Few things can spoil your day more than a night of bad sleep. Insufficient sleep can worsen mood, drain energy, and is even linked to a host of health problems including dementia, depression, heart disease, and a weakened immune system.
Between 2013 and 2020, according to the Centers for Disease Control and Prevention, more than one-third of adults in the United States reported sleeping less than the recommended seven hours each night.
And in 2020, a Department of Health and Human Services study found that about 8% of adults reported regularly taking sleep medication in order to help them fall asleep or stay asleep.
Some of those people, studies suggest, may be smoking, vaping or using cannabis products such as marijuana to fall asleep.
So we asked some experts, including cannabis and sleep researchers, a sleep psychologist and a pharmacist who specialises in cannabis, to explain the effects of cannabis on sleep and how its various chemical compounds influence them.
Will cannabis help me sleep?
In a survey published in 2022 among more than 27,000 medical marijuana users in the United States and Canada, nearly half cited sleep as a physical health reason for their use.
But it's hard to explain exactly how cannabis affects sleep because the studies that have been done are limited and their results are often conflicting, said Vyga Kaufmann, an assistant professor of psychology and neuroscience at the University of Colorado Boulder.
The two main active compounds in cannabis — tetrahydrocannabinol (THC, largely responsible for the "high") and cannabidiol (CBD, which doesn't produce it) — appear to affect sleep in different ways, according to Cinnamon Bidwell, a clinical psychologist and assistant professor of cognitive sciences also at the University of Colorado Boulder.
For example, limited studies found that low doses of THC can improve sleep and high doses can make it worse, while the opposite is true with CBD. This makes it difficult to study cannabis and sleep, according to Bidwell, especially since different cannabis products can have different proportions of the compounds.
That said, researchers from a review of 26 studies that was published in 2020 reported that there was "promising preliminary evidence" that cannabinoid therapies, including THC and CBD, should be investigated as potential treatments for sleep problems such as insomnia, sleep apnea, restless legs syndrome, and nightmares related to PTSD.
The effects of cannabis on sleep and sleepiness can also be influenced by how you take it, according to Dr. Ashima Sahni, a pulmonologist and sleep specialist at the University of Illinois College of Medicine.
Oral forms, such as pills or edibles, take longer to take effect than inhaled forms, but their effects on sleep last longer all night.
Inhaled, vaporized or smoked cannabis will produce faster results, but they won't last as long. Of course, Sahni added, vaping and smoking can lead to certain health problems, such as lung damage and inflammation of the airways.
There's also some evidence that cannabis could indirectly help with falling asleep by relieving chronic pain and anxiety, the two main concerns motivating new patients to try medical cannabis, said Rahim Dhalla, a pharmacist specializing in medical cannabis in Ottawa, Canada, who studied patients' experiences with cannabis for sleep.
Although research in this field is "limited" and "the data is a little bit all over the place," Kaufmann said.
Smoking marijuana is not the same as consuming cannabis oil. Photo Shutterstock.
What to consider before trying cannabis for sleep
In his clinical experience, Bidwell said people who use cannabis products for sleep seem to be more satisfied when they use them occasionally, but not every day. That's because using THC too often can lead to a tolerance or dependence, he said, which can reverse the benefits of cannabis on sleep.
"As you start taking it more chronically, you fall into the trap that, to get the same effect, you have to increase the amount," Sahni added. And, over time, you can get to a point where it doesn't work at all.
At the same time, you can become so dependent that you have to continue consuming it to avoid withdrawal.
According to Bidwell, in these people addicted to marijuana, quitting marijuana can lead to symptoms such as anxiety, irritability, nausea and even disturbing dreams that can disrupt sleep.
"That's one of the main reasons they go back to it, or why they can't quit at all," he said, "because of how hard it is to sleep as part of that withdrawal."
And some people who consume too much THC may suffer a "hangover" the next morning, which can include symptoms like fatigue, headache, and dry eyes and mouth.
However, CBD use does not seem to cause tolerance or dependence.
Based on Kaufmann's clinical experience, many of his patients want to try cannabis for sleep because they are wary of sleep medications.
But this urges them to try a few lifestyle strategies first: going to bed and getting up at the same time every day, reducing screen time before bed, eliminating afternoon caffeine, exercising daily, and keeping the room cool, clean, and comfortable.
Cognitive behavioral therapy for sleep
To his insomnia patients, Kaufmann recommended trying cognitive behavioral therapy for insomnia (CBT-I), a type of talk therapy designed to help change the way you think about sleep.
It's "the gold standard intervention for insomnia that has the longest-lasting effects," he says, and patients aren't even often aware that it's a possible treatment for them.
An important consideration for anyone curious about marijuana is that it's not legal everywhere. But even if you live in a place where it's legal, you should ask yourself a few questions before trying cannabis for sleep, Dhalla said:
Do you take any medications that may interact with it? (The blood thinner warfarin and several epilepsy drugs are especially worrisome with cannabis-derived products.)
- Do you want something you can use every day or only when you need it? If you are looking for a sleeping pill for daily use, cannabis is not the best option.
Bidwell said that if you're determined to try it, start with the lowest dose possible to see how you react. Sahni also cautioned that since these products are poorly regulated, it's difficult to know exactly what is being consumed and whether it is safe.
The bottom line is that we need more research, Kaufmann said. We want people to be satisfied with their dream, he said, so if cannabis works for you, great. But if you've never done it and you're looking for sleep help, it shouldn't be the first thing you turn to.
© The New York Times
Translation: Patricia Sar
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