CBD for Insomnia: Does CBD work as an effective sleep aid?

CBD for Insomnia: Does CBD work as an effective sleep aid?

Table of contents

Overview of Insomnia

A Promising Alternative for the Treatment of Insomnia

Studies about CBD and anxiety

Choosing the right dose of CBD

How to use

Notice when using CBD for Insomnia

Feedback from a report in Ottawa, Canada

 

Overview of Insomnia

As the American psychiatric association defined, insomnia is dissatisfaction with sleep quality or quantity, including trouble falling asleep, trouble staying asleep, or waking up early in the morning without being able to return to sleep. It’s a common health condition which affects your health, quality of life and work performance. Because of insufficient sleep time, you still feel tired when waking up, and your energy is low throughout the day. The average time an adult spends sleeping is about 7 to 8 hours.

In some cases, adults experience short-term sleep deprivation due to stressful or trauma events, which may last for days or weeks. However some people suffer from chronic insomnia that lasts more than a month.

Insomnia may be a primary disorder or caused by underlying causes, such as mental health conditions, medications, and substance abuse.

Causes

To date, there is currently no accepted theory to describe the exact mechanism of insomnia, however scientists know that it may be associated with mental health disorders, medical conditions and a wide range of risk factors.

Some common causes of insomnia will be listed in this section.

Insomnia often occurs with other mental health disorders. For example, anxiety may disrupt your sleep, and awakening too early is a sign of depression.

Insomnia is also a symptom of other medical conditions, such as uncontrolled blood glucose levels in diabetes, cardiovascular disease, overactive thyroid, sleep-related disorders, etc.

Consumption of stimulants, namely caffeine, alcohol, nicotine, can impair your sleep, which keeps you awake.

Many prescription drugs can interfere with sleep cycle, resulting in  sleeplessness and they include all antipsychotics, antidepressants, beta blockers, medications for asthma, etc.

Poor sleep habits is also a common reason leading to insomnia, and there are numerous factors that can be listed, including irregular work schedule, stressful environment, eating before bedtime, using electronic devices, or even taking exercise in the evening.

Treatment

No matter what your age, insomnia is usually treatable. First line therapy is lifestyle changing and practices sleep hygiene. These tips may help.

The basic tips:

Have regular sleep-wake cycle

Exercise regularly

Restrict sleep time and avoid sleeping in daytime

Avoid eating large meals before bedtime and avoid/limit stimulants if needed

Keep bedroom soundproof and sleep, only use it to sleep/intimacy

Have quiet period before bed

Screen for drugs/disorders causing insomnia. If present, treat the primary underlying cause along with practicing these tips.

In case of persistent symptoms in spite of practicing sleep hygiene, cognitive behavioral therapy may be an option, which is equally effective as medication therapy. This method teaches you to recognize and change your beliefs that affect your sleep, such as negative thoughts, worries that keep you awake. Your doctors may recommend cognitive behavioral therapy with lifestyle modifications to treat sleeplessness which is shown to be far more effective than each measure.

Lastly, if these methods are ineffective or patients require urgent relief, sleep medications can be prescribed. However, they don’t recommend relying on the drugs for more than a week because of many risks of side effects, dependence, rebound effect, tolerance, misuse, and so on.

In some cases, when people suffer from short-term jet lag, a non-prescription drug named melatonin can be recommended.

A Promising Alternative for the Treatment of Insomnia

There are a wide range of  medications for insomnia with varying success rates, however, all of them (e.g., benzodiazepine) are also related to dangerous side effects in long-term use, such as dependence, residual effects (e.g., drowsiness, difficulty concentrating, and memory impairment), rebound phenomenon when discontinued suddenly that can lead to secondary problems (e.g., fatigue, low, poor work performance). Although over the counter drugs (e.g., Anthistamine, melatonin) are generally less dangerous than prescription pharmaceuticals, but also less effective or their evidence is controversial. Especially, chronic use of Benzodiazepine was shown to increase the risk of dementia, which is a type of cognitive impairment These circumstances make experts find alternative sleep aids that balance between efficacy and safety.

