THC vs CBD for Sleep

By: Elena Schmidt October 2, 2019 • 8 minutes

75 million Americans suffer from sleep deprivation stemming from ailments such as insomnia, PTSD, and sleep apnea. If you are one of these people, you may feel constant brain fog and waking fatigue. As a result, you are statistically less likely to make “healthy” decisions on a day-to-day basis. Forget about that New Year’s resolution to rise with the sun, run five miles, and eat a healthy breakfast before starting the day. You barely have enough energy to find that matching sock.

Sleep is not only important for energy, but it is also vital for mental and physical wellness. While you rest, your body works hard to regulate hormones, combat inflammation, and detoxify the brain. Lack of sleep can lead to conditions such as chronic headaches, memory lapses, and mood swings. Conversely, sleeping for the recommended 7-9 hours each night can help you think clearer, feel calmer, and practice healthy habits like consistent exercise.

Cannabis and Your Sleep Cycle

Scientists recently discovered that every human body contains an Endocannabinoid System (ECS), which interacts with THC and CBD to send homeostatic signals throughout the body. These signals help regulate almost every function of the body from the nervous system to the immune and reproductive system. Most recently, research has shown that the ECS also helps regulate your circadian sleep and wake cycle. When receptors interact with cannabinoids like THC and CBD, a healthy ECS can help recover normal sleep patterns.

How Cannabis Can Help

Cannabis is a widely used sleep aid that can improve shut-eye by interacting with the ECS to relieve the stress and pain that may prevent you from falling asleep. In an analysis of our cannabis patients being treated between 2009-2016 at Tikun Olam Israel, 94% reported improvements in their conditions, including getting more sleep. 

THC has been shown to provide pain relief and sedative effects that increase the Stage 4 sleep cycle, known as slow wave deep sleep. CBD helps by relieving anxiety and pain. CBD also targets the inflammation that builds up with extended periods of insomnia. So, which of these two well-known cannabinoids works best for sleep and how do you determine the best prescription for you? The answer lies in the details.

THC & Sleep

THC is the most prevalent cannabinoid found in cannabis, known for its ability to get you “high.” Cannabis users also widely ingest THC for its sedative powers to aid in falling asleep faster and staying asleep longer. But THC has also been shown to prevent Stage 5 REM or dream sleep, which is associated with regulation of mood, memory, and learning. Thus, THC is extremely effective but you may consider whether or not long-term use is best based on your particular condition.

Sleep Apnea is the most common medical sleep disorder affecting 9% of adults. The normal protocol to treat sleep apnea is hooking up to CPAP machines at night to clear the airways for normal breathing; however, many patients decline CPAP due to its discomfort of use. A recent study in the Sleep Research Society Journal found that THC reduced apneas and modulated the upper airway muscles responsible for regulating breathing during sleep.

Nightmares associated with post-traumatic stress disorder (PTSD) are a major issue among veterans and anyone who has suffered from severe distress. While Prazosin is the only FDA-approved prescription to treat PTSD-related nightmares, military veterans consistently turn to cannabis for relief. Studies have shown that THC effectively reduced nightmares and lengthened sleep duration throughout the night. This may be due to the fact that THC reduces REM sleep, which is the stage responsible for dreams.

THC fine print. For the short-term, with the right dose and strain, THC can be an extremely effective sleep aid. While the results are helpful for those who suffer from sleep disorders, it is also important to note that THC can cause sleep disruption or inhibit REM sleep, which can cause unintended cognitive side effects over the long-term. So, with cannabis medicine, as with most things in life, a balance should be sought.

CBD & Sleep

CBD is the non-intoxicating compound found in cannabis that interacts with receptors in the body to minimize the “high” caused by THC. CBD is known for its powerful therapeutic effects, including aiding in reducing anxiety, combating pain, and targeting inflammation. While CBD is not directly sedative like THC, it supports restful sleep by soothing the symptoms related to sleep issues.

