If you are thinking about using medical marijuana for sleep disorders, you are not alone.
But can weed help insomnia?
Yes, in certain cases it may help improve quality of life for people who are having trouble getting a good night’s sleep.
Emerging research about the sleep-promoting properties of cannabis has made better sleep one of its chief medical uses.
40% of Canadians have a sleep disorder, and many are interested in the question of whether marijuana can help ease their symptoms of insomnia.
Research and anecdotal evidence support using marijuana for sleep, but there is a caveat.
Overmedicating with tetrahydrocannabinol (THC), a dominant cannabinoid in pot, can also cause sleep disturbances.
If you are new to medical marijuana, getting advice from a qualified health practitioner who can guide you in your cannabis treatment plan is really the best approach.
Some strategies and resources to help with your sleep can include your environment, external stimulus and diet. Anxiety Canada has some great resources to help with your overall sleep hygiene including a sleep diary.
As far as medical sleep aids go, cannabis has an excellent safety profile for short term use and is associated with less side effects than other pharmaceutical drugs.
As diagnoses of sleep disorders (including sleep apnea and insomnia) continue to increase, more individuals are turning to this powerful sleep aid.
Medical Marijuana for Sleep Disorders
First, what is insomnia?
Simply put, insomnia is a sleep disorder in which you cannot fall sleep, cannot stay asleep, and/or feel wide awake throughout the night. Insomnia can be caused by:
- Medications such as steroids, asthma inhalers, or allergy medicine
- Medical conditions such as GERD
- Chronic pain such as arthritis
- Poor sleep hygiene: Using blue light screens before bed, taking naps late in the day, sleeping in rooms that are not conducive to sleep
- Psychiatric conditions such as anxiety or depression
- Pregnancy: Many women experience insomnia during pregnancy
High-THC strains of cannabis have a reputation for creating muscle relaxing effects as well as a stony form of sedation.
Anecdotally, many have reported success using marijuana to drift to sleep. But beyond the patient reports, what does the available research say?
Marijuana & Sleep Apnea-Induced Insomnia
If you have insomnia due to sleep apnea, you may wonder if medical marijuana can help your condition.
Many individuals with sleep apnea tend to have insomnia. With sleep apnea, the airway is blocked, usually by the person’s own soft tissues.
These obstructions cause the individual to snore intensely in addition to constantly waking up throughout the night, gasping for air.
What does sleep apnea have to with insomnia? These individuals often have a hard time falling back to sleep after suddenly waking.
A 2017 placebo-controlled study suggested that THC may help those with sleep apnea.
73 participants with moderate or severe sleep apnea were given either a placebo or one of two dosage levels of synthetic THC. The placebos and THC dosages were administered 1 hour before bed for as long as 6 weeks.
The study found that cannabinoid therapy improved the self-reported measures of sleep in participants when compared to the placebo group (Carley et al. 2018).
THC & Healthy Sleep
How does THC affect sleep?
As noted above, THC may have a short-term benefit for sleep apnea.
However, there is some research to suggest that chronic THC use could hamper sleep quality long term (Gorelick et al. 2013).
Before medicating your sleep disorder with the cannabinoid THC, which is found in varying degrees in most cannabis strains, speak with a licensed health care practitioner who is authorized to prescribe cannabis in your province.
Nightmares for people who have suffered traumatic events are also a common hindrance for sleep. THC has been studied as a possible treatment path for sleep deprivation and nightmares arising from PTSD.
A 2017 systematic review of available literature on THC and PTSD identified one study that used medical marijuana as the intervention and reported improved sleep and cessation of nightmares in the results.
However, the authors of the review concluded that the evidence for this mechanism of THC is insufficient (Canadian Agency for Drugs and Technologies in Health 2017)
What does this mean for you if you are exploring THC as a possible treatment path for PTSD?
It means you should absolutely not go it alone.
The mechanism of cannabis for PTSD is not fully understood, and so a very measured approach to dosage by an expert licensed to prescribe cannabis-based medicine is highly recommended.
Marijuana Strains for Insomnia
Individuals who are planning on using marijuana for insomnia or other sleep disorders frequently choose high-THC indica strains.
These strains are known for their sedative and muscle-relaxant effects. But there are other strain considerations to keep in mind.
For one, chemical compounds called terpenes may be key to modulating the sedating and sleep promoting effects of a particular strain. That means you should pay close attention to the unique array of terpenes in each strain.
There is animal research to suggest that the terpenes Limonene and Myrcene can help support treatment plans for sleep deprivation (Do Vale et al. 2002).
And the other dominant cannabinoid, cannabidiol (CBD), isn’t to be left out of the better sleep equation. CBD can also play a role in treating insomnia.
Cannabidiol & Sleep Disorders
Patients use CBD for insomnia as well as THC.
As general rule, CBD is known to be wake-promoting. However, it has been observed to help sleeping disturbances as well.
How so? CBD has been observed to target one of the conditions that frequently contributes to insomnia—anxiety.
By working to lessen the symptoms of anxiety, CBD may help to aid sleep.
Post-traumatic stress disorder (PTSD) patients often struggle with sleep. Some patients struggle to fall sleep, and some struggle to stay asleep due to intense nightmares.
A double-blind placebo-controlled study published in the Journal of Psychiatric Research found that CBD effectively reduced fear in PTSD patients. When fear and anxiety are reduced, anxiety/fear-induced insomnia may also be alleviated (Campos et al. 2012).
And there is more research behind using CBD oil for sleep. Another study, this one published in the Permamente Journal, found that CBD was specifically useful in helping a pediatric patient who suffered from both insomnia and anxiety due to a traumatic event.
