CBD And Insomnia
A typical person will spend approximately 1/3rd of their life sleeping.1 With so much time of our lives dedicated to sleep, we ought to know a lot about it. We ought to understand why we need sleep, what benefits it brings us, and – perhaps most importantly – how to treat insomnia, the inability to fall and/or stay asleep.
Unfortunately, with sleep's intrinsic ties to the brain and the brain's complicated nature, nailing down the specific causes of insomnia aren't so easy. In fact, general knowledge about sleep is surprisingly sparse. A common joke among scientists studying sleep is that "Sleep cures sleepiness."
With so little known about sleep in general, there is little relief out there for those suffering insomnia. Rather than treat the real causes at hand (whatever the heck they may be), many doctors will simply suggest taking a sedative or sleep-aid at night. While these can help induce sleep, they can come with nasty side-effects, like grogginess in the morning after taking, nightmares, and general dependency. Isn't there a way to just fall asleep again?
As CBD is growing more and more popular, many people are turning to it as a potential cure and treatment for all sorts of maladies, sleep included. Indeed, many anecdotes suggest that CBD can help you fall and stay asleep, and without the unwanted side-effects that many sleep-aids come with. So, can CBD really help insomnia? Let's dive deeper into it and find out.
The Science of Sleep: What Does it Do?
Sleep is complicated. In general, the brain uses time asleep to help reset itself. It is a time during which antioxidant systems can clean up reactive oxygen species (ROS) that have polluted the cells of the brain. It is a time for transforming short-term memory into long-term memory. And it is a time to replenish the brain's sources of energy.
The brain is said to use up to 20% of the human body's energy.2 While research is still working towards a definitive understanding of sleep, it has been established in the rat brain that – during sleep – areas of the brain normally active during periods of wakefulness see surges in ATP – or Adenosine Tri-Phosphate – the molecular currency of cellular energy.3 While there is no direct evidence so far, this strongly suggests that sleep serves the role of keeping the brain "energized" for when we are awake.
Sleep also appears to be a time when short-term memory – or rather, the memories gathered throughout the day – can be permanently stored away into long-term memory. This process involves a part of the brain called the "hippocampus" (the name comes from the Greek for "Seahorse," because it somewhat resembles one… if you look really hard at it and seriously strain your imagination). During sleep, the hippocampus replays memories, consolidating those memories from the otherwise short-term hippocampus to the long-term storage of the neocortex – the outer part of the brain (the "thinky" parts that primates are especially known for having).4 This is thought to play an incredibly large role in consolidation of learning and general recall of events, although it should be mentioned that not all types of memory seem to stem from the hippocampus. Most importantly, the hippocampus appears to play a role in episodic memory – the kind of memory in which you can recall events happening in your life – and semantic memory – or "facts."5
One final noteworthy thing that sleep seems to do for the human body is give its systems a chance to cleanse themselves of pollution. This pollution comes in the form of "ROS," or reactive oxygen species. While oxygen is vital to human life, it is also highly reactive. The first life on Earth didn't use oxygen at all, likely due to how reactive it was, and only after sufficient antioxidant systems could be developed did life finally evolve ways of using it.6 During everyday life, your cells produce ROS along with your stores of energy. Just like a power plant polluting its nearby environment, your mitochondria – the cellular power plants – are producing toxins that pollute your cells.7
Sleep appears to be a time in which oxidative stress is dealt with. In several experiments involving fruit flies, it was established that the flies that slept less died more easily after oxidative stress. Furthermore, flies that slept more were more resilient to those same stress, and other flies mutant for having extra antioxidant capabilities in their brains naturally slept less. Altogether, this strongly suggests that sleep – a near universal phenomenon in animals – plays an important role in cleaning out the ROS pollution made during times of waking.8
Even with evidence for some of the above topics, scientists are still unsure of what sleep really does. The fact that sleep is highly preserved in vertebrate animals – and even all animals in general – suggests it plays some kind of significant role in life. And yet, that role still eludes us. Even so, for those suffering insomnia, one thing is clear: going without sleep is awful.
The Science of Sleep: How does it Work?
The actual act of falling asleep is complicated. While science has managed to narrow down certain elements and chemicals behind this or that part of sleep, the broad picture is still a tangled mess. Even so, we will discuss here what we do know, or what the current theories suggest.
First and foremost, sleep tends to be naturally controlled by something called a circadian rhythm, the name coming from the word "circle." There are many kinds of circadian rhythms, some corresponding to seasons, others to day and night. When talking about human sleep, we are mostly concerned with the day-night cycle.
