Cannabidiol in Anxiety and Sleep: A Large Case Series Cannabidiol (CBD) is one of many cannabinoid compounds found in cannabis. It does not appear to alter consciousness or trigger a “high.” A It is no surprise that oftentimes, we all find it hard to relax. With the stresses that we all experience on the daily it can be difficult to wind down, shut off and take time for ourselves. But it is so important to find the time, as giving yourself space to release tension from the day is essential for both your phys By now you already know that high-quality sleep is critical for physical and mental recovery. Yet, many of us struggle to get enough rest. Finding natural products to help can be confusing, as it can be hard to know where to start. With more supplements becoming available, the task becomes even more difficult. For thos
Cannabidiol in Anxiety and Sleep: A Large Case Series
Cannabidiol (CBD) is one of many cannabinoid compounds found in cannabis. It does not appear to alter consciousness or trigger a “high.” A recent surge in scientific publications has found preclinical and clinical evidence documenting value for CBD in some neuropsychiatric disorders, including epilepsy, anxiety, and schizophrenia. Evidence points toward a calming effect for CBD in the central nervous system. Interest in CBD as a treatment of a wide range of disorders has exploded, yet few clinical studies of CBD exist in the psychiatric literature.
To determine whether CBD helps improve sleep and/or anxiety in a clinical population.
A large retrospective case series at a psychiatric clinic involving clinical application of CBD for anxiety and sleep complaints as an adjunct to usual treatment. The retrospective chart review included monthly documentation of anxiety and sleep quality in 103 adult patients.
Main Outcome Measures
Sleep and anxiety scores, using validated instruments, at baseline and after CBD treatment.
The final sample consisted of 72 adults presenting with primary concerns of anxiety (n = 47) or poor sleep (n = 25). Anxiety scores decreased within the first month in 57 patients (79.2%) and remained decreased during the study duration. Sleep scores improved within the first month in 48 patients (66.7%) but fluctuated over time. In this chart review, CBD was well tolerated in all but 3 patients.
Cannabidiol may hold benefit for anxiety-related disorders. Controlled clinical studies are needed.
The Cannabis plant has been cultivated and used for its medicinal and industrial benefits dating back to ancient times. Cannabis sativa and Cannabis indica are the 2 main species.1 The Cannabis plant contains more than 80 different chemicals known as cannabinoids. The most abundant cannabinoid, tetrahydrocannabinol (THC), is well known for its psychoactive properties, whereas cannabidiol (CBD) is the second-most abundant and is nonpsychoactive. Different strains of the plant are grown containing varying amounts of THC and CBD. Hemp plants are grown for their fibers and high levels of CBD that can be extracted to make oil, but marijuana plants grown for recreational use have higher concentrations of THC compared with CBD.2 Industrial hemp must contain less than 0.3% THC to be considered legal, and it is from this plant that CBD oil is extracted.3
Many different cultures have used the Cannabis plant to treat a plethora of ailments. Practitioners in ancient China targeted malaria, menstrual symptoms, gout, and constipation. During medieval times, cannabis was used for pain, epilepsy, nausea, and vomiting, and in Western medicine it was commonly used as an analgesic.4,5 In the US, physicians prescribed Cannabis sativa for a multitude of illnesses until restrictions were put in place in the 1930s and then finally stopped using it in 1970 when the federal government listed marijuana as a Schedule I substance, claiming it an illegal substance with no medical value. California was the first state to go against the federal ban and legalize medical marijuana in 1996.6 As of June 2018, 9 states and Washington, DC, have legalized recreational marijuana, and 30 states and Washington, DC, allow for use of medical marijuana.7 The purpose of the present study is to describe the effects of CBD on anxiety and sleep among patients in a clinic presenting with anxiety or sleep as a primary concern.
