By Ian Hamilton
Problems with sleep are common.
In recent research, 48% of UK adults said sleeping badly had a negative effect on their mental health. For teenagers, this proportion was significantly higher – 66%.
The large number of people experiencing sleep problems makes for an attractive market. Some companies have seized the opportunity to provide remedies, including several manufacturers of cannabis products.
Changes to the way cannabis is regulated in many countries, including the UK, have helped the boom in cannabis products, with more people able to access these types of offerings – even if the cannabis compounds that can be used in sleep products in some countries are more limited than in others. In the US, where cannabis is fully legal in many states, California-based Ganja Goddess reported more than a sevenfold increase in revenue for its cannabis sleep products during the first year of the COVID pandemic.
But what is the evidence that cannabis products can help people get a better night’s sleep?
Cannabis and sleep
Sleep disturbance is a common feature of withdrawal from cannabis use, indicating there may well be a relationship between cannabis use and sleep. But we still don’t have a clear understanding of the mechanisms in the brain involved in this relationship.
The effects of cannabis are due to a group of chemicals in the drug called cannabinoids. These include cannabidiol (CBD), cannabinol (CBN) and tetrahydrocannabinol (THC). THC is the psychoactive substance in cannabis. CBN and CBD don’t cause you to get high in the same way.
In the UK, CBD products are available legally, providing they don’t contain more than 0.2% THC. Retailers and suppliers make all kinds of assertions about the benefits of CBD products, including how CBD can improve sleep. There is some evidence to support these claims, but this is mainly based on animal and human observational studies rather than randomised control trials, where comparisons can be made between CBD and a placebo.
Although not legal in the UK, CBN is one of the main compounds contained in commercial cannabis sleep products, with more and more CBN formulations coming onto the market. A recent review sought to find out whether CBN really does improve sleep.
The review included studies going back as far as the 1940s. These mainly involved administering CBN to people and comparing the self-reported quality of their sleep with participants in a control group who had not received the drug.
However, the author of the review, Jamie Corroon, noted several problems with the research to date, including the fact that participants tended to be male and white. This male-centric perspective is not unique to research on cannabis; it’s known to be a problem more broadly in research.
Corroon was also critical of the lack of structured, evidence-based questionnaires used to assess sleep in the studies. He concluded there is insufficient published evidence to support any assertions that these products improve sleep, noting: “Individuals seeking cannabis-derived sleep aids should be skeptical of manufacturers’ claims of sleep-promoting effects.”
Other factors to consider
The review concentrated primarily on sleep outcomes associated with pure medical-grade CBN. This doesn’t necessarily reflect the way most people use cannabis or cannabis products. Most will either smoke a joint, or ingest a liquid or pill if they’re using a commercially supplied product.
The type of commercial product, the way it’s administered and the dose are all known to affect sleep. Notably, the dose of CBN in many commercial products is lower than what was tested in the majority of the studies in the review.
While most commercial cannabis sleep products contain less than 1% THC (if any), a cannabis joint will contain hundreds of compounds, including THC. And combining THC with CBN is thought to be a sedative. Pure CBN would therefore not have the same effect it has in real life when consumed with THC.
Although the review found a lack of evidence to support the sedative properties of CBN, scientists have found that medicinal cannabis containing THC and CBD can improve sleep for people with chronic pain. This benefit decreases, however, for people using these products regularly, as their tolerance to medicinal cannabis builds.
Further, while it’s useful to have a review that focuses on sleep and cannabis, it doesn’t capture the varied reasons many people use cannabis or products containing cannabis. Many people use cannabis to manage physical problems such as muscle and joint pain, or psychological issues like anxiety or stress, rather than as a sleep aid. It’s logical that alleviating these symptoms will improve sleep.
One example is people experiencing vivid nightmares as a result of post-traumatic stress disorder (PTSD). Nabilone, a synthetic cannabinoid, has proved to be beneficial in suppressing these types of nightmares, which could improve the quality of sleep for this group of people suffering from PTSD. So you can see why it’s difficult to untangle the effects of cannabis on sleep.
We need better research
As with many issues in research, there isn’t a neat answer to how effective cannabis is in improving sleep. How the drug is prepared, the way it’s taken and the person’s expectations are just some important factors that may influence the outcome.
And, as with all health products, there is a risk of side-effects. A recent review of medicinal cannabis products used for sleep found a substantial increase in the risk of developing dizziness, for example.
What is clear is when millions of people have a problem with sleep, there will be a commercial incentive to make money by offering remedies. We need more rigorous research to investigate any associations between cannabis and sleep, and whether these products work.
Ian Hamilton is Associate Professor of Addiction at the University of York in Canada.
The Conversation arose out of deep-seated concerns for the fading quality of our public discourse and recognition of the vital role that academic experts could play in the public arena. Information has always been essential to democracy. It’s a societal good, like clean water. But many now find it difficult to put their trust in the media and experts who have spent years researching a topic. Instead, they listen to those who have the loudest voices. Those uninformed views are amplified by social media networks that reward those who spark outrage instead of insight or thoughtful discussion. The Conversation seeks to be part of the solution to this problem, to raise up the voices of true experts and to make their knowledge available to everyone. The Conversation publishes nightly at 9 p.m. on FlaglerLive.
The dude says
Reefer Madness. was a work of fiction created as propaganda.
It’s time to free the weed already.
Just tell the magats that it will cure COVID and it will be legalized faster than you can say “hydroxychloroquine”…
CBD industry is it’s own miracle cure of BS for everything. A stoner sitting on the couch taking another toke/hit of their recreational drug and then the thought happens, what if the stoner could cure the world with another toke or bong hit, or at least make money selling that fantasy to victims who are actually desperate for a cure ? Ever look at those selling anything vape or CBD ? Those folks aren’t experts at anything besides strip mall, brick & mortar retailing. CBD is not medical marijuana, more like the hot dog meat of Cannabis ? Use anything of the plant and sell with a claim that it cures everything. Reality of it all, if what anyone has that CBD is touted to cure, that means there is no cure. It’s like miracle eye drops for a cataract or the miracle cure for prostate emlargment, just another lie & deceit. The human race is full of snake oil salespeople & shell games, CBD is just yet another victimization in anyone’s lifetime to avoid. The criminals perpetuating that fraud & abuse need to handled appropriately for what they are. Tobacco & alcohol were lies, imagine that CBD is no different. Wake up, they’re only tools of deceit that may alleviate a craving or symptom momentarily, the substances don’t last and nothing was cured. Pain management is the soft term for it.
The author is an “Associate Professor of Addiction”, that says it all. Therefore, the author is predisposed to write in opposition to Cannabis based products due to his position. His research is antiquated and skewed. There are probably 10 times the number of research studies showing the benefits of Cannabis products that actually greatly assist patients in a number of neurological/psychological areas. And heaven forbid, Cannabis is being extensively used to help those with addictions to get off of the pain meds and other substances. Please don’t believe every “anti” Cannabis article that you read. Just because someone has a “title” behind their name, does not mean that they know what the facts are in any situation. In other words don’t believe every dang thing you read on the internet! If you have an advanced degree and have conducted any type of research, you have hopefully been taught the difference between objective, unbiased research and on the other hand research that can be skewed in minute ways just by the use of 2 or 3 leading, biased, or poorly worded questions on a survey. It can be complicated to sort it all out if you aren’t aware of the sneaky and manipulative things that some quote-unquote “researchers” will try and use to support their intended conclusions. After you learn the ropes, your stink-o-meter activates when you read articles like these. All I have to say is pfft, give me a break. After all Mr. Hamilton, your own government of Canada legalized Cannabis. Have an ax to grind?