Cannabidiol for sleep
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Cannabidiol (CBD) for Sleep: A Comprehensive Review
Introduction to Cannabidiol and Sleep Disorders
Cannabidiol (CBD), a non-psychoactive component of Cannabis sativa, has garnered significant attention for its potential therapeutic benefits, including its effects on sleep disorders. Unlike tetrahydrocannabinol (THC), CBD does not produce a "high," making it a more appealing option for those seeking relief from sleep disturbances without psychoactive effects 24.
CBD's Mechanism of Action in Sleep Regulation
CBD interacts with the endocannabinoid system, which plays a crucial role in regulating various physiological processes, including sleep. It influences anxiety, mood, autonomic function, and the circadian sleep/wake cycle 1. Studies suggest that CBD may modulate sleep by affecting serotonin-mediated apneas and increasing dopamine release, which can enhance alertness and wakefulness 49.
Clinical Evidence on CBD for Sleep Disorders
Insomnia
Research indicates that CBD may have therapeutic potential for treating insomnia. Medium to high doses of CBD have been shown to increase REM sleep latency, while medium-low doses decrease it 2. A systematic review found that CBD, either alone or in combination with THC, could improve insomnia symptoms, although the evidence is not yet robust enough to support routine clinical use 17.
Sleep Apnea and REM Sleep Behavior Disorder
Preliminary studies suggest that CBD may hold promise for treating sleep apnea and REM sleep behavior disorder. Synthetic cannabinoids like nabilone and dronabinol have shown short-term benefits for sleep apnea, while CBD may reduce nightmares associated with PTSD and improve sleep in chronic pain patients 4.
Chronic Insomnia Disorder
A proof-of-concept trial is currently evaluating the effects of a single dose of an oral cannabis-based medicine containing 10 mg THC and 200 mg CBD on sleep and daytime function in participants with chronic insomnia disorder. This study aims to provide more objective measures of CBD's efficacy in treating insomnia 3.
Preclinical Studies and Animal Models
Animal studies have also provided insights into CBD's effects on sleep. In rats, acute systemic administration of CBD increased total sleep time and sleep latency during the light period. Higher doses of CBD were associated with increased REM sleep latency and slow-wave sleep, although these results did not reach statistical significance 5.
Safety and Comparative Effectiveness
A randomized controlled trial involving 1,793 adults with sleep disturbances found that chronic use of low-dose CBD (15 mg) was safe and led to significant improvements in sleep quality. However, the effects were comparable to those of 5 mg melatonin, and the addition of other cannabinoids like cannabinol (CBN) and cannabichromene (CBC) did not enhance the effects of CBD 10.
Limitations and Future Research
Despite promising preliminary findings, the current body of research on CBD and sleep is limited by small sample sizes, short study durations, and a lack of objective measures. Many studies rely on self-reported data, which can introduce bias 278. Future research should focus on larger, rigorously controlled, long-term trials to better understand the safety and efficacy of CBD for treating sleep disorders 147.
Conclusion
While CBD shows potential as a treatment for various sleep disorders, the current evidence is insufficient to support its routine clinical use. More comprehensive and controlled studies are needed to establish definitive conclusions about its effectiveness and safety. Until then, individuals considering CBD for sleep should consult healthcare professionals to weigh the potential benefits and risks.
Sources and full results
Most relevant research papers on this topic
Cannabinoid therapies in the management of sleep disorders: A systematic review of preclinical and clinical studies.
Cannabinoid therapies show promising potential for treating sleep disorders, but more large-scale, rigorous trials are needed to confirm their safety and efficacy.
Systematic Review
Highly CitedCannabidiol (CBD) and Insomnia : Literature review
Short-term use of medium to high doses of CBD may improve insomnia, but combined use with THC may decrease slow wave sleep.
Systematic Review
Rigorous JournalCannabidiol (CBD) and Δ9-tetrahydrocannabinol (THC) for chronic insomnia disorder (‘CANSLEEP’ trial): protocol for a randomised, placebo-controlled, double-blinded, proof-of-concept trial
A single dose of an oral cannabis-based medicine (ETC120) containing 10 mg THC and 200 mg CBD may improve sleep and daytime function in individuals with chronic insomnia disorder.
RCTRigorous JournalCannabis, Cannabinoids, and Sleep: a Review of the Literature
Cannabidiol (CBD) shows potential for treating insomnia, while THC may improve sleep quality but may impair it long-term.
Literature ReviewHighly CitedEffects of acute systemic administration of cannabidiol on sleep-wake cycle in rats
Acute systemic administration of CBD increases total sleep time and sleep latency in rats during the light period of the day of administration.
RCT
Animal Study
Very Rigorous JournalNo Acute Effects of Cannabidiol on the Sleep-Wake Cycle of Healthy Subjects: A Randomized, Double-Blind, Placebo-Controlled, Crossover Study
Acute administration of CBD does not interfere with the sleep cycle of healthy volunteers, supporting the proposal that CBD does not alter normal sleep architecture.
RCTUse of Cannabidiol in the Management of Insomnia: A Systematic Review.
CBD alone or with equal quantities of THC may be beneficial in alleviating insomnia symptoms, but more validated research is needed before definitive conclusions can be made.
Systematic ReviewThe use of cannabinoids for sleep: A critical review on clinical trials.
Cannabinoids may improve sleep quality, decrease sleep disturbances, and decrease sleep onset latency, but more research is needed to confirm their long-term effects and potential side effects.
Systematic ReviewHighly CitedCannabidiol, a constituent of Cannabis sativa, modulates sleep in rats
CBD increases wakefulness and decreases rapid eye movement sleep in rats, potentially benefiting sleep disorders like excessive somnolence.
Non-RCTAnimal StudyHighly CitedThe Safety and Comparative Effectiveness of Non-Psychoactive Cannabinoid Formulations for the Improvement of Sleep: A Double-Blinded, Randomized Controlled Trial.
Chronic use of a low dose of CBD is safe and could improve sleep quality, but its effects do not exceed those of 5 mg melatonin, and adding low doses of CBN and CBC may not enhance these effects.
RCT
Large Human Trial