Copyright © 2020 Elsevier Ltd. All rights reserved.
Keywords: Cannabidiol; Cannabinoids; Cannabis; Insomnia; Obstructive sleep apnea; Sleep disorders; THC.
Cannabinoids, including the two main phytocannabinoids Δ 9 -tetrahydrocannabinol (THC) and cannabidiol (CBD), are being increasingly utilised as pharmacological interventions for sleep disorders. THC and CBD are known to interact with the endocannabinoid and other neurochemical systems to influence anxiety, mood, autonomic function, and circadian sleep/wake cycle. However, their therapeutic efficacy and safety as treatments for sleep disorders are unclear. The current systematic review assessed the available evidence base using PubMed, Scopus, Web of Science, Embase, CINAHL and PsycInfo databases. A total of 14 preclinical studies and 12 clinical studies met inclusion criteria. Results indicated that there is insufficient evidence to support routine clinical use of cannabinoid therapies for the treatment of any sleep disorder given the lack of published research and the moderate-to-high risk of bias identified within the majority of preclinical and clinical studies completed to-date. Promising preliminary evidence provides the rationale for future randomised controlled trials of cannabinoid therapies in individuals with sleep apnea, insomnia, post-traumatic stress disorder-related nightmares, restless legs syndrome, rapid eye movement sleep behaviour disorder, and narcolepsy. There is a clear need for further investigations on the safety and efficacy of cannabinoid therapies for treating sleep disorders using larger, rigorously controlled, longer-term trials.
Conflict of interest statement
Conflicts of interest RRG and NSM have received discounted investigational products for an unrelated clinical trial from Neurim Pharmaceuticals Inc. RRG and NSM have also received investigational product and matched placebo from Teva Pharmaceutical in unrelated clinical trials. ISM is a consultant for Kinoxis Therapeutics, and is an inventor on several patents relating to novel cannabinoid therapeutics. RV has received income as a consultant or advisory board member from Zynerba Pharmaceuticals, Canopy Health Innovations Inc., and FSD Pharma. The other authors have no conflicts of interest to disclose.
“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.
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.
Setting yourself up for sleep
“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.”
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.
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.