CBD has demonstrated preliminary efficacy for a range of physical and mental health care problems. In the decade before 2012, there were only 9 published studies on the use of cannabinoids for medicinal treatment of pain; since then, 30 articles have been published on this topic, according to a PubMed search conducted in December 2017. Most notable was a study conducted at the University of California, San Diego’s Center for Medicinal Cannabis Research that showed cannabis cigarettes reduced pain by 34% to 40% compared with placebo (17% to 20% decrease in pain).8 In particular, CBD appears to hold benefits for a wide range of neurologic disorders, including decreasing major seizures. A recent large, well-controlled study of pediatric epilepsy documented a beneficial effect of CBD in reducing seizure frequency by more than 50%.9 In addition to endorphin release, the “runner’s high” experience after exercise has been shown to be induced in part by anandamide acting on CB1 receptors, eliciting anxiolytic effects on the body.10 The activity of CBD at 5-HT1A receptors may drive its neuroprotective, antidepressive, and anxiolytic benefits, although the mechanism of action by which CBD decreases anxiety is still unclear.11 CBD was shown to be helpful for decreasing anxiety through a simulated public speaking test at doses of 300 mg to 600 mg in single-dose studies.12–14 Other studies suggest lower doses of 10 mg/kg having a more anxiolytic effect than higher doses of 100 mg/kg in rats.15 A crossover study comparing CBD with nitrazepam found that high-dose CBD at 160 mg increased the duration of sleep.16 Another crossover study showed that plasma cortisol levels decreased more significantly when given oral CBD, 300 to 600 mg, but these patients experienced a sedative effect.17 The higher doses of CBD that studies suggest are therapeutic for anxiety, insomnia, and epilepsy may also increase mental sedation.16 Administration of CBD via different routes and long-term use of 10 mg/d to 400 mg/d did not create a toxic effect on patients. Doses up to 1500 mg/d have been well tolerated in the literature.18 Most of the research done has been in animal models and has shown potential benefit, but clinical data from randomized controlled experiments remain limited.
Finally, the most notable benefit of cannabis as a form of treatment is safety. There have been no reports of lethal overdose with either of the cannabinoids and, outside of concerns over abuse, major complications are very limited.19 Current research indicates that cannabis has a low overall risk with short-term use, but more research is needed to clarify possible long-term risks and harms.
Given the promising biochemical, physiologic, and preclinical data on CBD, a remarkable lack of randomized clinical trials and other formal clinical studies exist in the psychiatric arena. The present study describes a series of patients using CBD for treatment of anxiety or sleep disturbances in a clinical practice setting. Given the paucity of data in this area, clinical observations can be quite useful to advance the knowledge base and to offer questions for further investigation. This study aimed to determine whether CBD is helpful for improving sleep and/or anxiety in a clinical population. Given the novel nature of this treatment, our study also focused on tolerability and safety concerns. As a part of the evolving legal status of cannabis, our investigation also looked at patient acceptance.
Design and Procedures
A retrospective chart review was conducted of adult psychiatric patients treated with CBD for anxiety or sleep as an adjunct to treatment as usual at a large psychiatric outpatient clinic. Any current psychiatric patient with a diagnosis by a mental health professional (psychiatrist, psychiatric nurse practitioner, or physician assistant) of a sleep or anxiety disorder was considered. Diagnosis was made by clinical evaluation followed by baseline psychologic measures. These measures were repeated monthly. Comorbid psychiatric illnesses were not a basis for exclusion. Accordingly, other psychiatric medications were administered as per routine patient care. Selection for the case series was contingent on informed consent to be treated with CBD for 1 of these 2 disorders and at least 1 month of active treatment with CBD. Patients treated with CBD were provided with psychiatric care and medications as usual. Most patients continued to receive their psychiatric medications. The patient population mirrored the clinic population at large with the exception that it was younger.
Nearly all patients were given CBD 25 mg/d in capsule form. If anxiety complaints predominated, the dosing was every morning, after breakfast. If sleep complaints predominated, the dosing was every evening, after dinner. A handful of patients were given CBD 50 mg/d or 75 mg/d. One patient with a trauma history and schizoaffective disorder received a CBD dosage that was gradually increased to 175 mg/d.
Often CBD was employed as a method to avoid or to reduce psychiatric medications. The CBD selection and dosing reflected the individual practitioner’s clinical preference. Informed consent was obtained for each patient who was treated and considered for this study. Monthly visits included clinical evaluation and documentation of patients’ anxiety and sleep status using validated measures. CBD was added to care, dropped from care, or refused as per individual patient and practitioner preference. The Western Institutional Review Board, Puyallup, WA, approved this retrospective chart review.
Setting and Sample
Wholeness Center is a large mental health clinic in Fort Collins, CO, that focuses on integrative medicine and psychiatry. Practitioners from a range of disciplines (psychiatry, naturopathy, acupuncture, neurofeedback, yoga, etc) work together in a collaborative and cross-disciplinary environment. CBD had been widely incorporated into clinical care at Wholeness Center a few years before this study, on the basis of existing research and patient experience.
