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Using Cannabis As A Sleep Aid
We regularly assess how the content in this article aligns with current scientific literature and expert recommendations in order to provide the most up-to-date research.
Medical Disclaimer: The content on this page should not be taken as medical advice or used as a recommendation for any specific medication. Always consult your doctor before taking any new medication or changing your current dosage.
Cannabis, also called marijuana, is widely used as a sleep aid, both recreationally and among medical users. Around 70% of young adults that casually use cannabis report that they do so to help them sleep. Among long-term cannabis users (those who have been using it for 10 years or more), about half use cannabis to improve their sleep. Among people who use cannabis for medical reasons, such as pain relief, as many as 85% say it improves their sleep.
Research into cannabis as a sleep aid is still developing. Cannabis may help relieve insomnia when used occasionally, though researchers are unsure whether long-term use is ultimately beneficial or detrimental for sleep quality.
Does Cannabis Help You Sleep?
Cannabis appears to improve sleep in certain cases. For people with certain conditions such as chronic pain, post-traumatic stress disorder (PTSD), and multiple sclerosis, cannabis may help them fall asleep faster, wake up less during the night, and enjoy better sleep quality overall. A recent study also found that cannabis effectively relieves symptoms for people with restless legs syndrome (RLS).
Many people use cannabis to self-treat insomnia, anxiety, and pain. Among these users, the effectiveness of cannabis for sleep is more ambivalent, though a study conducted on individuals with insomnia found that many participants reported relief from their symptoms when using cannabis.
Some studies have found a distinction between daily users and less frequent, non-daily users in how cannabis affects their sleep. Those who use cannabis daily are more likely to report more sleep problems than occasional users or people who do not use cannabis at all. Non-daily users report fewer sleep issues than both daily users and non-users.
How Does Cannabis Work as a Sleep Aid?
It is believed that the sleep-promoting effects of cannabinoids are due to their interactions with cannabinoid receptors in the brain. When cannabinoids bind to these receptors, they send messages to increase levels of sleep-promoting adenosine levels and suppress the brain’s arousal system. Together, these effects may help cannabis users feel sedated or sleepy.
Cannabis has several different active compounds, including tetrahydrocannabinol (THC) and cannabidiol (CBD). While THC typically acts as a sedative, it can have a stimulating effect for some people, especially for those who are new to using cannabis or taking higher doses. In these cases, using cannabis before bed may result in a longer time falling asleep. CBD appears to promote alertness at lower doses, and sleepiness at higher doses. The effects of the two compounds together may depend on the dose and timing.
Both CBD and THC may also have benefits for chronic conditions that interfere with sleep.
For example, synthetic forms of THC have shown potential for treating obstructive sleep apnea, reducing PTSD-related nightmares, and improving sleep for people living with chronic pain. CBD, on the other hand, may reduce symptoms of REM sleep behavior disorder and excessive daytime sleepiness.
When using cannabis as a sleep aid, the effects you feel may depend on the type of cannabis you are using. Cannabis has higher concentrations of THC, the primary psychoactive component. Hemp plants have higher levels of CBD.
Does Cannabis Affect Your Sleep Quality?
In addition to helping you fall asleep faster, cannabis may alter your sleep architecture, a term that describes how long you spend in the different sleep stages. Short-term cannabis use appears to increase the time you spend in deep sleep, the stage that helps you wake up feeling refreshed. However, THC decreases the amount of time you spend in rapid eye movement (REM) sleep, when you spend more time dreaming, processing emotions, and cementing new memories.
Decreasing REM sleep may have some benefits for people with PTSD, since nightmares are a common and disturbing symptom. A study on women with PTSD found that those with more severe PTSD symptoms and poor sleep were more likely to use cannabis to help them cope. One study found that synthetic forms of cannabis significantly decreased nightmares, or stopped them completely, for people with PTSD. Some participants in this study also reported experiencing better overall sleep quality and fewer daytime flashbacks.
How Is Cannabis Different from Other Natural Sleep Aids?
Because cannabis is considered a controlled substance, there is limited research on the safety and efficacy of cannabis sleep aids compared to other sleep aids. Only a few synthetic drugs made to mimic THC, as well as one naturally derived CBD product, have been approved by the FDA. These are prescribed for nausea and other conditions, but not sleep.
