Can CBD Help With Sleep?

Getting better sleep is a challenge for many people, and researchers are exploring whether cannabidiol (CBD) can help. Over 80 different chemicals, called cannabinoids, can be found in the Cannabis sativa plant. The most abundant cannabinoid found is tetrahydrocannabinol (THC), while the second most abundant is CBD.

Unlike THC, CBD is non-psychoactive, so it does not give you the high or buzz you feel when using cannabis products that contain THC. Instead, CBD is well known for its soothing, relaxing properties. This is why CBD is being actively investigated for its use in improving sleep difficulties.

The research, while emerging and evolving, is promising, suggesting that CBD may improve both sleep quality and quantity.

What the CBD Research Says

While it's true there is scientific evidence that CBD can help with sleep, many of the human studies examining this association are small, and/or they lack a control group.

In addition, some studies have examined the combined role of THC and CBD for sleep, which we are not addressing here.

That said, here are examples of research studies supporting the use of CBD for improving sleep:

• In a study of 72 adults with primary symptoms of anxiety and poor sleep, over 65% of the patients improved their sleep quality scores after taking daily CBD (average dose of 25 milligrams) for one month. This improvement was sustained over the duration of the study (a total of three months).
• In a study of 21 patients with Parkinson's disease without dementia or other psychiatric conditions, participants experienced improved quality of life (including sleep) when taking 300 milligrams of CBD per day.
• In a case series of four patients with Parkinson's disease and REM sleep behavior disorder, CBD (75 to 300 milligrams per day for 6 weeks) reduced the frequency of rapid eye movement (REM) sleep behavior events.
• In a pediatric case study of a 10-year-old patient with posttraumatic stress disorder (PTSD), the patient had an increase in sleep quality and quantity and decrease in anxiety after taking 25 milligrams of CBD at bedtime and 6 to 12 milligrams of CBD sublingual spray during the day (as needed for anxiety).

Taking a Step Back

The idea of finding a natural therapy for sleeping problems is certainly appealing. However, sleep is a complex phenomenon. In fact, there is an array of reasons why a person may suffer from sleeping difficulties.

While not an exhaustive list, some potential reasons include:

• Having a psychiatric condition like anxiety or depression
• Having a primary sleep disorder like restless leg syndrome or sleep apnea
• Experiencing chronic pain (which wakes a person from sleep)
• Having a medical condition like hyperthyroidism, Parkinson's disease, or acid reflux
• Experiencing trauma or chronic stress

Genetics, environmental factors (such as travel, a crying baby, a loud bedroom), medications, or substance abuse may also contribute to poor sleep.

Other Considerations

Besides addressing the cause behind you or your loved one's sleep issues, there are other problems to consider regarding the use of CBD.

Formulations

CBD oil is extracted from the marijuana or hemp plant, which are both strains derived from the Cannabis sativa plant.

Once extracted, CBD oil can be taken by itself or infused into other forms, including:

• Edibles (for example, gummies or chocolates)
• Tinctures (add drops to drinks or food)
• Capsules
• Vapors (inhaled)
• Ointments and lotions
• Sprays
• Bath salt

The concern here is that the concentration and absorption of CBD will vary among these different formulations—and this will ultimately affect CBD's therapeutic effect.

Dosing

Dosing is another consideration. Unfortunately, it's not yet clear exactly what dose of CBD is needed to give a person a restful night's sleep.

For instance, in one of the studies mentioned above, the average adult dose used was 25 milligrams per day, whereas in another study, the participants used 300 milligrams per day.

It's likely that the dose required needs to be individualized and perhaps, titrated, based on its effect.

Factors that may affect dosing include:

• The severity of the person's sleep disorder
• Medications the person is taking (both sleep-related and drugs that may interact with CBD)
• Side effects experienced (such as whether the person is feeling drowsy or fatigued the next day)
• The formulation used

Another factor in dosing is that there is only one CBD medication available by prescription—Epidolex—which is FDA-approved for some forms of epilepsy. Its CBD concentration and purity are standardized. CBD products bought without prescription lack standardization.

A 2017 study found that only 31% of 84 CBD products bought online were labeled accurately for concentration, with 43% having less CBD than stated and 26% having more. In addition, over 21% had detectable THC.

Side Effects

Research suggests that, in the short-term, CBD is largely safe and well-tolerated. Some people, however, do experience side effects, such as:

• A change in appetite (either reduced or increased)
• Weight gain or loss
• Tiredness
• Diarrhea
• Increase in liver enzymes

In addition, some people may experience a worsening of their sleep quality after taking CBD. This paradoxical effect warrants further investigation.

Legality

Lastly, there is the legal issue of CBD to consider. Here is a brief summary of the laws encompassing CBD:

Federal Law

CBD oil extracted from industrial hemp, which must contain less than 0.3% THC, is federally legal. Marijuana, however, remains illegal under federal law in the United States.

State Law

Hemp-derived CBD is legal in all 50 states. However, state laws vary with regard to the legality of marijuana. CBD oil that still contains THC or other cannabinoids may only be sold in states that have legalized marijuana use.

A Word From Verywell

While an encouraging prospect, there is still much to learn about CBD and its role in sleep. To ensure your safety, please only move forward with taking CBD under the guidance of your healthcare provider.