Cannabis and Sleep

November 2021

Gloria Lynne Smith, RN-BC, BSN

Quality sleep is essential for each one of us – sleep is where our body repairs and restores health. It is recommended that we get seven to nine hours a night in order to perform these complex processes, but the average American gets closer to 6 hours or less a night. Not getting enough sleep can negatively affect cognitive function, personality, energy levels, and can cause memory impairment. There are over 80 recognized sleep disorders, and over 100 million Americans suffer from them (Cleveland Clinic, 2021).

Our sleep cycle is incredibly complex, and it is largely regulated in our nervous system. There are processes that occur to help us stay in a wake cycle, and there are others to help keep us in a sleep cycle. The circadian rhythm describes the natural processes that interact with day and night and keep humans as diurnal, or daytime beings. No single chemical or signal helps support this rhythm, rather it is a cascade of events. This seems to explain why so many of us suffer from sleep disorders.

Our Endocannabinoid System (ECS) has a large part in the maintenance of our sleep and wake cycles. Endocannabinoids are important messengers in our neurological system and without them, certain processes are disrupted. Healthy people who sleep well have large concentrations of anadamide, which is our internal version of tetrahydrocannabinol, or THC. Anadamide is an endocannabinoid, which means it is produced on-demand. Anadamide acts on receptors in the central nervous system with a calming effect. Studies on rats show the rise and fall of levels of anadamide during the sleep/wake cycle, and how the introduction of THC can mimic anadamide and cause sleep (Babson et al, 2017).

Complexities aside, cannabis has been used for sleep for thousands of years. Most anyone who has used cannabis before will tell you that it has a sedative or relaxing effect, but using THC for sleep is a lot more complex than that. High THC consumption just prior to sleep will decrease sleep latency (or make you fall asleep quickly), but increase waking grogginess and will not keep you asleep. Pairing THC with CBD, usually around a 1:1 ratio, will often rectify those negatives, because CBD works in harmony with THC.

A 2014 study of patients with Parkinson’s disease patients showed that CBD was effective in not only improvement with tremors, but increased REM (rapid eye movement) sleep (Chagas et al, 2014). REM sleep is the “deep” sleep, and it’s important to reach in order to get the benefits of sleep. Those of use who wake many times during sleep don’t get the amount of REM sleep that we need, if we are getting any at all.

While CBD has been shown to increase REM sleep, THC can decrease it. Initially, this can seem like a negative side effect, but less REM sleep has its place. Those who suffer from trauma-related sleep disturbances, such as those often experienced with post-traumatic stress disorder (PTSD), will benefit from spending less time in REM sleep because that’s most often where vivid nightmares occur. Anxiety sufferers can benefit as well as they often experience similar nightmares.

Slow-wave sleep (SWS) is a non-rapid eye movement part of deep sleep. It is where dreaming and sleepwalking often occur, but more importantly, the time for memory consolidation. SWS is a deep sleep, and it’s necessary for not only memory storage, but restorative sleep. Those who suffer from insomnia do not spend much time in SWS, and because of this, they often suffer from memory problems and concurrent health disorders. THC increases time spent in SWS, but it decreases time in REM sleep.

So, what does this all mean? First, it means that there is so much more research to be done with cannabis in general, but particularly cannabis and sleep. Second, it means that if you suffer from a sleep disorder, cannabis will likely help you tremendously with getting “better” sleep. Remember – “better” sleep is different for all of us, and our daily needs change. Listen to your body, get education from reliable sources, ask questions, and make changes. Off to dreamland!

References

Babson, K. A., Sottile, J., & Morabito, D. (2017). Cannabis, cannabinoids, and sleep: A review of the literature. Current Psychiatry Reports, 19(4). https://doi.org/10.1007/s11920-017-0775-9

Chagas, M. H., Eckeli, A. L., Zuardi, A. W., Pena-Pereira, M. A., Sobreira-Neto, M. A., Sobreira, E. T., Camilo, M. R., Bergamaschi, M. M., Schenck, C. H., Hallak, J. E., Tumas, V., & Crippa, J. A. (2014). Cannabidiol can improve complex sleep-related behaviours associated with rapid eye movement sleep behaviour disorder in Parkinson's disease patients: A case series. Journal of Clinical Pharmacy and Therapeutics, 39(5), 564–566. https://doi.org/10.1111/jcpt.12179

Cleveland Clinic. Sleep Disorders Clinic. 2021. https://my.clevelandclinic.org/departments/ne