Sleep disturbance is one of the main reasons patients come to my office. Poor sleep leads to anxiety, depression, poor memory, anger, increased risk of accidents and increased risk of cardiovascular diseases and death. All of these conditions disrupt quality of life and interfere with the ability to function well at work and at home.
Many people suffering with sleep difficulty will try over-the-counter sleep aids and often seek prescription sleep medications. Unfortunately, research shows that taking hypnotics (sleep-aids) is associated with a greater than threefold increased risk of death even when only 18 doses per year are used.1
Limited research into cannabis use and sleep has reported mixed findings and various effects of cannabinoid administration on different aspects of sleep.2 How cannabinoids affect the stages of sleep and the long-term effects of using cannabis for sleep is still unknown.
That being stated, I have seen thousands of patients who report better sleep with cannabis use. Many of these patients suffer with pain, chronic illness and often anxiety, but I have also successfully treated patients with primary insomnia, sleep apnea, restless leg syndrome, nightmares and bruxism. Patients who report better sleep with cannabis use tell me they have quicker onset of sleep and are able to stay asleep through the night. They report that they feel well rested upon awakening and for the most part, do not experience morning grogginess.
THC and terpenoids, such as myrcene and linalool, are sedating for most people. Patients are using various methods to achieve better sleep. Inhalation or sublingual use of THC-rich cannabis helps with the onset of sleep. Ingestion of cannabis edibles often will prevent waking in the middle of the night due to their longer lasting effects. Lower doses appear to work best for most, as higher doses can be too psychoactive and may stimulate the mind. Many experts recommend taking cannabis 1-2 hours before you plan to go to sleep, as the sedating properties are likely to set in in this time frame. Experimenting with the different methods and timing will help you find what works.
In my experience, patients who are regularly using sleeping pills, who then found that THC-rich cannabis helped with sleep, may experience rebound insomnia when trying to wean themselves off the pills. You may misinterpret the rebound symptoms as an ineffective THC effect, thinking that THC stopped working. The poor sleep is likely due to your brain adjusting to the lack of sleeping pills. With time this will resolve, especially if cannabis is effective for you. I have witnessed thousands of patients discontinue the use of sleeping pills and have improved quality of sleep with cannabis, without any adverse side effects.
Be aware that CBD in low doses is alerting (but not for everyone), and in higher doses can be sedating. These effects vary person to person. Some patients report not feeling either alert or sedated with CBD. If you are using CBD for another condition, you may want to avoid taking it right before bedtime as it can interfere with sleep in some patients. Once you see how it affects you, you can adjust the timing so that it does not adversely interfere with sleep.
Kripke, Daniel F., Robert D. Langer, and Lawrence E. Kline. “Hypnotics' association with mortality or cancer: a matched cohort study.” BMJ open 2.1 (2012): e000850.
Gates, Peter J., Lucy Albertella, and Jan Copeland. “The effects of cannabinoid administration on sleep: a systematic review of human studies.” Sleep medicine reviews 18.6 (2014): 477-487.