How does cannabis use affect insomnia?

It is not for nothing that more and more insomniacs are turning to cannabis use. They toss and turn, count sheep and negotiate (“If I can fall asleep before 3am, I’ll get at least four hours of sleep”). Ten minutes becomes half an hour. Half an hour becomes an hour. Before you know it, the sun is rising. Insomnia is its own agony, but now that the stigma of cannabis is slowly dissipating, more and more people are seeking its therapeutic sedative properties.

Acute insomnia usually lasting only a night or two – affects almost all of us. It is usually triggered by a stressful external event. In contrast, chronic insomnia, which involves regularly spending three or more restless nights a week over the course of a month, affects one billion people worldwide. Interestingly, insomnia affects women twice as much as men. And it does not improve with age. Half of all elderly people suffer from insomnia on a regular basis. Beyond the sleepiness and irritability of the next day, chronic insomnia is associated with serious long-term health problems: cardiovascular disease, diabetes and obesity.

Causes of Insomnia

Insomniacs may suffer from primary or secondary insomnia :

• Primary insomnia is an autonomous condition – it has not been caused by another health condition.
• Secondary insomnia is associated with a secondary health condition or substance (e.g. depression, pain, alcohol or a prescription drug).

The number one cause of insomnia is stress. While we can’t control all the external stressors in our lives, there are healthy ways to manage stress. Dr. Rachna Patel, a physician in Walnut Creek, California, who has personally dealt with years of insomnia, notes that anything you can do to reduce stress will also help you sleep better. Jog. Swim. Eat better. Do relaxation exercises or meditate. Even if you still need a sleep aid like cannabis, lifestyle changes will improve your overall health!

Traditional treatment options for insomnia

Before trying any medication, consider lifestyle changes such as a regular sleep schedule, more exercise and healthier eating. Some patients have so much trouble sleeping that they need a drug to help them.

Prescription drugs such as Zolpidem (Ambien) and Zaleplon (Sonata) have gained popularity over the years, but they may not be all that effective. A study by the National Institutes of Health found that sleeping pills add an average of only 11 minutes of sleep and shorten the time to sleep by only 13 minutes. Worse, they can have serious side effects and health consequences. According to the Department of Health and Human Services, over the past two decades, the number of emergency room visits related to the prescription of sleep aids has increased dramatically.

Similarly, benzodiazepines such as Xanax and Valium, which are approved for sleep, are highly addictive and potentially dangerous. According to the Centers for Disease Control and Prevention (CDC), in 2013, benzodiazepines were involved in 30% of fatal overdoses, second only to opioids. Some also claim that natural supplements, such as melatonin, valerian root, lemon balm or chamomile, help people fall asleep.

Can cannabis treat insomnia?

Dr Patel turned to cannabis after being prescribed Ambien. Frightened by the potential side effects, she discovered that research validated what cannabis users had long suspected: cannabis helps you sleep.

Here is more evidence:

• Fall asleep more easily. As early as 1973, research showed that subjects fell asleep more quickly after ingesting THC. More recently, a 2013 study on healthy subjects confirmed the earlier findings.
• Sleep better and longer. Early studies demonstrated the effectiveness of cannabinoids in facilitating sleep. A study on THC showed that subjects had fewer interruptions during the night and woke up less often in the first half of the night.
• Enjoy deeper sleep. Cannabis can have a positive impact on the sleep cycle. Studies show that THC can promote deep sleep. Why is this important? Because scientists believe that deep sleep plays a vital role in our body’s natural restoration process.
• Better breathing during sleep. About 17% of men and 9% of women regularly have breathing problems when they sleep – a condition called sleep apnoea – and most of these are never diagnosed. However, preliminary research published in January 2013 by Frontiers in Psychology shows that cannabis could help people breathe better while they sleep. Who knows? Maybe one day sleep apnoea sufferers will be able to swap their CPAP mask for a THC-infused brownie (but don’t count on Medicare to cover the cost yet).

How does cannabidiol (CBD) affect sleep?

The evidence for the effectiveness of cannabidiol, or CBD, as a sleep aid is conflicting. In one study, CBD – which is not intoxicating – appears to be effective as an “arousal agent”, meaning it can make you more alert, which is the opposite of what an insomniac wants. However, other study participants reported that ingesting CBD-rich extracts or tinctures a few hours before bedtime had a relaxing effect that allowed them to sleep better at night. According to Project CBD, some patients with sleep disorders report that ingesting a CBD-rich tincture or extract a few hours before bedtime has a balancing effect that facilitates a good night’s sleep.

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