CBD/THC and Sleep
Inadequate sleep is becoming a more aggressive public health problem, and is associated with a number of chronic diseases and conditions. An estimated 50-70 million US adults have sleep or wakefulness disorders, many of which may be caused by broad scale societal factors such as round-the-clock access to technology and busy work schedules (CDC), but also by underlying medical conditions. CBD has been recognized as a useful sleep aid, and a number of current clinical trials are in process to further understand CBDs contribution to healthy sleep cycles.
A recent case study provides clinical data that support the use of cannabidiol oil as a safe treatment for reducing anxiety and improving sleep in a young girl with post-traumatic stress disorder, with a dosage of 25mg/night, although the researchers stated “In our experience, this supplement given 12 mg to 25 mg once daily appears to provide relief of key symptoms with minimal side effects. Our patient did not voice any complaints or discomfort from the use of CBD” 1.
Another researcher conducted clinical trials with CBD in healthy volunteers and insomniacs in a laboratory between 1972 and 1981. They found that acute doses of CBD ranging from 10 to 600 mg and chronic administration of 10 mg for 20 days, or 3 mg/kg/day for 30 days did not induce any negative psychological effects or toxicity. Doses of 40, 80, and 160 mg CBD were compared to placebo and 5 mg nitrazepam in 15 people with insomnia. Subjects receiving 160 mg cannabidiol reported having slept significantly more than those receiving placebo; the volunteers also reported significantly less dream recall with the three doses of CBD than with placebo 2.
REM sleep is the time when we often dream and replay our day. A physiological component of REM sleep is muscle atonia, or muscle paralysis, do that we don’t act out our dreams, which could result in injury to ourselves or others. REM sleep behaviour disorder (RBD) is a disorder characterized by the loss of muscle atonia during REM sleep, allowing the person to “act out” their dreams. A research group looked into RBD in patients with Parkinson’s disease. Four patients treated with CBD had prompt and substantial reduction in the frequency of RBD-related events without any adverse side effects. This case series indicates that CBD is able to control the symptoms of RBD at a dose of 75mg/evening 3.
Adenosine accumulation is sleep-promoting. Here, we report that intrahypothalamic injection of CBD (10μg/1μL) increases the extracellular levels of adenosine collected from nucleus accumbens. Furthermore, the pharmacodynamic of this drug shows that effects on the contents of adenosine last 2h post-injection. These preliminary findings suggest that CBD promotes the endogenous accumulation of adenosine 4
Cannabidiol (CBD) is one of the main components of Cannabis sativa and has a wide spectrum of action, including effects in the sleep-wake cycle. Adult male Wistar rats were randomly distributed into four groups that received intraperitoneal injections of CBD 2.5 mg/kg, CBD 10 mg/kg, CBD 40 mg/kg or vehicle (n=seven animals/group). During the sleep period of the test day, the total percentage of sleep significantly increased in the groups treated with 10 and 40 mg/kg of CBD compared to placebo. REM sleep latency increased in the group injected with CBD 40 mg/kg and was significantly decreased with the dose of 10 mg/kg on the post-test day. There was an increase in the time of slow-wave sleep in the group treated with CBD 40 mg/kg, although this result did not reach statistical significance. The systemic acute administration of CBD appears to increase total sleep time, in addition to increasing sleep latency in the light period of the day of administration 5
CBD microinjected into the central nucleus of amygdala (CeA) significantly enhanced time spent in centre arena of OF, increased time during the open arms and decreased frequency of entry to the enclosed arms of EPM, further confirming its anxiolytic effect. The decrease of NREM sleep during the first hour and the suppression of REM sleep during hours 4e10 after the RCT represent the similar clinical observations (e.g. insomnia and REM sleep interruption) in PTSD patients. CBD efficiently blocked anxiety-induced REM sleep suppression, but had little effect on the alteration of NREM sleep. Conclusively, CBD may block anxiety-induced REM sleep alteration via its anxiolytic effect, rather than via sleep regulation per se 6.
Wake-Promoting Effects of CBD
Some studies have found that CBD actually has wake-promoting effects. It seems that lower doses are alerting, while higher doses are more sedative.
Fifteen milligrams THC would appear to be sedative, while 15 mg CBD appears to have alerting properties as it increased awake activity during sleep and counteracted the residual sedative activity of 15 mg THC 7.