Recently, researchers discovered that cannabis consumption can improve sleep outcomes through interaction with the endocannabinoid system which plays an important role in the sleep/wake cycle. Among cannabis compounds, Cannabidiol (CBD) is a potential agent to treat insomnia because it may act as an anxiolytic, and interact with some receptors of the ECS. In the next section, we will provide a series of studies using CBD for treatment of sleep disturbances. Given the effectiveness, the researches also focus on tolerability and safety concerns.

Studies about CBD and anxiety

Medical cannabis flower for treating insomnia: A naturalistic research

The scientists from the University of New Mexico use mobile application to measure which characteristics of natural cannabis flower are associated with changes in perceived insomnia under real-world conditions. In this study, 409 participants completed 1056 medical cannabis sessions and used the software to record symptom relief (self-assessment in insomnia symptoms severity from 0 to 10 with most severity intensity) and side effects. Product characteristics include combustion methods, cannabis subtypes (Sativa, Indica, or Hybrid), and major cannabis content (%THC or % CBD consumed). Starting symptoms of insomnia levels average 6.6, while ending symptoms is 2.2, which was increased by -4.5 points after consuming medical cannabis flower. In addition, the authors observed greater symptom relief with medical cannabis having high percentage of CBD, and the cannabinoid content wasn’t associated with side effects.

CBD in anxiety and sleeplessness: A large case series

The case series were published in the Permanente Journal in 2019 to determine whether CBD helps improve sleep and/or anxiety in a clinical population. The data was collected in a large mental health clinic in Fort Collins, reviewing changes in symptoms when using CBD as an adjunct to treat anxiety and sleep disorders. There are 72 adults taking part in this trial with concerns of anxiety or poor sleep. Nearly all patients took CBD doses ranging from 25 to 175 mg/kg in capsule form. After 1-month follow up, about 67% of all patients experienced an improvement in sleep, while up to 80% reported an improvement in anxiety symptoms. There is no evidence to suggest that patients discontinued care because of tolerability concerns. In conclusion, CBD displays promise as a tool to reduce both anxiety and sleep disorders in the clinical population with no evidence of safety issues.

Effectiveness of CBD oil for Insomnia as symptom of post traumatic stress disorder: A case report

A ten year old girl who was sexually abused and treated to post traumatic stress disorder by pharmaceutical medications. However, the symptoms were partially relieved, but not stable, and there were major side effects. After 3-year treatment, her underlying anxiety continued. At this time, CBD oil was recommended as a potential  additional treatment to help her insomnia and anxiety. A trial CBD dose was 25 mg/kg, used at bedtime, and 6-12 mg of CBD was sprayed under the tongue as needed for anxiety. 5 months later, the patient was sleeping in her own room most nights and learning in the new school with no difficulties and inappropriate behaviors. In this report, the dose given 12 to 25mg  once daily appears to provide significant relief of key symptoms with minimal adverse events.

Choosing the right dose of CBD

There is no one size fits all dosage for CBD. What’s optimal mainly depends on a range of factors, such as body weight, tolerance, symptoms, metabolism, and so on. These factors can yield unique effects for each CBD consumer. Keep in mind that you should pay close attention to how you feel after each dose. It might not occur immediately, and you should be patient to remember that you’re unlikely to get immediate results. As soon as you experience positive effects, lock in that dose and stick with it.

Start at a dose of 20 milligrams per day (using twice a day, including one before bedtime about 2-3 hours) and increase the dose gradually to achieve desirable effects. Do not increase or decrease your dose more often or longer than recommended. Your condition may not improve faster, your risks of side effects will increase.

The recommended dosage forms are CBD capsule and CBD oil. As compared to capsule, CBD oil is extremely versatile because it can be taken under the tongue, vaporized, infused in food, or cosmetics.

How to use

Taking capsules is the simplest and most convenient way to use CBD. You only need to swallow the capsule with at least 300 ml of water. The drawbacks of the oral route are low availability and delayed onset of effects.

There are some ways to take CBD oil, and we will provide two most common and effective methods to use CBD in this section.

Firstly, applying CBD sublingually is incredibly easy. CBD oil needs to be put under the tongue and held from 60 to 120 seconds without swallowing to allow adequate time for CBD to diffuse completely across the epithelial cells. The method remains the same when you use CBD oils or tinctures. You must hold the CBD under the tongue since different areas of the mouth might not be permeable enough for diffusion into the bloodstream. Taking CBD sublingually provides fast onset of action and high bioavailability.

