The last few years have seen the scientific community make leaps and bounds in their understanding of the different health properties of the myriad chemical compounds derived from the cannabis plant. Two of the most studied phytocannabinoids are Tetrahydrocannabinol (THC) and Cannabidiol (CBD). Initially discovered in 1940, CBD’s chemical structure was finally determined in 1963.1 CBD does not have the intoxicating effects of some other cannabinoids such as THC, and instead has many documented health benefits.
CBD has demonstrated important therapeutic properties useful in the management of chronic conditions associated with pain, anxiety, and sleep disorders. Restorative sleep, and good sleep quality are crucial for emotional, mental and physical health. CBD has also been found to be useful for managing pain in several chronic conditions, such as malignant brain tumors, multiple sclerosis, and neuropathic pain.2
As the scientific community has deepened their understanding of CBD, further insight has been gained into how CBD affects the endocannabinoid system. This system has been largely studied within the past decade and its therapeutic potential remains an increasing target of pharmaceutical research. Studies done on the endocannabinoid system show that it may have an important role across a wide array of diseases and pathological conditions, ranging from mood and anxiety disorders, to neurological diseases such as Parkinson’s, multiple sclerosis, and conditions with chronic or hard-to-treat pain.3
CBD has several mechanisms of action, mostly through the two specific receptors for CBD present in the body, CB1, and CB2 receptors. CB1 receptors are located mainly in the brain, and help modulate the release of different neurotransmitters that slow-down neuronal activity. This specific function gives CBD it’s calming and anxiety-reducing effect. CB2 receptors are located in peripheral tissue throughout the body and have an effect on the immune system and inflammation, which in turn facilitates the beneficial effects of CBD on pain. CBD has proved to be especially useful in mitigating the effects of chronic stress, and particularly, sleep disorders associated with stress.
Sleep disorders encompass several different conditions that can have negative health repercussions among different systems. Insomnia, or lack of sleep, is said to afflict 60 million Americans according to the National Institute of Neurological Disorders and Stroke.4 Insomnia is the most common sleep disorder, and is defined as difficulty with the initiation, maintenance, duration, and quality of sleep that results in the impairment of daytime functioning, despite adequate opportunity and circumstances for sleep.5 Insomnia and poor sleep quality, are major risk factors for chronic disease, and are associated with markedly increased prevalence of depression, anxiety, missed work, accidents, and increased healthcare expenses.6 In contrast, restorative sleep promotes healing, enhances cognition and memory, and strengthens the immune system.
Receptors for CBD are found across many brain areas, especially in the vicinity of the area responsible for maintaining sleep/wake cycles.7 Experiments done in animal models, have shown that activation of these brain receptors by CBD induce sleep and reduce wakefulness.8
CBD has been used to improve the quality of sleep in patients with chronic neurological conditions and has also demonstrated neuroprotective properties.9 CBD has an important effect on anxiety and quality of sleep. Animal models show that the reduction of anxiety and stress reactions by the use of CBD leads to beneficial effects in regard to quality of sleep.10
Scientists have studied the neurobiology of the sleep/wake cycle and have discovered several ways by which CBD has an important effect on sleep. Early studies done among healthy volunteers provided important data on the sedative and sleep inducing effects of CBD.11 Other early studies showed CBD’s effect on insomnia. In one study, 160 mgs of CBD were administered to healthy volunteers that were struggling with insomnia. After only a few days, these study participants reported increased sleep time, and less frequent arousals during the night.12
One recent sleep study, carried out in an animal model, demonstrated that CBD plays an important role in extending the total length of time asleep among study subjects who received CBD when compared to subjects who had received a placebo.13
Cannabinoid extracts have also been used as a therapeutic agent for treatment of sleep apnea. Sleep apnea is characterized by loud snoring caused by obstruction of the airways during sleep. This obstruction of the airways results in absence of breathing (apnea), or insufficient breathing (hypopnea). Left untreated, sleep apnea may have detrimental effects on cardiovascular health such as heart disease and stroke. One study followed 73 adult participants who had moderate to severe sleep apnea. One group of participants from the study were given different formulations of cannabinoid extracts one hour before bedtime.14 Another group of participants received a placebo. Researchers then examined their sleep patterns for six weeks. Participants who took the higher dose, reported the highest satisfaction with their treatment, and also demonstrated decreased signs of subjective sleepiness and a lower incidence of apnea and hypopnea.
The benefits of CBD have also been studied in children with sleeping disorders, its benefits are of special importance in children who have sleeping disorders due to traumatic or stressful experiences. Supplementation with 12-25mg per day of CBD oil has been shown to increase sleep and decrease anxiety scale scores in children.15
Another study examined the effect of CBD in conjunction with other cannabinoid compounds and its effects on nocturnal sleep and early morning behaviors.16 Researchers followed a double-blinded and placebo-controlled group of young men and women who took a compound containing CBD and examined their sleep patterns and performance on a number of different controlled tasks. Results for the study showed increased levels of alertness and proper completion of tasks, highlighting the positive effects of CBD as a therapy for sleep disorders.