Anxiety. Have you ever experienced anxiety? It’s that knot in your belly, heaviness in your chest, and spiraling thoughts that have no purpose or end. Anxiety can be so distracting that it is one of the main causes of sleep deprivation and reasons for cannabis use. 

In a study published in 2019, 103 adults with anxiety were treated with CBD as an adjunct to prescription medication. After one month, 80% of people reported a reduction in anxiety and nearly 70% reported improvement in sleep. While the study cannot prove direct correlation, it indicates that CBD’s calming effects may translate to deeper sleep.

Overall sleep support. In the context of all causes for sleep deprivation, CBD has been shown to provide widespread support. For example, CBD helps treat symptoms of Alzheimer’s, epilepsy, autism, and anxiety. All of these conditions are physically taxing and often lead to difficulty sleeping.

In 2018, the Medicines Journal published a study that surveyed 409 people with insomnia due to various medical and emotional conditions. Respondents collectively consumed cannabis over 1,000 times and reported usage through a software app. Using real time ratings of self-perceived insomnia, CBD was shown to provide greater statistical relief than THC. 

CBD fine print. CBD can be an incredibly effective sleep aid due to its power to soothe anxiety and treat disruptive medical conditions. However, just like THC, CBD dosage and strain matter. Studies show that a low dose of CBD may actually be stimulating, thereby creating the opposite effect. Additionally, CBD may help calm those with anxiety, but it will not necessarily prevent nightmares that may wake patients throughout the night.

CBD:THC & Pain

If you’ve ever had a headache and grabbed the nearest aspirin bottle, you understand how pain might be a distraction when trying to fall asleep and stay asleep. 20% of Americans suffer from chronic pain and many of those do not experience relief from pharmaceuticals. Alternatively, many chronic pain patients report that cannabis is a viable solution. Several studies have tested and proven the efficacy of cannabis for pain.

In 2007, the Chemical Biodiversity Journal published a review of all clinical trials related to self-reported sleep quality among chronic pain patients. These patients suffered from ailments such as MS, cancer, and rheumatoid arthritis. The review discovered that the most effective strain for pain relief is cannabis with equal ratios of CBD:THC. Research on our Midnight strain, a 1:1 with equal amounts of CBD and THC, has similarly shown effectiveness in treating pain and thus aiding in sleep.

Which Cannabinoid is Most Effective?

There is no clear-cut victor in the competition for the most effective sleep aid. THC is considered effective to ease short-term insomnia, reduce nightmares, and treat those with sleep apnea, but can also disrupt sleep patterns if taken long-term. CBD research shows that medium to high dosages are effective for general sleep disorders but do not reduce nightmares. There is also the issue of pain, which seems to respond best to equal amounts of THC and CBD.

Where do I Begin?

Strains. To promote maximum relaxation, try an indica-dominant strain about 30 minutes before bed. Different indicas will have different cannabinoid ratios and this is where further experimentation comes into play. Starting with a CBD-dominant strain will help minimize psychoactive effects, allowing you to gradually test strains with more THC, if needed.

Delivery Method. Cannabis can be consumed as flower or via extractions in the form of oils, patches, edibles, and creams. Intake method also varies, from smoking and vaping, to topical application and oral ingestion. Each delivery method produces a different effect and onset time, but the most popular method for sleep is vaping and oils. Edibles are effective but they can take up to 2 hours to kick in and last 6-8 hours. For a more rapid effect, try vaping or taking an oil under the tongue. 

Tikun for Sleep. Tikun Olam’s indica strains, Avidekel, Erez, Eran Almog, and Or, have all been shown to improve sleep quality – as reported by our patients in Israel. Avidekel was developed to have 15-18% CBD and almost no THC, making it ideal if you are looking to skip the “high.” Erez, Eran Almog, and Or are all THC-dominant strains that provide powerful nighttime relief. If you are looking to combat pain with equal parts CBD:THC, our 1:1 Midnight strain is the perfect choice. Choose a Tikun vape or tincture for easy dosing before bed. Need advice on which strain is best for a good night’s sleep? Reach out to us at askthedoc@tikunolam.com for guidance.