The sampling frame consisted of 103 adult patients who were consecutively treated with CBD at our psychiatric outpatient clinic. Eighty-two (79.6%) of the 103 adult patients had a documented anxiety or sleep disorder diagnosis. Patients with sole or primary diagnoses of schizophrenia, posttraumatic stress disorder, and agitated depression were excluded. Ten patients were further excluded because they had only 1 documented visit, with no follow-up assessment. The final sample consisted of 72 adult patients presenting with primary concerns of anxiety (65.3%; n = 47) or poor sleep (34.7%; n = 25) and who had at least 1 follow-up visit after CBD was prescribed.
Main Outcome Measures
Sleep and anxiety were the targets of this descriptive report. Sleep concerns were tracked at monthly visits using the Pittsburg Sleep Quality Index. Anxiety levels were monitored at monthly visits using the Hamilton Anxiety Rating Scale. Both scales are nonproprietary. The Hamilton Anxiety Rating Scale is a widely used and validated anxiety measure with 14 individual questions. It was first used in 1959 and covers a wide range of anxiety-related concerns. The score ranges from 0 to 56. A score under 17 indicates mild anxiety, and a score above 25 indicates severe anxiety. The Pittsburg Sleep Quality Index is a self-report measure that assesses the quality of sleep during a 1-month period. It consists of 19 items that have been found to be reliable and valid in the assessment of a range of sleep-related problems. Each item is rated 0 to 3 and yields a total score from 0 to 21. A higher number indicates more sleep-related concerns. A score of 5 or greater indicates a “poor sleeper.”
Side effects and tolerability of CBD treatment were assessed through spontaneous patient self-reports and were documented in case records. Any other spontaneous comments or complaints of patients were also documented in case records and included in this analysis.
Deidentified patient data were evaluated using descriptive statistics and plotted graphically for visual analysis and interpretation of trends.
The average age for patients with anxiety was 34 years (range = 18–70 years) and age 36.5 years for patients with sleep disorders (range = 18–72 years). Most patients with an anxiety diagnosis were men (59.6%, 28/47), whereas more sleep-disordered patients were women (64.0%, 16/25). All 72 patients completed sleep and anxiety assessments at the onset of CBD treatment and at the first monthly follow-up. By the second monthly follow-up, 41 patients (56.9%) remained on CBD treatment and completed assessments; 27 patients (37.5%) remained on CBD treatment at the third monthly assessment.
Table 1 provides means and standard deviations for sleep and anxiety scores at baseline and during the follow-up period for adults taking CBD. Figure 1 graphically displays the trend in anxiety and sleep scores over the study period. On average, anxiety and sleep improved for most patients, and these improvements were sustained over time. At the first monthly assessment after the start of CBD treatment, 79.2% (57/72) and 66.7% (48/72) of all patients experienced an improvement in anxiety and sleep, respectively; 15.3% (11/72) and 25.0% (18/72) experienced worsening symptoms in anxiety and sleep, respectively. Two months after the start of CBD treatment, 78.1% (32/41) and 56.1% (23/41) of patients reported improvement in anxiety and sleep, respectively, compared with the prior monthly visit; again, 19.5% (8/41) and 26.8% (11/41), respectively, reported worsening problems as compared with the prior month.
Does CBD relax you?
It is no surprise that oftentimes, we all find it hard to relax. With the stresses that we all experience on the daily it can be difficult to wind down, shut off and take time for ourselves.
But it is so important to find the time, as giving yourself space to release tension from the day is essential for both your physical and mental wellbeing.
Relaxation looks different for everyone, but whether it is crashing on the sofa after a long day, grabbing drinks with a friend or taking your dog for a walk, it is essential for our mental wellbeing.
With the last year having been more stressful than ever, it is evermore essential to find time to relax. In TRIP’s 2021 Survey it was found that 7 out of 10 people had the most stressful year of their life, with 70% of people indicating that they had the worst sleep of their lives. Many people found it hard to relax due to the stresses of everyday life, such as financial issues, not seeing friends and spending too much time on screens.
Now more than ever people are looking for easy ways to relax and shake off the day (and the year!). There are so many different strategies that we can take to relax, from finding time to meditate, doing some exercise and moving our bodies to journaling and spending time in nature.