As with other natural sleep aids, it is possible that some people may turn to medical cannabis in an effort to avoid more potent drugs, such as opioids. Although they can be very effective in the short term, many prescription and over-the-counter sleep medications are associated with a risk of abuse, tolerance, or dependence. Some natural sleep aids, like oral melatonin, appear to reduce insomnia without strong side effects, while other homeopathic options, like valerian, still need more research.
Which Type of Cannabis is Best For Sleep?
There are different strains of cannabis, which each produce different effects. The most common strains are indica and sativa:
- Indica is thought to be more calming, and may help produce feelings of relaxation and sleepiness. People appear to prefer indica for pain management, relaxation, and sleep.
- Sativa is considered more stimulating, and it may produce feelings of euphoria for some. People tend to use sativa to gain an energy boost.
Due to its relaxing effects, indica may be considered the best cannabis strain for sleep. However, individuals who use cannabis to avoid nightmares may prefer sativa. Hybrid strains with a mix of indica and sativa may produce different effects based on the specific makeup of cannabinoids and other ingredients.
Most of the differences attributed to sativa versus indica strains are based on the subjective experiences of cannabis users. Some researchers argue that the distinction between indica and sativa strains is less relevant than the variety in THC content and other ingredients in any particular product.
Risks and Side Effects of Using Cannabis for Sleep
Used on a short-term basis, cannabis may help you fall asleep faster. Health experts generally do not recommend using sleep aids, including cannabis, on a long-term basis, because of their potential to negatively impact your sleep quality and cause other side effects.
Studies suggest that people who use cannabis as a long-term sleep aid tend to develop a tolerance to its sedative effects, and may need to take more to obtain the same results. Heavy cannabis use, especially on a long-term basis, may have consequences for sleep, including:
- Less sleep overall
- Less time spent in deep sleep
- Longer time to fall asleep
- Frequent awakenings
One study found high doses of THC at night can lead to unwanted side effects the following day, such as impaired memory and sleepiness. Cannabis withdrawal can also produce sleep-related side effects, such as strange dreams, difficulty falling asleep, and less time spent in deep sleep.
Long-term cannabis use may also have health-related side effects. Studies have found the substance may reduce the volume of gray matter in your brain and, when smoked, increase your risk of chronic bronchitis. Health experts also recommend people avoid using cannabis while pregnant or breastfeeding.
Tips When Using Cannabis for Sleep
If you plan on trying cannabis as a sleep aid, your care provider can provide the best guidance based on your needs and medical history. However, it helps to have an understanding of the different options available.
What Form of Cannabis to Use for Sleep
Cannabis can be smoked, vaporized, eaten, or placed under the tongue as a sublingual tincture. Each format has different benefits and drawbacks. Those who are concerned about the effects of smoke on the lungs may prefer to avoid smoking it.
Different forms of cannabis offer different bioavailability, or how much of the active THC you can expect to make it into your bloodstream. Inhaled cannabis tends to have high bioavailability, as the THC enters your system directly. By contrast, edibles lose a significant amount of THC through the digestive process. Smoked cannabis can have bioavailability rates as high as 56%, compared with 4% to 20% for orally ingested cannabis.
When to Take Cannabis for Sleep
When choosing a type of cannabis, it is worth noting that different forms also take more or less time to produce effects. When you smoke cannabis, you can generally feel the effects almost immediately, whereas edibles can take longer to have an effect as they must work their way through your digestive system first.
The effects of smoked cannabis are highly variable depending on the person, the length of inhalation, the number of times it is inhaled, and other factors. It may be helpful to know that THC levels generally peak after about 10 minutes.
What Effects You May Notice
Because cannabis comes in a variety of strains and affects everyone differently, you may need to experiment before you find the format, dosage, and timing that work for you. THC is a psychoactive drug that tends to have other effects apart from promoting sleep. You may feel sleepy, relaxed, euphoric, or energized.
When using cannabinoids, some users may also experience dizziness, nausea, fatigue, dry mouth, vomiting, confusion, loss of balance, or hallucinations. You may also experience anxiety, panic attacks, or paranoia.
Using cannabis may not be a good idea for children and adolescents, as cannabis use has been linked to changes in the developing brain.