The circadian rhythm is naturally ingrained in the brain, based upon the amount of light that the eyes detect. Even blind individuals tend to have some basic ability to sense light, helping them regulate their sleep patterns. As light becomes less plentiful, the hypothalamus – a small structure of the brain – begins the part of the circadian rhythms that correspond to night time.9 A complex set of plans that the brain has stored in it begins to play out, ultimately leading to what we consider sleep.
Chemically, it is difficult to say "this" or "that" causes sleep. However, there do appear to be some chemical promoters of sleep, even if we have yet to fully determine the scope of their role. One major sleep promoter seems to be Adenosine, an amino acid that acts as a precursor to building DNA, RNA, proteins, and the all-important ATP energy molecules. As the day progresses, levels of Adenosine in the brain rise. These levels peak at around the time we became sleepy, and then they decrease during the night. Adenosine may be one kind of chemical signal responsible for inhibiting wakefulness. As more of it fills the brain, the brain is naturally inhibited more and more, up until you become ready for sleep. This inhibition is then removed during sleep, allowing the brain to jump back up to function the following day.1 10
Another apparent chemical involved in sleep processes is GABA – a neurotransmitter that acts as a nervous system inhibitor. Although the research is still early, and there are some conflicting elements, a correlation between GABA levels in the occipital lobe of the brain and those suffering insomnia has been discovered. In the Insomnia group, GABA levels were higher in the occipital cortex than in the control group. At the same time, those in the Insomnia group also demonstrated less time awake after falling asleep when they had higher GABA.11 This suggests GABA at least plays some kind of meaningful role in sleep regulation.
Something important to note is that, again, even with evidence for this or that chemical aiding sleep, the exact causes are still more complex, and hard to pin down. As a result, treating insomnia is difficult. So finally, can CBD help?
Insomnia Treatment: CBD
Research into CBD in general is relatively new, but at least one major study on CBD and sleep has been performed. In this study, 48 subjects (68%) reported improved sleep during the first month of use. Strangely, results fluctuated after this time.12
To be clear, the subjects used in the above study were not suffering from insomnia, but the results still suggest CBD can interact with the mechanisms of sleep in a positive way – at least for the first month of use. How might CBD do this?
One of CBD's major benefits is its activation of the Endocannabinoid System. It doesn't do this directly, but instead boosts the body's own natural endocannabinoid, Anandamide.13 Anandamide happens to play a very powerful role in the brain. In fact, it is now recognized as a major part of the "runner's high" that accompanies physical exercise (its levels go up during such exercising).14
Anandamide will suppress two specific neurotransmitters: glutamate, an excitatory molecule, and GABA – the same molecule that seems to be raised in insomniacs.15 By suppressing both inhibitory and excitatory molecules, anandamide is considered to "balance" the brain, allowing it to overcome any powerful overabundance that it may have been suffering from before.
Is this the exact reason CBD can help improve sleep? The verdict is still out on that. CBD may be improving sleep in other ways, involving other facets of the Endocannabinoid System, or via unrelated actions, such as its antioxidant capabilities. In the previously mentioned study involving fruit flies, greater antioxidant systems in the brain corresponded to flies requiring less sleep.8 As CBD can boost the body's antioxidant systems via zinc homeostasis, regulation of transcription factors like PPARand the induced death of toxic cells, it may be that better sleep comes with it naturally.16 CBD has been noted to have a neuroprotective effect, which may further add to its sleep-aiding effect.17
Unfortunately, there is little more data on CBD for sleep, and instead anecdotes are the primary source of information. As a result, even if you choose to take CBD, it may be worth it to consider some other basic strategies for improving sleep in general.
Insomnia Treatment: Other Aids
Besides using sleeping medication, there are other – quite simple – methods of improving sleep, and helping insomnia. Here, we will discuss a few of them.
One possible cause of insomnia is the circadian rhythm that controls sleep getting "off." Even as night sets in, we tend to be around plenty of screens and lights, which can keep the hypothalamus from initiating the start of sleep. As a result, one major suggestion is to avoid looking at screens in the hour or two before going to bed. Choose a definitive bed time, and adhere to your own "no-screen" rule to help your brain's natural clock stay on time.18
It is also good to maintain a regular sleep schedule. By keeping consistent with a time for waking up every day, and a time for falling asleep, you keep the circadian rhythm well maintained.