The researchers concluded that Cannabidiol oil was a “safe treatment for reducing anxiety and improving sleep in a young girl with posttraumatic stress disorder” (Shannon and Opila-Lehman 2016).
One literature review suggested that the available research shows that CBD may help promote REM sleep (Babson et al. 2017)
The REM cycle comes immediately after Stage 4 sleep and accounts for about 20% of your total sleep time. REM cycles occur about an hour and half after falling asleep, and this is the cycle where dreaming is possible.
During REM cycles, the body is a deep relaxation known as REM atonia. This sort of paralysis accounts for the fact that people do not “act” out their dreams — the body is too relaxed too move.
Improved REM can help alleviate wakefulness at night and excessive sleepiness during the day.
You should seek the advice of a licensed health care practitioner before using CBD for sleep as high-CBD strains can be quite stimulating and lead to worsened sleep problems.
Sleeping While High
To understand more about sleeping while high, first let’s take a look at the mechanism of action of marijuana.
The mechanism of action refers to the process of how a drug works, or how it produces its effects.
In general, medications work by binding to certain receptor sites in the body. In the case of marijuana the biggest receptor sites for THC are CB1 and CB2. The CB1 receptor in particular has been linked with the regulation of sleep (Murillo-Rodríguez et al. 2008)
If you are smoking weed before bed, some psychoactivity with the right strain will create the sedative effects needed to drift off to sleep. However, getting overly high could backfire.
Below are some tips most doctors offer patients who are trying to treat insomnia with cannabis.
How to Take Marijuana to Help with Sleep
What strain to take:
High-CBD strains should be avoided because it may cause a patient to feel stimulated, energized, wakeful, or excited. Experts recommend strains with 20% or less of THC.
Apart from some exceptions, most people who use a strain with more than 20% THC run the risk of feeling overly tired or groggy the following morning.
When to take the marijuana:
It is recommended to smoke or vaporize cannabis an hour before bed to let the sedative THC metabolites accumulate. Patients can also use THC drops under your tongue.
How much to take:
It is important to be thoughtful when dosing so as to keep psychoactive effects at a minimum.
Getting into a state of intense psychoactivity will make that falling asleep even harder and this can mess with a person’s sleep cycle even more.
Doctor’s recommend aiming for a low to moderate dosage in most cases. Speak to a health care practitioner to identify the right dosage of cannabinoids is right for your unique needs.
It’s always easier to add a dose throughout the night if you need to. However, do not take another dose if you are planning on waking up within four hours or less.
How long should you take it:
This is a conversation to have with your health care practitioner.
The long-term, chronic use of THC may create tolerance to marijuana’s somnolent effects (Gorelick et al. 2013). A health care practitioner will be able to set you up on a sustainable dosage schedule to avoid tolerance issues.
In addition to using marijuana to help with your insomnia, you can improve your sleep health by practicing good sleep habits and addressing any underlying conditions (like GERD, sleep apnea, or anxiety).
The most important thing to remember is that you need to speak to a health care practitioner before experimenting with this form of medicine.
Before using medical marijuana for sleep disorders, consult a physician or a practitioner licensed to prescribe cannabis in your province who is knowledgeable in the human encocannabinoid system and can assign you the correct dosage you need to get a better night’s sleep.
- Babson, Kimberly A., James Sottile, and Danielle Morabito. “Cannabis, cannabinoids, and sleep: a review of the literature.” Current psychiatry reports 19, no. 4 (2017): 23.
- Campos, Alline Cristina, Frederico Rogério Ferreira, and Francisco Silveira Guimarães. “Cannabidiol blocks long-lasting behavioral consequences of predator threat stress: possible involvement of 5HT1A receptors.” Journal of psychiatric research 46, no. 11 (2012): 1501-1510.
- Carley, David W., Bharati Prasad, Kathryn J. Reid, Roneil Malkani, Hryar Attarian, Sabra M. Abbott, Boris Vern, Hui Xie, Chengbo Yuan, and Phyllis C. Zee. “Pharmacotherapy of apnea by cannabimimetic enhancement, the PACE clinical trial: effects of dronabinol in obstructive sleep apnea.” Sleep 41, no. 1 (2017): zsx184.
- Do Vale, T. Gurgel, E. Couto Furtado, J. G. Santos Jr, and G. S. B. Viana. “Central effects of citral, myrcene and limonene, constituents of essential oil chemotypes from Lippia alba (Mill.) NE Brown.” Phytomedicine 9, no. 8 (2002): 709-714.
- Gorelick, David A., Robert S. Goodwin, Eugene Schwilke, Jennifer R. Schroeder, David M. Schwope, Deanna L. Kelly, Catherine Ortemann‐Renon, Denis Bonnet, and Marilyn A. Huestis. “Around‐the‐clock oral THC effects on sleep in male chronic daily cannabis smokers.” The American journal on addictions 22, no. 5 (2013): 510-514.
- “Medical Marijuana for Post-Traumatic Stress Disorder: A Review of Clinical Effectiveness and Guidelines [Internet].” Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2017 Jan 11. SUMMARY OF EVIDENCE.
- Murillo-Rodríguez, Eric. “The role of the CB1 receptor in the regulation of sleep.” Progress in Neuro-Psychopharmacology and Biological Psychiatry 32, no. 6 (2008): 1420-1427.
- Shannon, Scott, and Janet Opila-Lehman. “Effectiveness of cannabidiol oil for pediatric anxiety and insomnia as part of posttraumatic stress disorder: a case report.” The Permanente Journal 20, no. 4 (2016): 108.
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