CBD for Insomnia: Can It Help?

That particular 2018 study involved 409 patients who had been diagnosed with insomnia. They each completed a series of over 1000 medical cannabis administration sessions, in which they reported on their insomnia levels before and following the consumption of cannabis flower delivered through various combustion methods. A mobile software app was used to measure which characteristics of the raw flower were associated most with changes in insomnia rates, with CBD coming out ahead of even THC in terms of those benefits ^{2 Effectiveness of Raw, Natural Medical Cannabis Flower for Treating Insomnia under Naturalistic Conditions Vigil, J. M., Stith, S. S., Diviant, J. P., Brockelman, F., Keeling, K., & Hall, B. (2018). Effectiveness of Raw, Natural Medical Cannabis Flower for Treating Insomnia under Naturalistic Conditions. Medicines (Basel, Switzerland), 5(3), 75. https://doi.org/10.3390/medicines5030075 Vigil, J. M., Stith, S. S., Diviant, J. P., Brockelman, F., Keeling, K., & Hall, B.} .

Other studies have looked specifically at CBD for insomnia treatment, producing similar results. A review of CBD sleep studies up to 2017, for instance, concluded that CBD showed promise in improving a variety of sleep conditions, including insomnia ^{3 Cannabis, Cannabinoids, and Sleep: a Review of the Literature Babson, K. A., Sottile, J., & Morabito, D. (2017). Cannabis, Cannabinoids, and Sleep: a Review of the Literature. Current psychiatry reports, 19(4), 23. https://doi.org/10.1007/s11920-017-0775-9 Babson, K. A., Sottile, J., & Morabito, D.} .

In 2019, researchers looked at the potential benefits of CBD for treating anxiety and sleep disturbances. This study included 72 participants with pre-existing anxiety concerns. The patients were each given 25 mg of CBD every day. Patients who complained most about anxiety took CBD capsules in the morning, while those who struggled more with sleep took their dose in the evening. Within the first month of the study, 57 patients reported decreased anxiety, and 48 reported an improvement in sleep ^{4 ). Cannabidiol in Anxiety and Sleep: A Large Case Series Shannon, S., Lewis, N., Lee, H., & Hughes, S. (2019). Cannabidiol in Anxiety and Sleep: A Large Case Series. The Permanente journal, 23, 18–041. https://doi.org/10.7812/TPP/18-041 Shannon, S., Lewis, N., Lee, H., & Hughes, S} .

Smaller-scale studies have further shown improvements in sleep scores when CBD is given to patients with trauma histories, including the study of a ten-year-old girl with posttraumatic stress disorder. She had shown some success with pharmaceutical medication, but the results never seemed to last long and involved undesirable side effects. However, providing her with CBD oil resulted in an enduring reduction in anxiety and a steady improvement in both the quality and quantity of her sleep ^{5 Effectiveness of Cannabidiol Oil for Pediatric Anxiety and Insomnia as Part of Posttraumatic Stress Disorder: A Case Report. Shannon, S., & Opila-Lehman, J. (2016). Effectiveness of Cannabidiol Oil for Pediatric Anxiety and Insomnia as Part of Posttraumatic Stress Disorder: A Case Report. The Permanente journal, 20(4), 16-005. https://doi.org/10.7812/TPP/16-005 Shannon, S., & Opila-Lehman, J} .

One of the recurring themes in CBD for sleep research is the association between treating both anxiety and sleep. This makes sense, as several research studies have linked sleep disturbances to anxiety and other mental health conditions ^{6 Insomnia and Relationship with Anxiety in University Students: A Cross-Sectional Designed Study Choueiry, N., Salamoun, T., Jabbour, H., El Osta, N., Hajj, A., & Rabbaa Khabbaz, L. (2016). Insomnia and Relationship with Anxiety in University Students: A Cross-Sectional Designed Study. PloS one, 11(2), e0149643. https://doi.org/10.1371/journal.pone.0149643 Choueiry, N., Salamoun, T., Jabbour, H., El Osta, N., Hajj, A., & Rabbaa Khabbaz, L.} . The link most likely exists because anxiety can contribute to intrusive thoughts, and physiological responses like experiencing an increased heart rate and restlessness— none of which make for ideal sleeping conditions ^{7 Stressful life events, anxiety sensitivity, and internalizing symptoms in adolescents McLaughlin, K. A., & Hatzenbuehler, M. L. (2009). Stressful life events, anxiety sensitivity, and internalizing symptoms in adolescents. Journal of abnormal psychology, 118(3), 659–669. https://doi.org/10.1037/a0016499 McLaughlin, K. A., & Hatzenbuehler, M. L.} .

In fact, research has found insomnia to be a comorbidity in a variety of psychiatric disorders. Up to two-thirds of patients with social anxiety will also experience insomnia, and insomnia is one of the diagnostic criterion for major depressive disorder ^{8 Comorbid Insomnia and Psychiatric Disorders: An Update. Khurshid K. A. (2018). Comorbid Insomnia and Psychiatric Disorders: An Update. Innovations in clinical neuroscience, 15(3-4), 28–32. Khurshid K. A} .

Given all this, CBD may benefit patients with insomnia because of how it works to treat and reduce their underlying anxiety. Several research studies have pointed to CBD as a potential treatment option for anxiety disorders, including a 2015 review of existing data that found strong evidence in support of CBD for treating anxiety ^{9 Cannabidiol as a Potential Treatment for Anxiety Disorders. Blessing, E. M., Steenkamp, M. M., Manzanares, J., & Marmar, C. R. (2015). Cannabidiol as a Potential Treatment for Anxiety Disorders. Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics, 12(4), 825–836. https://doi.org/10.1007/s13311-015-0387-1 Blessing, E. M., Steenkamp, M. M., Manzanares, J., & Marmar, C. R} . Even the NIH notes CBD has shown therapeutic efficacy in treating anxiety and stress in animals and small human trials ^{11 Potential effects of cannabidiol as a wake-promoting agent Murillo-Rodríguez, E., Sarro-Ramírez, A., Sánchez, D., Mijangos-Moreno, S., Tejeda-Padrón, A., Poot-Aké, A., Guzmán, K., Pacheco-Pantoja, E., & Arias-Carrión, O. (2014). Potential effects of cannabidiol as a wake-promoting agent. Current neuropharmacology, 12(3), 269–272. https://doi.org/10.2174/1570159X11666131204235805 Murillo-Rodríguez, E., Sarro-Ramírez, A., Sánchez, D., Mijangos-Moreno, S., Tejeda-Padrón, A., Poot-Aké, A., Guzmán, K., Pacheco-Pantoja, E., & Arias-Carrión, O.} .