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How Cannabis Affects Sleep

Cannabis has a long history of use as a sleeping aid, with the first studies into its sedative effects being published way back in the mid-nineteenth century[i]. Around that same time, the famous French novelist Alexandre Dumas published his masterpiece, The Count of Monte Cristo, in which hashish is used on numerous occasions in order to send certain characters into a deep and restful sleep.

In more recent times, scientists have delved into the chemical workings of marijuana in order to learn about the soporific effects of different cannabinoids. As a result, we can now take a more nuanced approach to using cannabis as a sleeping aid, selecting the appropriate strains in order to tackle specific sleep-related issues. This has led to marijuana becoming many people’s go-to remedy when they’re having trouble catching some shut-eye, with a recent study revealing that 65 percent of patients at a dispensary in New England were able to reduce their use of sleeping pills once they started using cannabis[ii].

Cannabinoids and Sleep

The body’s own cannabinoid system – known as the endocannabinoid system – is thought to play a role in the neurobiology of sleep, as several of its components have been found to influence circadian rhythmicity, which is what scientists call the body clock. In other words, cannabinoids help to define our daily sleep-wake cycle, and there is some evidence that cannabis can be used therapeutically in individuals with disrupted circadian function, such as those with sleeping problems.

It has also been reported that the role of endocannabinoids in sleep typically involves the CB1 receptor, which is the same receptor that tetrahydrocannabinol (THC) binds to. It should therefore come as little surprise that high-THC cannabis strains are typically the best at inducing sleep.

THC and Sleep

The sedative potency of THC is something that will be familiar to all cannabis users, and numerous scientific studies have highlighted the benefits associated with this cannabinoid when dealing with sleep disorders. Use of the compound has been found to reduce the amount of time it takes people to fall asleep and to decrease their likelihood of waking up once they have dozed off, making it an excellent medicine for anyone suffering from insomnia[iii].

Tetrahydrocannabinol has also been found to increase sleep quality in people suffering from post-traumatic stress disorder (PTSD), partially due to its ability to prevent nightmares[iv]. This is likely down to the fact that THC inhibits rapid eye movement (REM) sleep, which is the phase of sleep when dreams tend to occur. However, it’s worth noting that REM is associated with memory consolidation and other important functions, so it’s only a good idea to take high doses of THC before bed if you’re really struggling to sleep.

On top of all that, THC has also been shown to help treat a condition called obstructive sleep apnea, which occurs when the throat muscles relax too much during sleep, resulting in an inability to breathe properly. It is thought that THC corrects this by stimulating the release of serotonin, which then excites motoneurons in the airways, causing the relevant muscles to remain taut[v].

CBD and Sleep

Until recently, cannabidiol (CBD) was largely overlooked as a sleeping aid, with THC receiving most of the attention. However, recent discoveries have revealed that CBD can also be used to help people regulate their sleep patterns.

For instance, low doses of CBD have been found to have a stimulating effect, and can therefore be of great use to those who suffer from excessive daytime sleepiness. One study revealed that a daily dose of 15 milligrams of CBD helps to keep people awake, with scientists speculating that it achieves this by stimulating the release of dopamine in the brain[vi].

Higher doses of CBD, however, have the opposite effect, and can be used to put people to sleep. In one study involving insomniacs, a daily dose of 160 milligrams of CBD resulted in prolonged sleep at night[vii].

Meanwhile, separate research has found that CBD helps to correct a condition called REM sleep behaviour disorder, which occurs when people act out behaviours linked to their dreams while they are asleep. After being treated with CBD, the study participants reduced their nocturnal activities, remaining safely in their beds until morning[viii].

[i] Clendinning J. Observations on the medicinal properties of the Cannabis Sativa of India. Medico-chirurgical transactions. 1843;26:188. – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2116906/

[ii] Piper BJ, DeKeuster RM, Beals ML, Cobb CM, Burchman CA, Perkinson L, Lynn ST, Nichols SD, Abess AT. Substitution of medical cannabis for pharmaceutical agents for pain, anxiety, and sleep. Journal of Psychopharmacology. 2017 May;31(5):569-75. https://journals.sagepub.com/doi/abs/10.1177/0269881117699616

[iii] Cannabinoids, Endocannabinoids and Sleep – https://www.frontiersin.org/articles/10.3389/fnmol.2020.00125/full

[iv] Jetly R, Heber A, Fraser G, Boisvert D. The efficacy of nabilone, a synthetic cannabinoid, in the treatment of PTSD-associated nightmares: a preliminary randomized, double-blind, placebo-controlled cross-over design study. Psychoneuroendocrinology. 2015 Jan 1;51:585-8. – https://www.sciencedirect.com/science/article/abs/pii/S0306453014004132

[v] Babson KA, Sottile J, Morabito D. Cannabis, cannabinoids, and sleep: a review of the literature. Current psychiatry reports. 2017 Apr 1;19(4):23. – https://link.springer.com/article/10.1007/s11920-017-0775-9

[vi] Murillo-Rodríguez E, Sarro-Ramírez A, Sánchez D, Mijangos-Moreno S, Tejeda-Padrón A, Poot-Aké A, Guzmán K, Pacheco-Pantoja E, Arias-Carrión O. Potential effects of cannabidiol as a wake-promoting agent. Current Neuropharmacology. 2014 May 1;12(3):269-72. – https://pubmed.ncbi.nlm.nih.gov/24851090/

[vii] CARLINI EA, CUNHA JM. Hypnotic and antiepileptic effects of cannabidiol. The Journal of Clinical Pharmacology. 1981 Aug 9;21(S1):417S-27S. – https://accp1.onlinelibrary.wiley.com/doi/abs/10.1002/j.1552-4604.1981.tb02622.x

[viii] Chagas MH, Eckeli AL, Zuardi AW, Pena‐Pereira MA, Sobreira‐Neto MA, Sobreira ET, Camilo MR, Bergamaschi MM, Schenck CH, Hallak JE, Tumas V. Cannabidiol can improve complex sleep‐related behaviours associated with rapid eye movement sleep behaviour disorder in Parkinson’s disease patients: a case series. Journal of clinical pharmacy and therapeutics. 2014 Oct;39(5):564-6. – https://static1.squarespace.com/static/5bd4b8d9e666694b6fcead6c/t/5bde72fe03ce642d249e55b3/1541305087141/Cannabidiol+can+improve+complex+sleep-related+behaviours+associated+with+rapid+eye+movement+sleep+behaviour+disorder+in+Parkinson%E2%80%99s+disease+patients+A+case+series.pdf

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Ben Taub