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The Cannabis-Insomnia Connection

Cannabis has long been used as a sleep aid due to its relaxing and sedative effects. What does the science say? While we are learning more about the impact of cannabis on the sleep cycle, cannabis may be able to help you get a good night’s rest by alleviating symptoms of other conditions that keep you awake at night.

Insomnia as a symptom, not a condition

One in four Americans experience short-term, acute insomnia[1]. These bouts of insomnia can last for days or weeks, but typically wane over time. Oftentimes, insomnia is the result of a traumatic event or underlying health conditions. In some cases, short-term insomnia can develop into a chronic, long-term problem.

Insomnia takes many forms, including some or all of the following symptoms:

  • Difficulty falling asleep
  • Waking up during the night
  • Waking up early
  • Feeling unrested after sleep
  • Fatigue
  • Irritability, depression, and anxiety
  • Lack of focus
  • Anxiety regarding sleep

Despite its symptoms and diagnosis, insomnia is not, in and of itself, an approved condition for most states’ medical cannabis programs. It is, however, a common symptom of many approved conditions. This means that if you’re approved under your state’s medical cannabis program for another condition, you may also find relief from sleepless nights with cannabis.

Let’s illustrate this with pain, a common symptom of many approved conditions under state medical cannabis programs. Pain is often related to difficulty falling asleep or inability to achieve restful sleep throughout the night. Using cannabis to alleviate pain could be an effective way to help consumers fall asleep and stay asleep longer. This is also especially important for patients with chronic pain or a condition that causes pain, like neuropathy.

How cannabis helps conditions that trigger insomnia

  • Pain: Intense pain can keep you from getting a good night’s rest. The analgesic (pain relieving) properties of cannabis may provide much-needed relief for those who struggle to fall asleep and stay asleep due to the pain. For example, CBD has been observed to reduce inflammation related to pain[2].
  • Neuropathy: Neuropathic pain is notoriously difficult to treat, keeping patients from falling asleep and staying asleep due to the intense burning, shooting, or numbing sensations caused by nerve damage. Many with neuropathy also experience a phenomenon known as “hypernociception,” causing pain from stimuli as subtle as sheets brushing  against skin. This can make it even more difficult to get comfortable before sleeping. Research suggests phytocannabinoids can help mitigate this effect by serving to regulate pain signaling in patients living with neuropathy[3].
  • Anxiety: Several cannabinoids and terpenes — including THC, CBD, myrcene, and limonene — are thought to exhibit anti-anxiety properties. The endogenous cannabinoid system (ECS) includes internally produced compounds, called endocannabinoids, which serve to regulate the release and uptake of neurotransmitters, some of which regulate anxiety responses. There is evidence that phytocannabinoids can augment this interaction by influencing the CB1 receptor, offering potential for anxiety relief and subsequent improvements to a restful night’s sleep[4].

Do cannabinoids and terpenes directly help insomnia?

Although we know that cannabis helps certain conditions that cause insomnia, whether cannabis itself can help insomnia is a separate question. It’s theorized that cannabis can help insomnia because of the ECS’s influence on the sleep cycle, but exactly how that happens is still being explored by researchers. Here’s what we know so far about how these cannabinoids and terpenes influence the sleep cycle:

  • THC: In high doses, THC is known to reduce the amount of time spent in the Rapid Eye Movement (REM) cycle. However, low doses of THC appear to promote a relaxing consumption experience which could help you fall asleep more quickly. Studies have yet to prove the THC-sleep connection[5].
  • CBD: Regular consumption of CBD may promote more restful sleep. In a survey of 72 adults living with anxiety who sleep poorly found that two-thirds reported improvements after one month of regular CBD consumption. However, these findings proved inconsistent, with 25% of participants reporting exacerbated symptoms after one month of regular CBD consumption[6, 7].
  • CBN: Cannabinol (CBN) is the cannabinoid that results from the degradation of THC exposed to air, light, and heat over time. This cannabinoid could help consumers fall asleep more quickly. One study showed subjects who consumed high-CBN cannabis strains reported feeling more drowsy than those who consumed high-THC strains without significant levels of CBN. Findings regarding CBN and the sleep cycle have proven inconsistent[8].
  • Myrcene: Myrcene is prevalent in indica strains, perhaps contributing to the conventional wisdom that indica strains are best for nighttime use. This terpene is thought to induce sedative-like effects[10].
  • Linalool: Linalool is thought to help reduce stress and anxiety, as well as increase the production of adenosine, a sleep hormone that can help you fall asleep more quickly[11]. In addition to cannabis, linalool is found in herbs like lavender, which are often associated with relaxation and alleviating stress.
  • Beta Caryophyllene: Beta Caryophyllene is thought to excel at stress relief and pain reduction, making it an important terpene for consumers living with pain or anxiety. Beta Caryophyllene is often found alongside myrcene, making the two a potentially potent combination for addressing sleep issues[12].

Which cannabis products are the best for sleep?

The type of product you choose depends on your goals. For consumers looking to fall asleep more quickly, inhaled products offer near-instant effects. However, for consumers who want to stay asleep, the slower-acting, longer-lasting effects of products like cannabis capsules or edibles may be better. These products take a longer time to get into your system therefore helping you stay asleep.

It can be difficult to pinpoint which products are the most effective for combating insomnia and promoting restful sleep. It does appear, however, that selecting products with a terpene profile suited for relaxation and drowsiness is key. Additionally, if insomnia is caused by specific symptoms related to an approved condition, finding a product or strain that effectively alleviates those symptoms could also prove effective.

At Ethos, we know it can be challenging to make the right choice, and we strive to be your partner along your cannabis journey. Discuss your needs with an Ethos associate or pharmacist to help choose the product that may best suit your unique circumstances. Together we can help you make the right choice so you can catch a good night’s rest and awake refreshed and ready to take on your day.

Sources:

  1. One in four Americans develop insomnia each year: https://www.sciencedaily.com/releases/2018/06/180605154114.htm#:~:text=Summary%3A,according%20to%20a%20new%20study.
  2. Antioxidative and Anti-Inflammatory Properties of Cannabidiol https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7023045/
  3. The role of central and peripheral Cannabinoid1 receptors in the antihyperalgesic activity of cannabinoids in a model of neuropathic pain https://pubmed.ncbi.nlm.nih.gov/11323130/
  1. Role of Endocannabinoid Signaling in Anxiety and Depression https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3808114/pdf/nihms518943.pdf
  1. Around-the-clock Oral THC Effects on Sleep in Male Chronic Daily Cannabis Smokers: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1521-0391.2013.12003.x
  2. The Use of a Synthetic Cannabinoid in the Management of Treatment-Resistant Nightmares in PTSD: https://onlinelibrary.wiley.com/doi/full/10.1111/j.1755-5949.2008.00071.x
  3. Cannabidiol in Anxiety and Sleep: https://pubmed.ncbi.nlm.nih.gov/30624194/
  4. Effects of delta-9 Tetrahydrocannabinol and Cannabinol in Man: https://pubmed.ncbi.nlm.nih.gov/1221432/
  5. Which Cannabis Terpenes are Best for Insomnia & Where Can You Find Them? https://www.leafly.com/news/strains-products/best-terpenes-for-insomnia
  1. Central Effects of Citral, Myrcene, and Limonene: https://pubmed.ncbi.nlm.nih.gov/12587690/
  2. Involvement of Adenosine A1 and A2A Receptors in Linalool-induced Antinociception: https://pubmed.ncbi.nlm.nih.gov/16343551/
  3. Beta Caryophyllene is a Dietary Cannabinoid: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2449371/

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