Exercising during the day has also been shown to aid in sleep. Despite what is commonly said, exercising an hour and a half before bedtime seems to be capable of actually improving sleep, at least in younger people. Such exercise seems to increase the amount of "deep sleep" had compared to "REM" sleep, where the brain becomes highly active (and dreams are most present).19
Finally, avoid caffeine! Chemically, caffeine is preventing Adenosine from working in the brain. If Adenosine naturally pushes the brain towards sleeping, then caffeine will do the opposite, and keep you awake. Most Americans consume more caffeine than the known functional amount for decreasing sleep. So cut back: you may be surprised by what it can do.10
Research on sleep and insomnia may be frustratingly lackluster, but there are a few things you can do to help. If your insomnia is affecting your daily life in a negative way, talk to your doctor about it. Your doctor may be able to recommend sleep specialists to further investigate your problems, and even find a solution. Make sure to always speak with your doctor before trying anything new like CBD, especially if you are on medications. While CBD's safety has been well demonstrated, your doctor will still likely know what's best for your specific situation.17
1 Bear, Mark F., Barry W. Corners, and Michael A. Paradiso.Neuroscience: Exploring the Brain. Philadelphia: Wolters Kluwer, 2016. https://www.studyblue.com/notes/b/neuroscience-exploring-the-brain/2759/0
2 Magistretti, Pierre J., and Igor Allaman. "A Cellular Perspective on Brain Energy Metabolism and Functional Imaging." Neuron 86, no. 4 (2015): 883-901. doi:10.1016/j.neuron.2015.03.035.
3 Dworak, M., et al. "Sleep and Brain Energy Levels: ATP Changes during Sleep." Journal of Neuroscience 30, no. 26 (2010): 9007-016. doi:10.1523/jneurosci.1423-10.2010.
4 Sakaguchi, Masanori, et al."Memory Consolidation during Sleep and Adult Hippocampal Neurogenesis." Neural Regeneration Research 14, no. 1 (2019): 20. doi:10.4103/1673-5374.243695.
5 Manns, Joseph R, et al."Semantic Memory and the Human Hippocampus." Neuron 38, no. 1 (2003): 127-33. doi:10.1016/s0896-6273(03)00146-6.
6 "Which Came First: Complex Life or High Atmospheric Oxygen?" Astrobiology Magazine 4 Jan. 2018 doi:10.1016/s0896-6273(03)00146-6.
7 Murphy, Michael P. "How Mitochondria Produce Reactive Oxygen Species." Biochemical Journal 417, no. 1 (2009): 1-13. doi:10.1042/bj20081386.
8 Saper, Clifford B., et al. "A Bidirectional Relationship between Sleep and Oxidative Stress in Drosophila." PLOS Biology 16, no. 7 (2018). doi:10.1371/journal.pbio.2005206.
9 Saper, Clifford B., et al."The Hypothalamic Integrator for Circadian Rhythms." Trends in Neurosciences 28, no. 3 (2005): 152-57. doi:10.1016/j.tins.2004.12.009.
10 Bjorness, Theresa, and Robert Greene."Adenosine and Sleep." Current Neuropharmacology 7, no. 3 (2009): 238–245. doi:10.2174/157015909789152182.
11 Morgan, Peter T., et al."Cortical GABA Levels in Primary Insomnia." Sleep 35, no. 6 (2012): 807-14. doi:10.5665/sleep.1880.
12 Shannon, Scott. "Cannabidiol in Anxiety and Sleep: A Large Case Series." The Permanente Journal, 2019. doi:10.7812/tpp/18-041.
13 Leweke, F M, et al."Cannabidiol Enhances Anandamide Signaling and Alleviates Psychotic Symptoms of Schizophrenia." Translational Psychiatry 2, no. 3 (2012). doi:10.1038/tp.2012.15.
14 Fuss, Johannes, et al."A Runner's High Depends on Cannabinoid Receptors in Mice." Proceedings of the National Academy of Sciences 112, no. 42 (2015): 13105-3108. doi:10.1073/pnas.1514996112.
15 Rey, Alejandro Aparisi, et al. "Biphasic Effects of Cannabinoids in Anxiety Responses: CB1 and GABAB Receptors in the Balance of GABAergic and Glutamatergic Neurotransmission." Neuropsychopharmacology 37, no. 12 (2012): 2624-634. doi:10.1038/npp.2012.123.
16 Peres, Fernanda F., et al."Cannabidiol as a Promising Strategy to Treat and Prevent Movement Disorders?" Frontiers in Pharmacology 9 (2018). doi:10.3389/fphar.2018.00482.
17 Iffland, Kerstin, and Franjo Grotenhermen. "An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies." Cannabis and Cannabinoid Research 2 2, no. 1 (2017): 139-54. doi:10.1089/can.2016.0034.
18 PhD, Catharine Paddock. "Screen Time Disrupts Sleep by Resetting Internal Clocks." Medical News Today. November 29, 2018. Accessed July 31, 2019.
19 Dolezal, Brett A., et al."Interrelationship between Sleep and Exercise: A Systematic Review." Advances in Preventive Medicine. March 26, 2017. Accessed July 31, 2019.