You may have been hearing aboutCBD everywhere and anywhere for a while now, and the hype around it is still growing. Hailed for its calming properties, many users of CBD integrate into their daily rituals to help them de-stress and find their calm. Whether it is a few drops of CBD oilto start your day, a CBD Drink before a big meeting or a can of TRIP to wind down in the evening, many use CBD daily to help them relax.
CBD is short for Cannabidiol, and is one of the many active compounds found in hemp plants. Unlike THC it is not psychoactive, so can’t get you high and is mostly known for its calming effects. Used commonly in the wellness world for its wide range of benefits.
Many CBD fans rave about CBD’s calming effects and claim that it helps them relax. Whether they are feeling anxious, wound up from the day or just looking to find some calm in the everyday chaos.
CBD (Canndabidiol) is well known for its calming properties, but how does it work?
CBD works with a system in our body called our Endocannabinoid system (our ECS), a system of nerves and receptors that works to help our body stay in balance. CBD helps to regulate this system, which can affect our levels of stress and anxiety, can help to alleviate pain, soothe inflammation and even support our immune systems. It has also been said that CBD can help promote better sleep, reduce fatigue and improve focus!
When trying to relax, we need to soothe stress, release tension and rest. Everyday stress, long hours at the desk staring at screens and trouble sleeping can be big barriers to relaxation.
When trying to restore this balance, CBD can be a very helpful tool, helping us to reduce anxiety, inflammation and tension that we may have in our body, while also helping us to wind down ahead of bedtime and gain a good night’s sleep – essential for wellbeing.
If you are struggling to relax, CBD may be for you. Whether that is with a CBD oil, a CBD drink or even CBD capsules you can create your own ritual. The process of taking CBD can itself become relaxing, for example when you place a few drops of Wild Mint CBD Oil under your tongue and hold for a minute, that minute gives you a moment of headspace and calmness to reflect and take a moment for yourself.
Or perhaps you might grab an Elderflower Mint CBD drink in the evening instead of a glass of wine, and as you are sipping on it find some time to breathe, relax and take a break.
Does CBD Make You Sleepy?
By now you already know that high-quality sleep is critical for physical and mental recovery. Yet, many of us struggle to get enough rest. Finding natural products to help can be confusing, as it can be hard to know where to start. With more supplements becoming available, the task becomes even more difficult. For those seeking a safe and natural solution to help them sleep, finding natural products can be time consuming and confusing.
As CBD has become more widely available, more people have started to integrate it into their daily lives, particularly to see if CBD can help them sleep. At Champions + Legends we take the science of CBD seriously. We get these types of questions a lot and we’re here to help you answer the question: does CBD make you sleepy? Furthermore, can CBD oil help you sleep better and more deeply?
Introduction to CBD
CBD is one of one of at least 120 identified plant compounds, known generally as cannabinoids, which exist in the hemp plant. It is non-psychoactive, so it won’t get you “high” like THC does. Instead, it has shown a variety of health benefits without causing negative effects in most.
CBD works by interacting with receptors in the body’s Endocannabinoid System (ECS) to help enhance its responses to factors such as stress, pain, inflammation, and fatigue. A few potential benefits of CBD include:
- Supporting healthy sleep cycles
- Helps with managing and recovering from inflammation and pain
- Improved blood flow and circulation
- Relief from everyday stress
- Sense of calm or focus
- Improved athletic performance
Does CBD make you sleepy?
As to whether CBD oil can make you sleepy, it’s still open for discussion. Although more research is needed to definitely answer whether or not there is a direct link between CBD and feeling sleepy, research has shown that CBD can support better sleep.
Feelings of relaxation and the diminished anxiety brought on by a regular evening CBD routine can be effective as a sleep aid for people seeking to calm down and relax before bed.
Does CBD make you sleepy during the day?
No research has shown that that CBD makes you sleepy during the day. CBD’s ability to support feelings of calm can lead to improved focus and well being, whether you’re gearing up for a big day at work or preparing for athletic training or competition.
Studies (Blessing et al, 2015; Berger et al, 2009) show that CBD’s anxiety-reducing properties make it a useful tool to manage stress levels, boost focus, and improve mental clarity, all without experiencing drowsiness or lethargy. CBD also supports increased serotonin levels in the brain and can help decrease levels of cortisol, a natural byproduct of stress that can have harmful effects on the body.
CBD vs THC for Sleep
Some cannabis users depend on THC as a sleep aid, however, evidence suggests that CBD has definite advantages over THC (and other sleep aids) when it comes to helping you get a good night’s rest. CBD does not have intoxicating properties like THC, so it won’t cause any negative effects like excessive sedation, drowsiness or feelings of fatigue.
