Original Blog On Medium
Name a sleep aid and I can describe the specific type of hangover it gives me. The morning after overdoing melatonin by even five milligrams, I wake up to pressure at my temples and mental fog so thick that conversation is difficult. Post-Benadryl fatigue feels as if each of my cells are begging me to get back in bed. If I take too much Ambien, it’s like I never woke up at all: I float around half-sentient, reanimating just in time for dinner.
Enter cannabidiol, or CBD, one of many chemical compounds produced by cannabis, and the latest darling of the wellness world.
CBD is all the rage right now, with a former Coca-Cola exec declaring it the “new avocado toast” thanks to its popularity among millennials. It’s estimated that the market for CBD products will hit $22 billion in the next four years. Unlike another well-known cannabis compound, tetrahydrocannabinol (better known as THC), CBD is non-psychoactive, meaning it won’t get you high. Many of us use it to calm down, and some of us take it to fall asleep.
I was unmoved by the CBD craze until last year, when a sample of hemp extract oil crossed my desk at work and I started experimenting with a dropperful or two in the evening. The calming effect was subtle, but noticeable, and I was falling asleep more easily. The peppermint-flavored oil became part of my nighttime routine. Taking it was a habit, and the taste became a signal that it was time for me to start getting sleepy. I wasn’t sure exactly how it was working, but it seemed like it was.
Many of my CBD-taking friends say they also use the compound for better sleep, and that they found their way to CBD after other unsavory sleep aid experiences like mine. “I used to take melatonin, but it gives me the craziest dreams,” says Madeleine Kerr, 24. “Super vivid and I always wake up confused. I definitely wake up feeling more refreshed with CBD and don’t get that foggy feeling.”
Hannah Rimm, 25, says she is taking CBD every night with her psychiatrist’s support. “I’ve been on a million sleeping pills — Lunesta made me super exhausted all the time, Ambien gave me crazy dreams, Remeron made me gain 20 pounds in a month,” she tells me. With CBD, “I’ve been sleeping through the night much more and it feels less like a drugged sleep… My psychiatrist said she doesn’t actually know the science well enough to comment because there haven’t been enough studies, but she said if it works, keep taking it and keep her updated.”
“My working hypothesis is that they’re actually sleeping better because their anxiety’s better.”
Evidence in favor of CBD as a sleep aid is stronger on the anecdotal side than the clinical, but there’s a growing body of research to support CBD’s anti-anxiety effects. It’s thought that the compound acts on cannabinoid receptors in the brain that regulate anxiety-related behaviors as part of the body’s endocannabinoid system, which is involved in regulating a wide range of physiological and cognitive functions. The literature is much scarcer when it comes to sleep. A study of 27 volunteers published earlier this year in the journal Frontiers in Pharmacology found that cannabidiol had no acute effects on the volunteers’ sleep-wake cycles, and the authors called for further research. In a review of studies on cannabinoids and sleep published last year in Current Psychiatry Reports, the authors stated that CBD may have “therapeutic potential for the treatment of insomnia,” but that “[r]esearch on cannabis and sleep is in its infancy and has yielded mixed results.”
“It’s just an area we haven’t delved into very well yet,” says Aimée Shunney, a naturopathic doctor and medical advisor to CBD manufacturer, CV Sciences. Often, “people don’t sleep because they’re anxious or because they can’t get their brains to quiet down,” and it’s this particular kind of sleep problem that responds best to CBD, she tells me. “My working hypothesis is that they’re actually sleeping better because their anxiety’s better.”
“As a healthcare professional, I’ve seen enough anecdotally that I believe it,” registered dietitian nutritionist and holistic cannabis practitioner Janice Newell Bissex says. “I have [patients] who used to use Ambien and now can find a result using CBD… But, I still want more studies.”
Bissex says CBD does not work for everyone, and appears to produce different effects in different people. Those who find it stimulating, for example, should take it in the morning rather than later in the day. Nor does the same dose work for every user, she adds, which is why both she and Shunney advise their patients to “start low and go slow” with dosing. Bissex recommends “full-spectrum” or “whole-plant” hemp extract, which contains CBD and a range of other cannabis compounds. Full-spectrum hemp extracts do contain trace amounts of THC, but typically not enough to trigger a positive result in urine or blood drug tests. (You’d have to consume massive quantities).
Bissex also stresses the importance of purchasing wisely. As more sellers jump on the CBD bandwagon, a confusing regulatory landscape, and the compound’s hazy legality mean it’s buyer beware when it comes to shopping for CBD, which may be inaccurately labeled or even contaminated.
In search of a sleep expert’s perspective, I call Jennifer Martin, a clinical psychologist, board-certified behavioral sleep medicine specialist, and associate professor at the University of California, Los Angeles (UCLA). She focuses on using cognitive behavioral therapy to improve her patients’ sleeping habits, but says they’re bringing up CBD more and more these days. “People are always looking for something that they can do to help them sleep better, [that] doesn’t have side effects, [that] feels like it’s natural,” she tells me. She cautions that just because something is “natural” doesn’t mean it’s safe or benign. Research ndicates that CBD has a favorable safety profile, but more study of possible side effects and drug interactions is needed.
“We know that about 30 percent of people with insomnia actually have a great response to placebos,” she adds. Taking a sleep aid like CBD, she explains, may help people feel as if they’ve taken action to “protect themselves against this threat of not getting a good night of sleep,” which becomes a self-fulfilling prophecy: When they stop worrying about the threat of poor sleep, they sleep better. “Now I’m ruining this for you, right?” she asks.
I’ve considered the role the placebo effect likely plays in my appreciation of CBD, and know that placebos can work even when patients know they’re taking one. While Martin doesn’t discount the possibility that CBD has other effects on sleep, her account jibes with how I use it: as a note to self to power down. And as Martin points out, that could also come in the form of meditating, listening to music, or whatever else gets me in the headspace for bed.
Martin’s emphasis on pre-bed rituals has me assessing my own. I’ve written much of this story both in bed and directly before bed, expecting to fall asleep moments after I close my laptop, open my eyes seven hours later, and pick up my to-do list where I left off. Insomnia is a serious disorder, and solutions aren’t clear-cut. More than insomnia, though, what I struggle with is the pressure to be on within moments of waking up, and to be asleep within moments of deciding it’s time for bed.
I know I’m not alone. Many of us extend the productive hours of our days in both directions: reaching for our phones to check email first thing in the morning, or working until bedtime instead of savoring a cup of chamomile tea.
Whether part placebo or not, CBD provides me with a calming effect in minimal time, and that’s valuable to me. Still, while I don’t plan on overhauling my bedtime routine, I’m considering adding other steps to it, like initiating a cutoff time for checking my phone. It’s on my to-do list. Right after stocking up on more CBD.