phytocannabinoids without the THC content.
The extraction method may also affect CBD product quality.
The supercritical CO2 extraction process is considered a safe method to ensure the extraction of potent, chlorophyll-free, and high-quality CBD(55).
Other safe extraction methods include solvent or ethanol extraction and olive oil CBD extraction(56).
The following tips can help ensure the purchase of high-quality products:
- Trustworthy brands ensure their products undergo third-party testing and make the lab test results readily available to consumers.
- It is advisable to learn how to read third-party lab testing reports or certificates of analysis (COAs) to make sure the information on the labels and lab results match.
- Make sure the products are tested for harmful contaminants, such as residual solvents, heavy metals, pesticides, and toxins.
- If possible, choose products that are made from organic hemp, non-genetically modified organisms (non-GMO). Ideally, they should also contain all-natural ingredients. Vegan and gluten-free CBD oil are also good options for consumers with allergies.
- Look for products that come with a 15- or 30-day money-back guarantee. Brands that give such guarantees are more likely to be offering quality CBD oil and products.
It is best to research each product extensively and read up on customer reviews to understand how the product works and the recommended dose.
Examples of companies that have built a reputation as reliable and transparent CBD brands are NuLeaf Naturals, Medterra, and Charlotte’s Web.
Legality of CBD
Before the 2018 Farm Bill, industrial hemp plants and marijuana plants are classified as illegal Schedule I drugs(58). The bill redefined hemp plants and removed them from the Schedule I drugs category.
Schedule I drugs have a high potential for abuse and no approved medical use(59).
Taking large doses of THC may lead to hallucinations, delusions, and heightened sensory perceptions. Prolonged use of THC may also cause psychotic disorders, such as schizophrenia(61).
High-THC medical cannabis may only be available to patients with qualifying medical conditions. These patients may also need to get a medical marijuana card or a physician’s written recommendation to receive medical cannabis(62).
Federal law allows the transport of CBD across state lines, provided that the product is lawfully produced or licensed(63).
However, state governments may still impose laws and regulations regarding CBD use that may supersede the federal mandate, at least within the state.
For instance, New York does not allow the sale of CBD food and drinks infused with CBD(64). However, proposed state regulations seek to amend this rule.
Meanwhile, Colorado limits the purchase of CBD products that are also age-restricted commodities, such as CBD-infused alcoholic beverages(65).