Deciding If Cannabis Is Right for You
Whether or not to use cannabis for sleep is a highly personal decision. Synthetic forms of cannabis appear to relieve nightmares and insomnia, but some researchers warn about the limitations of these studies and the potential risks of using cannabis until dosing is more standardized.
Many people use cannabis to successfully manage their pain and insomnia. However, some people find it makes them feel more paranoid or anxious. If you do not like the feeling of being high, a strain with a higher amount of CBD may be a better option for you.
Another important consideration is whether cannabis is legal where you live. If not, talk to your doctor about other ways to improve your sleep, such as better sleep hygiene or alternative sleep aids.
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Of the 376 posts assessed, 90 percent claimed CBD could treat a diagnosable health condition. Psychiatric issues like autism and depression were the most frequently cited in the channel.
Others reported using CBD oral capsules and tinctures for joint pain, sleep disorders, and neurological conditions, as well as gut issues, addiction, oral health, and even cardiovascular conditions, like heart palpitations.
“The public appears to believe CBD is medicine,” says one of the researchers, Davey Smith, Chief of Infectious Diseases and Global Public Health at the University of California San Diego.
“Who would have predicted that the public might ever think CBD is a cardiology medication?”
CBD holds lots of promise in the medical world, especially as a potential therapy for sleep and chronic pain, but its recent popularity has far outpaced the actual science.
The health benefits of this non-psychoactive compound need to be studied more, but as a paper in 2014 put it: “We must also ask if we are getting ahead of ourselves.”
Over the course of the five years researchers studied, posts on r/CBD went from roughly 2,000 posts per year to nearly 12,000 per year, and most of these conversations are about CBD’s therapeutic uses.
To date, however, the United States Food and Drug Administration (FDA) has only approved one CBD treatment for two severe forms of epilepsy, and this product requires a prescription.
“The benefits include a couple very rare types of seizures,” explains James Adams, Chief Medical Officer at Northwestern Medicine, who was not involved in the current study.
“But the misconception is that it’s broadly beneficial. It’s not that well researched or understood.”
The FDA has apparently seen only limited data on the safety of over-the-counter alternatives. There are some lines of evidence to suggest extended use of CBD is not without its harms, especially concerning the liver and possible interactions with other drugs being taken.
Interestingly enough, a frequently asked question on r/CBD is whether or not it’s safe or effective to take CBD at the same time as an antidepressant, like Lexapro.
“CBD is probably not that harmful, but we shouldn’t expect it to be a medicine,” says Adams, who works at Northwestern University.
“It’s being promoted for all kinds of purposes for which it’s never been studied.”
The real risk, researchers say, is that people with treatable conditions will turn to CBD as a valid alternative, something the FDA promised Congress it would be stronger on.
But while the FDA has issued several warnings to CBD companies in the past for the contents of their products and their marketing practices, little other action has been taken.
“Although many potential therapeutic uses of CBD remain to be explored, our findings suggest that the public already perceives CBD as an effective therapeutic for many health conditions in ways that are potentially detrimental to public health,” the authors write.
“Because CBD is not an FDA-approved treatment for nearly all the conditions cited by users who post to Reddit, CBD users may unnecessarily experience prolonged illnesses that would otherwise be alleviated with proven effective treatments.”
Regulations need to become stricter, researchers argue, not only when it comes to marketing but also when it comes to the contents of the product itself.
Because CBD oil and tinctures are sold as supplements, they are not regulated for safety or purity by the FDA, which means we have no idea about dosage.
As a result, some CBD products can contain psychoactive ingredients, like THC, which may make a person feel unexpectedly high. In fact, there are several posts on r/CBD discussing this very problem, with one user admitting they unintentionally failed a drug test because they use CBD for pain management.
Obviously, what’s said on Reddit doesn’t necessarily reflect the views of the larger public, but because few other surveys and studies exist on this topic, online testimonials are a good place to start.
The sample of the study is small, but the longitudinal research suggests CBD use is on the rise, and in the minds of many consumers, the product has gone from supplement to medicine.
“CBD is this generation’s snake oil,” argues lead author Eric Leas, who studies public health at UC San Diego, “as millions believing to have discovered a new medical breakthrough are actually taking a product without evidence of a benefit.”