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cbd and sleep

CBD: Can It Help With Sleep?

A plethora of new research and CBD products have come on the market in a very short time since the Hemp Farming Act of 2018 removed hemp from Schedule I controlled substances.

The Hemp Farming Act of 2018 removed hemp, which is defined as cannabis with less than 0.3% tetrahydrocannabinol (THC), from Schedule I controlled substances and made it an ordinary agricultural commodity. 1 Since then, a plethora of new research and CBD products have come on the market in a very short period of time.

For this reason, pharmacists will come across more patients who use CBD and CBD-related products, yet many pharmacists may remain uncertain of how to manage their patients’ medication regimen along with CBD. The research and data on CBD are new and more is coming out over time, making this a dynamic medicinal agent on which to stay informed.

The Evidence Behind CBD’s Use for Sleep

The endocannabinoid system (ECS) is an extensive, endogenous signaling system with many elements that are still being discovered as research progresses. In consideration of the fact that the ECS is modulated by diet, sleep, exercise, and stress, researchers believe that the modulation of ECS may hold therapeutic promise for a diverse scope of diseases, one of which is insomnia. 2

Specifically, a study published in Current Psychiatry Reports demonstrated that CBD may hold promise for rapid-eye movement (REM) sleep behavior disorder, but there are mixed results and the research is still in its infancy. 3

In a more robust literature review of studies exploring sleep and CBD published in Experimental and Clinical Psychopharmacology, the authors found that in the studies they assessed, sleep was often a secondary outcome, the study sample sizes were small, and many of the studies were short-term in nature. The authors of the review concluded that drawing any conclusions from these studies would be difficult. 4

A retrospective case study published in the Permanente Journal revealed that out of 72 adults who took CBD on a regular basis in a psychiatric clinic, 48 (66.7%) of them had improved sleep scores and 57 (79.2%) had reduced anxiety scores, both after the first month. The results fluctuated over time and the benefits diminished once supplementation was stopped. 5

This supports a larger study, published in Medicines, which followed 409 patients taking cannabis (not CBD) and found a 4.5-point reduction on a 0 to 10 visual analog scale of their sleep symptoms. 6

Overall, the data behind the use of CBD and sleep are new and in the beginning stages of development. Small studies over a short period of time do not provide conclusive evidence for the recommendation of CBD for sleep, though larger studies do seem to indicate there may be benefit for patients with insomnia.

However, more research is needed regarding the specific ways that CBD can affect sleep, the implications of long-term use, and interactions it may have with other medications. Finally, with CBD being a health and dietary supplement, several brands have entered the market, and so the gold standard product or brand has not yet been identified.

At the moment, pharmacists should recommend to their patients to choose a brand of CBD that is reputable. A search on the Better Business Bureau and the FDA’s CFSAN Adverse Event Reporting System can provide information on the product’s reliability.

Additionally, patients should be urged to take only one kind of product, to start taking it on its own so that adverse events (AEs) can be more easily identified, and to stop taking it and seek medical attention if AEs do develop, such as excessive somnolence, diarrhea, fatigue, and vomiting.

More patients may start taking or seeking CBD in their desire to achieve their optimal health. Pharmacists are the ideal health care practitioners to educate patients on these products and provide up-to-date information as it becomes available.

A plethora of new research and CBD products have come on the market in a very short time since the Hemp Farming Act of 2018 removed hemp from Schedule I controlled substances.

Can CBD Help You Sleep?

A sleep psychologist says you should reconsider stocking up on CBD products for catching some zzz’s.

CBD main image

Cannabidiol (CBD) oil seems to be all over the place, used as treatment for anxiety, chronic pain, acne and even infused in some foods and drinks. It’s readily available in various doses and forms over-the-counter. It’s natural to wonder what this mystical compound of marijuana is and what it does in the body.

You might be thinking, “Wait, marijuana? Doesn’t that make you high?” But let’s set the record straight: unlike CBD’s counterpart delta-9-tetrahydrocannabinol (THC), CBD is a non-psychoactive compound, meaning it doesn’t alter your cognitive state.

Similar to THC though, CBD can help you relax and people are wondering if it will help them finally get some good shut eye.

“It’s a tricky question to answer,” says Deirdre Conroy, Ph.D. , clinical director of the Behavioral Sleep Medicine Clinic at Michigan Medicine. “There have been few studies on CBD and its effect on sleep, and those published have few participants with differing doses and forms of CBD administered.”

However, many of these studies suggest there could be some benefit to using CBD as a sleep aid, and it’s worth researching. “For example, there’s evidence that CBD can be helpful in managing anxiety . If someone’s anxiety is creating their sleeping problem, a CBD product may benefit them,” Conroy says.

But reaping the rewards of CBD is a slippery slope since much of its long term safety or efficacy is still unknown. One study showed taking less than 160 mg of CBD oil may actually promote wakefulness . While higher doses can promote sleep, the FDA has approved only one CBD product, a prescription drug to treat two rare, severe forms of epilepsy. Because other CBD products aren’t regulated, you might not know what you’re really getting.

“This compound is used in various forms and their doses may differ, so you might not know how much CBD you’re actually using,” Conroy says. Regular usage of high dose CBD could harm you before you become aware of it, according to the FDA. It can cause liver injury and affect how other drugs are metabolized, causing serious side effects. Similarly, when used with alcohol or other central nervous system depressants, the increased risk of sedation and drowsiness can lead to injuries.

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“Non-pharmacological interventions have long-term, long-standing data that proves their safety and efficacy,” Conroy says. “I know CBD oil for the treatment of sleep disorders is intriguing, but we’re looking for answers we just don’t have yet. The products are outpacing the science.”

Setting yourself up for sleep

Melatonin for sleep , like CBD, needs more research to unmask its benefits and harms. “We secrete melatonin naturally as our bodies prepare for bed,” Conroy says. “I believe in harnessing what you already have.”

Until we have more answers about CBD, there’s a plethora of behavioral strategies that promote better sleep, including:

Allowing yourself time to wind down before bed in a dark setting without bright screens. If you need to look at a screen, make sure you use a brightness filter.

Having outlets for managing stress and anxiety, like journaling or seeking professional help with a therapist if it’s more serious.

Training your body to follow a regular sleep and wake cycle if you don’t already have a routine.

If you’re having trouble sleeping on a regular basis, you may have an underlying sleep disorder that a sleep specialist could help diagnose and manage.

If sleep problems persist, Conroy recommends seeking help from a sleep medicine specialist. “We might recommend undergoing a sleep study or offer other therapies to improve your quality of life,” Conroy says. “This also opens dialogue between you and a medical professional about what kind of treatment option you’re looking for, what your sleep goals are and what your expectations from a sleep aid are.”

A sleep psychologist says you should reconsider stocking up on CBD products for catching some zzz’s.