Insomnia and other sleep problems may be improved with cannabis.
The past year has given us more reasons than ever to lose sleep. If you’re up in the middle of the night staring at the ceiling, worrying or aching or unable to relax, you’re not alone. But that’s cold comfort when all you want is some sleep.
Of course, there are endless products, methods and drugs that promise to improve sleep, and some of them—we’re looking at you, extra-large serving of cough syrup—are not the healthiest. There is, however, a natural remedy that you might not have considered: marijuana for sleep.
Cannabis may help you fall asleep, and it may relieve the pain and anxiety that could be keeping you awake. When Silas Wonderling, PharmD, a pharmacist and general manager of the RISE Dispensary in Monroeville, Pennsylvania, sees a medical marijuana patient for the first time, he always asks about the quality of their sleep. He wants to make as much of an impact in the person’s quality of life as possible, as quickly as possible.
“Whenever a new patient comes in, I usually try to start helping with the sleep cycle,” he says. “Whatever medical issue people have, helping them out at night time can be a real game-changer for them.”
Medical condition or not, trouble sleeping happens to most of us at some point. More than one-third of U.S. adults don’t get the recommended seven hours of sleep a night, and about 3 in 10 experience insomnia at least some of the time. As a result, the sleep aids market, including everything from drugs and supplements to special pillows, is expected to be a $102 billion industry by 2023.
At RISE, Wonderling often helps people who are ready to stop taking prescription sleep aids and interested in trying cannabis.
“Our job in the dispensary is to help you find the most ideal product for you, without you spending too much money,” Wonderling says. “We want to make the trial-and-error process of finding the right product as quick as possible.”
Read on if you’re tired of tossing and turning and interested in trying marijuana for sleep.
The Science of How Cannabis Affects Sleep
The research on cannabis and sleep is ongoing, but we know one thing for sure: Cannabis has been shown to help people fall asleep. “Cannabis has been well-established to help promote the onset of sleep, going back a few decades at least,” Wonderling says.
It’s also been shown to have potential benefits in helping people with chronic pain stay asleep throughout the night, though researchers are trying to understand whether frequent cannabis use can diminish its sedative effects.
To understand how cannabis affects sleep, look to cannabinoids, the active compounds in cannabis, including CBD and THC. Cannabinoids in cannabis interact with the endocannabinoid system in our bodies, which influences many physical processes, including our sleep-wake cycles.
CBD facilitates sleep by mimicking a cannabinoid we naturally produce in our bodies: anandamide, sometimes called the “bliss molecule” for its ability to promote calm, Wonderling says.
THC, which is responsible for the psychoactive effects of marijuana—the high—has been shown to help people fall asleep, even at low doses, Wonderling says. It also depresses the rapid eye movement (REM) sleep cycle, which means you’re less likely to dream when you use marijuana. This can be helpful for people with upsetting or frightening dreams because of post-traumatic stress disorder; it’s unclear if there are consequences for depressing REM sleep long-term.
The real power of cannabis for sleep might be its ability to ease symptoms of conditions that keep people awake at night, Wonderling says, such as anxiety disorders, post-traumatic stress disorder and chronic pain. And the ripple effects can be powerful: when people get better sleep, their health problems are less likely to flare during the day.
The Best Cannabis Strains for Sleep
When Wonderling meets a new patient who needs help sleeping, he first asks if the patient is comfortable with using THC and potentially experiencing a high. CBD-only products may help with sleep, but a product with a combination of both THC and CBD is usually most effective, Wonderling says.
For people without a lot of cannabis experience, or those who have not used cannabis in years, Wonderling recommends starting with a low dose of a product that’s balanced in its THC and CBD content (look for a 1:1 on the packaging). You’ll want to find a strain with indica effects, meaning it’s more likely to promote calm and relaxation, rather than sativa, which can be energizing.
For people looking to get to sleep, Wonderling often recommends tinctures, a concentrated liquid cannabis preparation that the user drops under the tongue. Tinctures have a longer expected effect than an inhalable product (three to six hours versus two to four hours), and the dose can be adjusted easily. Wonderling tells new patients to start with 2.5 mg of THC about 20 to 30 minutes before bed; tinctures typically take between 20 and 30 minutes to take effect. Stay at that dose for a couple of nights, and then increase the dose 1 mg of THC at a time, Wonderling says, giving each dose some time to see how it works for you. Take note of how you feel and how you sleep in a cannabis journal so you can work with a pharmacist or cannabis consultant to get to your optimal dose.
“We want to find the lowest effective dose for the patient,” Wonderling says.
If you’re inhaling marijuana, start with two puffs at bedtime and wait 15 to 20 minutes to see if you feel anything before trying more, Wonderling says. He generally doesn’t recommend starting with edibles for sleep because they can be difficult to dose predictably and can take hours to kick in. Once you have a sense of your personal best dose of cannabis, however, edibles can be added to the toolbox.
THC and CBD aren’t the whole story: the cannabinoid CBN, which THC turns into as the plant ages, may help with sleep; several tinctures are sold with 1:1:1 concentrations of THC to CBD to CBN.
And last but definitely not least, there are terpenes, the compounds that give plants and foods their aroma. Wonderling recommends strains with myrcene, prominent in indica weed plants, which promotes relaxation. Another beneficial terpene for sleep is linalool, because it may decrease anxiety.
Cannabis Sleep Aid
As a pharmacist, Wonderling spends a lot of time trying to help people who want to decrease their reliance on prescription pharmaceuticals, including sleeping pills. “A lot of our patients have found this one plant can replace a variety of prescription medications,” he says.
Some commonly prescribed medications are very effective for sleep, but they’re such powerful sedatives that they have unwanted side effects, such as people doing things in their sleep that they don’t remember. There are no reports of such incidents with cannabis, Wonderling says. Some doctors prescribe benzodiazepines (Xanax, Valium) for sleep, but these can be habit-forming and an overdose can be fatal.
Using cannabis for sleep does come with some caveats: More research is needed into the impact of repressing the REM sleep cycle long-term with cannabis, Wonderling says, and stopping cannabis may lead an REM-rebound effect where dreams are especially vivid. However, this rebound effect appears to be even more pronounced with pharmaceutical sleep drugs, he adds.
Wonderling encourages people curious about cannabis and sleep to talk to a pharmacist or cannabis consultant at RISE to learn more.
“When you’re not getting enough sleep, everything in life becomes harder,” he says. “We can help you figure out if cannabis might be useful for you and how to incorporate it into your lifestyle.”