The following review provided experimental evidence regarding the potential role of CBD as a wake-inducing drug 8
They found that microdialysis perfusion of CBD (30, 60, or 90 nM) into LH of rat enhances alertness and suppresses sleep. This effect was accompanied with an increase in DA extracellular levels collected from the AcbC. Furthermore, perfusion of CBD into LH after total sleep deprivation prevented the sleep rebound 9
Multiple Sclerosis Studies:
In a study of 479 MS patients given 2.5-25mg THC/day, 50% found an improvement in their sleep, 38% didn’t experience a difference, and 12% felt it had deleterious effects on their sleep 10
In another study CBD + ∆9-THC (34 mg), the ∆9-THC > BAS (sleep quality) 11
2.5–120 mg/24 hours CBD + ∆9-THC increased sleep quality 12.
Flexible-doses, 2.5 mg per spray CBD + ∆9-THC increased sleep quality 13
Flexible-dose; CBD & ∆9-THC 20 mg or 8–10 sprays per day increased sleep quality 14.
- Shannon, S. & Opila-Lehman, J. Effectiveness of Cannabidiol Oil for Pediatric Anxiety and Insomnia as Part of Posttraumatic Stress Disorder: A Case Report. Perm. J. 20, 108–111 (2016).
- Carlini, E. A. & Cunha, J. M. Hypnotic and antiepileptic effects of cannabidiol. J. Clin. Pharmacol. 21, 417S–427S (1981).
- Chagas, M. H. N. et al. Cannabidiol can improve complex sleep-related behaviours associated with rapid eye movement sleep behaviour disorder in Parkinson’s disease patients: A case series. J. Clin. Pharm. Ther. 39, 564–566 (2014).
- Mijangos-Moreno, S., Poot-Aké, A., Arankowsky-Sandoval, G. & Murillo-Rodríguez, E. Intrahypothalamic injection of cannabidiol increases the extracellular levels of adenosine in nucleus accumbens in rats. Neurosci. Res. 84, 60–63 (2014).
- Chagas, M. H. et al. Effects of acute systemic administration of cannabidiol on sleep-wake cycle in rats. J Psychopharmacol 27, 312–316 (2013).
- Hsiao, Y. T., Yi, P. L., Li, C. L. & Chang, F. C. Effect of cannabidiol on sleep disruption induced by the repeated combination tests consisting of open field and elevated plus-maze in rats. Neuropharmacology 62, 373–384 (2012).
- Nicholson, A. N., Turner, C., Stone, B. M. & Robson, P. J. Effect of ??-9-Tetrahydrocannabinol and Cannabidiol on Nocturnal Sleep and Early-Morning Behavior in Young Adults. J. Clin. Psychopharmacol. 24, 305–313 (2004).
- Murillo-Rodríguez, E., Millán-Aldaco, D., Palomero-Rivero, M., Mechoulam, R. & Drucker-Colín, R. The nonpsychoactive cannabis constituent cannabidiol is a wake-inducing agent. Behavioral Neuroscience 122, 1378–1382 (2008).
- Murillo-Rodríguez, E., Palomero-Rivero, M., Millán-Aldaco, D., Mechoulam, R. & Drucker-Colín, R. Effects on sleep and dopamine levels of microdialysis perfusion of cannabidiol into the lateral hypothalamus of rats. Life Sci. 88, 504–511 (2011).
- Zajicek, J. et al. Cannabinoids for treatment of spasticity and other symptoms related to multiple sclerosis (CAMS study): Multicentre randomised placebo-controlled trial. Lancet 362, 1517–1526 (2003).
- Dasgupta, R., Berkley, K. J. & Fowler, C. J. dysfunction in advanced multiple sclerosis. 425–433 (2004).
- Wade, D. T., Robson, P., House, H., Makela, P. & Aram, J. A preliminary controlled study to determine whether whole-plant cannabis extracts can improve intractable neurogenic symptoms. Clin Rehabil 17, 21–29 (2003).
- Notcutt, W. et al. Initial experiences with medicinal extracts of cannabis for chronic pain: Results from 34 ‘N of 1’ studies. Anaesthesia 59, 440–452 (2004).
- Berman, J. S., Symonds, C. & Birch, R. Efficacy of two cannabis based medicinal extracts for relief of central neuropathic pain from brachial plexus avulsion: Results of a randomised controlled trial. Pain 112, 299–306 (2004).