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The Centers for Disease Control and Prevention say that a third of US adults reported not getting the recommended amount of sleep. And things are no different in other parts of the world — especially during the pandemic when many of us have lost sleep, as found by a recently published international study.
With so many people not sleeping as well as they should, there has been growing interest in natural sleep remedies like THC and CBD. Their popularity has grown sharply over the past decade with the legalization of marijuana for medical and recreational use.
If you too are considering cannabis derivatives for sounder sleep, you also want to know which one of the two most popular cannabis products is best: THC vs. CBD.
Cannabis is a psychoactive plant with more than 500 compounds, of which over 100 are cannabinoids. However, only two cannabinoids have been studied carefully:tetrahydrocannabinol (THC)andcannabidiol (CBD).
These two can be extracted from the cannabis plant or produced in the laboratory to make synthetic cannabinoids. Or, people can get them directly from cannabis by smoking it, through cannabis oil, tinctures, or edibles.
Cannabinoids are responsible for the psychoactive and therapeutic effects of cannabis. The way they work is by binding to cannabinoid receptors found on the surface of cells. Two main cannabinoid receptors are CB1 and CB2. CB1 is mostly expressed in the brain, while CB2 is mostly expressed in body cells.
These days, physicians can prescribe cannabis and its derivatives to their patients; however, neither has undergone enough testing to determine their safety and efficiency. As a result, not many cannabis products have been FDA-approved. But the FDA and medical professionals do recognize cannabis potentials, including in the treatment of sleep disorders.
Preliminary research shows cannabis can reduce nausea and vomiting due to chemotherapy, improve appetite in HIV/AIDS, help with chronic pain, help with muscle stiffness in multiple sclerosis, alleviate mood and anxiety disorders, and for better sleep.
Cannabis can have a relaxing effect, which many people know. But that’s not the only reason it can help you sleep better.
Research on how cannabis affects sleep started in the 1970s. Some of these studies found cannabis helped people fall asleep faster, while others found it increased time spend in slow-wave sleep (deep sleep) and reduced time spent in REM sleep (dreaming). But research from this area also raised concerns that using cannabis this way can lead to dependence and because it was known that cannabis withdrawal causes sleep problems. And yes, cannabis can become addictive, despite misconceptions.
Later studies have confirmed findings from the 70s, i.e. that cannabis can make you fall asleep and make your sleep deeper and more restful.
But how does it do that?
Through the endocannabinoid system (ECS), which is involved in the sleep-wake cycle. The ECS is your body’s system composed of endocannabinoids, neurotransmitters that bind to cannabinoid receptors. Studies have found that a lack of sleep leads to a dysregulated ECS, while the elevation of the ECS at the receptor level improves sleep.
Studies done since the turn of the century found that different cannabinoids have different effects on sleep. Turns out THC and CBD have completely different effects and their effects also depend on their dose and ratio.
THC and sleep
This cannabinoid is the psychoactive compound in cannabis, producing the “high” people are after with recreational use. Research from the 70s found this compound is good at making you feel sleepy and helping you stay asleep. But it can result in tolerance after chronic use, so you’ll need more of it to get the same sleep-inducing effect later on.
CBD and sleep
The non-psychoactive cannabinoid, CBD has a stimulating effect. In other words, it is likely to make you more alert. But interestingly, higher doses of CBD were found to have a sedating effect. One study found that taking CBD at a dose of 160 mg/day improved sleep, while smaller doses increased wakefulness.
But there are also conflicting findings that can make it hard to figure out whether THC or CBD is better for sleep. Some researchers believe CBD may be better for sleep problems resulting from anxiety, PTSD, and similar disorders as CBD seems to have a particularly calming effect. And while CBD does not suppress REM sleep the way THC does, it doesn’t mean THC is better. REM sleep is important for normal immune and cognitive functioning, and a healthy sleep architecture will have four to five REM periods.
All in all, what you can take from this is that both cannabis derivatives can help you fall asleep and stay asleep. But don’t use them for too long as you could develop tolerance after a while and even disrupt your sleep architecture.
Insomnia isn’t the only reason for poor sleep. Some people suffer poor sleep due to restless leg syndrome, narcolepsy, sleep apnea, and simple snoring. Cannabis may help some of these folks as well.
A study published last year in Sleep and Breathingfound that cannabis is effective for restless leg syndrome (RLS). RLS is a dopamine-dependent disorder that responds well to drugs that imitate the actions of dopamine. Cannabis may help RLS by regulating the release of dopamine and other neurotransmitters.
But for other sleep disorders, like sleep apnea, there’s not as much evidence. The American Academy of Sleep Medicine even declared in their position statement that medical marijuana or synthetic cannabinoids shouldn’t be used for sleep apnea because there’s no evidence of efficiency, tolerability, or safety. And the same likely holds true for simple snoring.
Positive airway pressure (PAP) remains the most effective treatment for sleep apnea. And if you suffer from simple snoring, you may be able to improve your sleep through snore solutions like weight loss, decongestants, side sleeping, nasal strips, or snoring mouthpieces like ourGood Morning Snore Solution tongue-stabilizing devices.
References:
Sleep and Sleep Disorder. Centers for Disease Control and Prevention website. April 15, 2020.
https://www.cdc.gov/sleep/index.html
Mandelkorn U, Genzer S, Choshen-Hillel S, et al. Escalation of sleep disturbances amid the COVID-19 pandemic: a cross-sectional international study.J Clin Sleep Med. 2021;17(1):45-53.doi:10.5664/jcsm.8800
Lafaye G, Karila L, Blecha L, Benyamina A. Cannabis, cannabinoids, and health.Dialogues Clin Neurosci. 2017;19(3):309-316.doi:10.31887/DCNS.2017.19.3/glafaye
Whiting PF, Wolff RF, Deshpande S, et al. Cannabinoids for Medical Use: A Systematic Review and Meta-analysis.JAMA. 2016 Apr 12;315(14):1522.doi:10.1001/jama.2015.6358
Babson KA, Sottile J, Morabito D. Cannabis, Cannabinoids, and Sleep: a Review of the Literature.Curr Psychiatry Rep. 2017;19(4):23.doi:10.1007/s11920-017-0775-9
Ghorayeb I. More evidence of cannabis efficacy in restless legs syndrome. Sleep Breath. 2020;24(1):277-279.doi:10.1007/s11325-019-01978-1
Ramar K, Rosen IM, Kirsch DB, et al. Medical Cannabis and the Treatment of Obstructive Sleep Apnea: An American Academy of Sleep Medicine Position Statement.J Clin Sleep Med. 2018;14(4):679-681. Published 2018 Apr 15.doi:10.5664/jcsm.7070
