Let’s face it, who hasn’t battled insomnia at some point? Insomnia is no fun! Maybe you toss and turn, count sheep, or watch the clock, only to find the sun is coming up, and you haven’t slept. It can make getting through the next day almost unbearable. It sucks you dry of energy, affects your mood, disrupts your ability to concentrated, and if persistent, it can take a toll on your health.
Doctors seem to be a bit too enthusiastic in dispensing prescriptions for popular sleep medications like Ambien, or antianxiety medications like Valium or Xanax. However, these drugs often come with side effects, are habit forming, and can even be addictive.
Many people report using cannabis to help them sleep. But, few states allow doctors to recommend cannabis to treat insomnia. However, other conditions — like chronic pain — are often accompanied by difficulty sleeping. And, many people believe cannabis helps alleviate sleep issues.
But, since insomnia isn’t typically considered an appropriate condition to treat with cannabis, there isn’t a lot of credible information about whether or not cannabis is a safe and efficacious treatment for sleeplessness.
Fear not, we’ve got you covered with the straight facts and latest research on cannabis and insomnia, so you can decide for yourself if cannabis is appropriate to treat those pesky bouts of insomnia.
Advertisements for sleep medications are in abundance in the media, and many doctors enthusiastically prescribe popular drugs such as Lunesta and Ambien. From 1994 to 2007, the number of prescriptions grew by a factor of 30 times — which was five times more than the increase in insomnia diagnoses during the same period, and 21 times greater than patient complaints. These statistics suggest “Big Pharma” has done a good job of marketing to doctors and the public. But, while these drugs have become increasingly popular, their efficacy and safety have been called into question.
The National Institutes of Health (NIH) found that sleeping pills, on average, only add 11.4 minutes of sleep time, while reducing the time to fall asleep by just 12.8 minutes. Moreover, some of these drugs can come with severe side effects, including "temporary amnesia" (forgetting what happened between taking the medication and it wearing off).
Many people assume that if a doctor prescribes it, it must be safe. However, in recent years we’ve seen a dramatic increase in emergency room visits from prescription sleep medications, particularly zolpidem, the active ingredient in Ambien®, Ambien CR®, Edluar®, and Zolpimist®.
According to a report conducted by the Department of Health and Human Services’ Substance Abuse and Mental Health Services Administration (SAMHSA), from 2005 to 2010 emergency room visits doubled. Reasons for visits included everything from a bad reaction to the correct dosage to suicide attempts. Just one-third of visits were attributed to patients taking more than the prescribed dosage. Interestingly, women account for two-thirds of patients, despite the fact they don’t make up a significantly greater proportion of consumers.
Similarly disturbing, Ambien, the most popularly prescribed sleep aid, has been associated with what’s been termed, an “Ambien blackout.” Patients have blamed "Ambien blackouts" for “sleepwalking,” "strange behaviors," "abnormal thinking," "sleep eating," “sleep shopping,” and even “sleep driving.”
Other side effects can include nausea, gastrointestinal issues, daytime drowsiness, and feeling "drugged." Many are also known to be habit forming and can cause withdrawal symptoms upon cessation of use. Reported withdrawal symptoms include insomnia, restlessness, sweating, agitation, anxiety, and depression.
Further, the Department of Health and Human Services report that emergency room visits related to prescription sleep-aids have dramatically increased over the last twenty years.
Benzodiazepines (often called "benzos") -- such as Xanax, Klonopin, and Valium -- are commonly prescribed to treat anxiety, but many physicians also prescribe them for sleep. However, benzodiazepines can be highly addictive, and potentially toxic. In fact, benzodiazepines overdose deaths have soared in recent years, accounting for nearly one in three fatal drug overdoses in 2013, according to the Centers for Disease Control and Prevention (CDC).
Natural supplements including valerian root, chamomile, lemon balm, and melatonin are also popular sleep aids. While presumably safe, only melatonin has high-quality research that suggests efficacy.
How many times have you heard cannabis can help you fall asleep? Anecdotally, people have reported using cannabis as a sleep aid for several millennia. You may personally use it to help you sleep. However, few state medical marijuana programs consider insomnia a qualifying condition. But, why not? Unlike the numerous other approved medications, cannabis has few side effects, nor has been responsible for many emergency room visits or a single overdose death.
In fact, research is far more than anecdotal. There have been numerous studies on human subjects that validate what most cannabis users have long known: consuming a little pot before bed makes it easier to fall asleep, and sleep better.
As noted, an NIH study that found that when analyzed as a group, popular prescription sleep medications reduce the average time to go to sleep 12.8 minutes, while only increasing sleep time by 11.4 minutes. In contrast, studies going back as far as 1973, found moderate doses of THC significantly decreased the time (up to an hour faster) it takes physically healthy insomniacs to fall asleep. And, once asleep, people experienced fewer sleep interruptions and awakenings through the night (particularly the first half of the night.) Notably, too high of doses were associated with a residual “hangover” feeling the next day, underscoring the importance of finding the right dose (not too much, not too little).
Curiously, the National Institute on Drug Abuse (NIDA) and a Cooperative Research and Development Agreement between Sanofi-Aventis and the National Institutes of Health (NIH) funded a study that showed consuming THC enabled subjects to fall asleep easier and more quickly. And, that next-day feelings of lethargy reported by some subjects was tolerable. Results from the study are especially interesting because Sanofi-Aventis is the maker of Ambien. Most likely, they expected a different outcome.
Cannabis can positively impact the sleep cycle. Studies prove THC can increase deep sleep — or slow-wave sleep. Why is this important? Because scientists believe deep sleep plays a vital role in our body’s natural restoration process. That cannabis may promote slow-wave sleep is particularly notable because scientists believe the lack of deep sleep may be the most harmful effect of sleep deprivation and can be a strong predictor of high blood pressure.
Sure, most of us take breathing for granted — that is, until breathing becomes difficult! And, for the roughly 17% of men and 9% of women who regularly have breathing problems when they sleep (clinically termed, “sleep apnea”) — trying to sleep can become a dreaded activity. Most people with sleep apnea never get diagnosed. But the good news is that early research published in Jan. 2013 by Frontiers in Psychology shows promise that cannabis can help people breathe easier when they sleep. According to the study, THC opens up breathing pathways and “blocks serotonin-induced exacerbation of sleep apnea.”
Who knows? Maybe someday sleep apnea sufferers can swap out their CPAP mask for a THC-infused brownie? But, I doubt Medicare will cover that!
Many people report, cannabidiol, better known as CBD, helps them sleep. However, results from studies have provided contradictory results. One study of the (largely) non-psychoactive CBD showed that it was “wake-inducing agent.” Translation: it makes you feel “awake.” True, CBD can be mildly alerting. Cannabidiol activates the same adenosine receptors as caffeine, a stimulant. But several patients with sleep issues 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. And, in another study of three dosage levels, patients who received 160 mg of CBD reported they slept significantly more than those who received a placebo.
An of CBD subjects receiving 160 mg cannabidiol reported having slept significantly more than those receiving placebo; the volunteers also reported significantly less dream recall; with the three doses of cannabidiol than with placebo.
Comparing cannabis to other drugs, Uwe Blesching, PhD, author of The Cannabis Health Index, puts it best: “Cannabis can provide a 100 percent natural approach to managing insomnia free of side effects commonly associated with prescription drugs.”