Current research has likely only scratched the surface of the potential therapeutic benefits of CBD. New therapeutic strategies based on the endocannabinoid system are being constantly developed. CBD has demonstrated its value as a safe and powerful, disease fighting agent that has beneficial effects on sleep, anxiety and pain management, and is available in a convenient supplement form.
- F. Keeler (30 November 1983). Handbook of Natural Toxins. CRC Press. p. 477. ISBN 978-0-8247-1893-0.
- Maroon J, Bost J. Review of the neurological benefits of phytocannabinoids. Surg Neurol Int. 2018 Apr 26;9:91. doi: 10.4103/sni.sni_45_18. eCollection 2018.
- Pacher P, Bátkai S, Kunos G. The Endocannabinoid System as an Emerging Target of Pharmacotherapy. Pharmacol Rev. 2006 Sep; 58(3): 389–462. doi: 10.1124/pr.58.3.2
- Brain Basics: Understanding Sleep, National Institute of Neurological Disorders and Stroke, Bethesda, 2006.
- Silber MH. Clinical practice: chronic insomnia. N Engl J Med. 2005;353:803–810.
- Russo EB, Guy GW, Robson PJ. Cannabis, pain, and sleep: lessons from therapeutic clinical trials of Sativex, a cannabis-based medicine. Chem Biodivers. 2007 Aug;4(8):1729-43.
- Herkenham M, Lynn AB, Johnson MR, Melvin LS, de Costa BR, Rice KC. Characterization and localization of cannabinoid receptors in rat brain: a quantitative in vitro autoradiographic study. J Neurosci, 1991;11:563–583.
- Murillo-Rodriguez E, Sanchez-Alavez M, Navarro L, Martinez-Gonzalez D, DruckerColin R, Prospero-Garcia O. Anandamide modulates sleep and memory in rats. Brain Res, 1998;812:270–274.
- Chagas MH, Eckeli AL, Zuardi AW, Pena-Pereira MA, Sobreira-Neto MA, Sobreira ET, Camilo MR, Bergamaschi MM, Schenck CH, Hallak JE, Tumas V, Crippa JA. Cannabidiol can improve complex sleep-related behaviours associated with rapid eye movement sleep behaviour disorder in Parkinson's disease patients: a case series. J Clin Pharm Ther. 2014 Oct;39(5):564-6. doi: 10.1111/jcpt.12179. Epub 2014 May 21.
- Yi-Tse Hsiao, Pei-Lu Yi Chia-Ling Li Fang-Chia Chang. Effect of cannabidiol on sleep disruption induced by the repeated combination tests consisting of open field and elevated plus-maze in rats. Neuropharmacology. 2012 Jan;62(1):373-84. doi: 10.1016/j.neuropharm.2011.08.013. Epub 2011 Aug 16.
- Zuardi AW, Guimarães FS and Moreira AC (1993) Effect of cannabidiol on plasma prolactin, growth hormone and cortisol in human volunteers. Braz J Med Biol Res 26: 213–217.
- Carlini EA and Cunha JM (1981) Hypnotic and antiepileptic effects of cannabidiol. J Clin
- Chagas MH, Crippa JA, Zuardi AW, Hallak JE, Machado-de-Sousa JP, Hirotsu C, Maia L, Tufik S, Andersen ML. Effects of acute systemic administration of cannabidiol on sleep-wake cycle in rats. J Psychopharmacol. 2013 Mar;27(3):312-6. doi: 10.1177/0269881112474524. Epub 2013 Jan 23.
- Carley DW, Prasad B, Reid KJ, Malkani R, Attarian H, Abbott SM, Vern B, Xie H, Yuan C, Zee PC. Pharmacotherapy of Apnea by Cannabimimetic Enhancement, the PACE Clinical Trial: Effects of Dronabinol in Obstructive Sleep Apnea. Sleep. 2018 Jan 1;41(1). doi: 10.1093/sleep/zsx184.
- Shannon S. Effectiveness of Cannabidiol Oil for Pediatric Anxiety and Insomnia as Part of Posttraumatic Stress Disorder: A Case Report. Perm J. 2016 Fall; 20(4): 108–111.
- Nicholson AN, Turner C, Stone BM, Robson PJ. Effect of Delta-9-tetrahydrocannabinol and cannabidiol on nocturnal sleep and early-morning behavior in young adults. J Clin Psychopharmacol. 2004 Jun;24(3):305-13.