Vaping CBD seems to be slightly more difficult than taking CBD sublingually. The first step to vaping properly is to determine how much CBD you consume each time. If you feel unconfident at first,  you should start with the easiest option. Disposable cartridges and pods are the simplest tools for new users. Refillable vape pens are a little bit more advanced but more cost-effective in the long term. It is important to read the instructions carefully before using them.

Notice when using CBD for Insomnia

Basic notifications

Overall, it is vital that your doctor check your improvements, disease progression, side effects, and interaction with food or drugs at regular visits to make sure CBD is working properly.

Notice any side effects and tell your doctor right away.

Only buy CBD products from reliable sources with business registration, certificate of analysis, third-party tests, etc…

Don’t take other medicine (including ETC, OTC medicines, herbal, or vitamin supplements) unless they have been discussed with your doctor.

If you use CBD by taking it under the tongue or vaping, there are a few things that you should take into account. We will provide details in the following section.

Applying CBD sublingually

Shake well before use

Determine the number of drops in accordance with the dose of CBD consuming each time

Start at a low dose as we recommend above and increase the dose to have the therapeutic effects.

Hold the CBD under the tongue for at least 60 seconds

Accidentally swallowing the CBD oil won’t pose any risks  to your body. However, once you swallow this substance, you no longer take it sublingually. Instead, you are eating it, which means that it has to pass the digestive system and metabolism before your body can utilize it. Although it’s not dangerous, it does mean decreased bioavailability and slower onset of action.

Taking CBD sublingual bypasses the digestive system, there’s no need to  worry about taking it with or without food.

After the necessary time is up, drinking water or eating food won’t interfere with the working of the CBD. At best, you might wait a few minutes prior to drinking water.

Putting a few drops of CBD under the tongue won’t turn your teeth yellow as well as make your breath smell.

Vaping CBD

Determine your suitable CBD dosage, the number of puffs each time, and types of CBD vape

Read carefully the user manual, especially if you are a new user

Wait 5 – 10 minutes between puffs and observe how CBD affects you

Always start at low dose, and work your way up to the optimal dose

After inhaling, you should check the battery life or clean the vape tank if needed

Drug interaction

People considering or taking CBD products should always mention their use to their doctor, especially if you are taking other medications or have underlying ailments, such as kidney disease, liver disease, heart failure, or immunocompromised condition. Pharmacists are also a reliable source to help you learn about potential drug interaction with supplements, over-the-counter drugs or prescribed drugs.

Feedback from a report in Ottawa, Canada

Patients with insomnia and other sleep disorders report positive improvements after using cannabis, and a significant number of them report being able to reduce or stop using prescription drugs, according to data published in the Canadian Journal of Pharmacists.

Canadian investigators evaluated the effects of cannabis on sleep disturbances 38 patients authorized to use medical cannabis products. Patients were assessed at baseline and then three months after initiating cannabis use.

The investigators reported that 71% of patients using medical cannabis improved their sleep subjectively. 39% of the study's subjects were able to completely stop sleeping pills or not take them in the evening.

The study's results align with other observational studies, which have found that patients with sleep disturbances often improve their symptoms from cannabis.

The authors conclude, “Clinical trials of cannabinoids in patients with insomnia are an integral part of ensuring evidence-based decisions about the role of cannabinoid therapies in the treatment of disorders of sleep disturbance.”

Conclusion

In conclusion, insomnia is a common sleep disorder worldwide, affecting work performance, wellness, and reducing quality of life. It is curable with a variety of treatments, such as lifestyle changing, cognitive behavioral therapy, and drugs. Among these options, non-pharmacological therapies are the first line, however, if they are ineffective or patients require urgent relief, hypnotics are recommended by doctors. The main drawback of hypnotics is side effects.

Some studies suggested that CBD may be a promising agent to treat insomnia because of anxiolytic properties and interaction with the Endocannabinoid system. Besides efficacy,  taking CBD is generally safe and tolerable.

Keep in mind that you should consult with your doctor, in terms of dose, how to use, side effects, etc, before using CBD to treat insomnia to ensure this compound works effectively.

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