Additionally, CBD has been shown to be a safer alternative to over-the-counter and prescription sleep medications, which can cause undesirable side effects and lead to dependence. Research studies (Iffland & Grotenherman 2015) have shown that CBD is safe to use for sleep, with no major side effects.
THC can also have other negative effects on sleep cycles as well. According to a 2008 study (Schierenbeck et al, 2008) ingesting marijuana strains with higher levels of THC typically reduces the amount of REM sleep you get. This is key because REM sleep is extremely important for healthy cognitive and immune functioning, and ultimately using THC as a sleep aid could impair your sleep quality over the long term.
Can CBD help with sleeping disorders?
For many, trouble sleeping goes beyond difficulties letting go of the day and relaxing or getting sustained deep and restful sleep. Many suffer from more severe sleep disorders like insomnia, which can have a significant impact on their quality of life. In many cases people struggling with sleep disorders don’t want to resort to medication or intoxicants, leaving them to wonder: can CBD help with sleeping disorders and other serious sleep issues?
In addition to supporting better sleep in general, CBD has shown to be a great option for many people with sleep disorders. Because CBD interacts directly with the endocannabinoid system (responsible for maintaining homeostasis, or balance, within the body), it can help regulate sleep patterns and support the body’s natural circadian rhythms.
A 2019 study (Shannon et al, 2019) showed that CBD can also serve as a natural solution to combat insomnia, helping individuals fall asleep. The research also demonstrated that CBD helped reduce the number of instances of waking up and other night time disturbances.
How does CBD make you feel?
Overall, your response to CBD will depend largely on factors that are specific to you. This includes your body type, weight, gender, and metabolism. Additionally, the effects of CBD can be influenced by other variables including how you consume CBD (such as ingesting oil or applying a topical to your skin) as well as existing medications or supplements you may be taking.
Another important factor to consider is the type of CBD you’re using. CBD comes in three primary types: full-spectrum, broad-spectrum, and isolate. Full-spectrum contains over 120 of naturally-occurring plant compounds found in the hemp plant. Research shows that full-spectrum CBD can offer the maximum potential of benefits because all of the compounds from the plant interact together, referred to as the “entourage effect”.
Other types of CBD include broad spectrum and CBD isolate. Broad-spectrum contains most of the other cannabinoids and compounds within the plant, with the exception of THC, which is removed after the initial extraction.
CBD isolate is the most simple form of CBD and results from the removal of all of the plant compounds found in hemp except for just CBD. While some people prefer these forms of CBD because they do not include THC, they’re commonly seen as less effective than full-spectrum CBD because they do not benefit fully from the “entourage effect” mentioned earlier.
With this in mind, some of the ways CBD can affect your body and make you feel include:
- Feeling relaxed
- Sense of calm and focus
- Decreased anxiety
- Sense of improved well being
It’s also important to know that, per a study published in the Brazilian Journal of Psychiatry, different doses of CBD may affect you in different ways. Lower doses can cause feelings of focus and alertness while higher doses may be relaxing.
Additionally, a 2017 study showed that CBD can have anxiolytic effects, meaning that it can reduce anxiety and be calming. When this potential for reducing anxiety and enhancing calm is combined with CBD’s potential to help muscle relaxation, many experience feelings of relaxation in both the mind and body.
The Bottom Line
In order to answer the question “Does CBD make you sleepy?” you need to understand how CBD works within the body and the factors which affect how you will respond to it.
If you’re considering a CBD routine to help you sleep, it’s important to determine the dosage that’s right for you. While we recommend starting with 12mg – 20mg twice daily, there is no standard dosage or ‘official serving size’, as it varies based on individual factors mentioned earlier. You will need to adjust your dosage in response to how you are feeling to find the amount and form of CBD that’s right for you. If you are interested in know more about CBD dosage tips and guidelines, we have another blog post on this subject that you can read by clicking here.
As with any supplement or nutrition product you’re considering adding to your regular routine, consider speaking to a health professional first.
Solutions For Quality Sleep & Recovery
Now that you have read through facts and research, how about some potential solutions if you are looking for all-natural sleep aid supplements? Our RECOVER Tincture 500mg, RECOVER Tincture 1000mg, and our RECOVER SoftGels 750mg are great to take post-workout or 60 minutes before bed.