Written by: Aimee Prasek, PhD
Most research on cannabidiol (CBD) has looked at its possible benefits for anxiety disorders, perceived stress, and more general feelings of anxiousness. This research is helpful for sleep concerns, considering stress and anxiety-related sleep disruption is quite common. Past research reporting CBD applications for sleep have lacked quality, likely a factor in why some results seem to be mixed . However, more recent and sound research for the use of CBD for specific sleep concerns looks very promising [11, 20].
At this point, research most solidly points to CBD as a support for stress and anxiety-related sleep concerns. This application is also supported by current evidence indicating CBD's us for anxiety-related concerns [1, 5, 6, 7, 8, 14, 17, 20].
Interestingly, some individuals may find CBD makes them more alert, but without increased anxiousness . In these individuals, using CBD at night may negatively impact sleep, whereas use earlier in the day may support sleep. More research is needed here to understand how CBD modulates the sleep-wake cycle and how dosage might be adjusted to promote sleep for certain populations. This phenomena is also why melatonin in combination with CBD over a short-term period may address more substantial sleep concerns as melatonin may offset the wake-inducing effects of CBD. However, it's important to not rely on long-term melatonin supplementation unless advised by a doctor. So, once a more normal sleep schedule is established, then it's likely wise to reduce the melatonin amount over a period of a week until the melatonin/CBD product is completely removed. A CBD product could then be moved earlier in the day and as needed to address stress and general anxiousness, in effect likely supporting sleep as well.
CBD Dosage and Use
It's important to not there is no established dosage for CBD and individuals may respond quite differently to different dosages. However, a common dose range for CBD in adults is 15-50 mg daily, taken as needed. With some conditions, such as those involving pain or inflammation, effective dosages appear to be higher, but it seems to be best-tolerated and most helpful for anxiety, sleep, and mood in this more moderate range. Of course, this isn't always the case as Liares et. al. (2019)  found 300 mg to be most effective for a simulated speaking test. A U-shaped dose-response curve was identified meaning the 150 mg dose and the 600 mg groups did not fare as well as the 300 mg. It's important to note the difference in this acute situation compared to concerns that may be more constant (e.g., feelings of anxiousness or stress throughout the day). It may be the case that more consistent and moderate doses taken for stress and anxiousness are helpful, whereas higher doses could be advantageous for acute situations.
With all this said, we rely on the statement, "start low, go slow." Everyone is different and without clear dosage recommendations, it's important to work with your healthcare provider to establish the lowest dosage that can be taken daily or as needed.
After discussing with a doctor, look for a high quality, broad-spectrum, all natural, non-GMO hemp product that is THC-free (i.e. measures less than 0.3% THC). Avoiding THC is particularly important for some individuals looking to support anxiousness or for sleep concerns as THC may increase anxiety for some individuals and long-term THC use is associated with sleep disruption . CBD is commonly take in doses of 10-25 mg twice times daily, with or without meals, or in a single dose of 20-50 mg daily.
CBD Side Effects
As noted, CBD is generally considered well-tolerated. However, CBD can cause side effects. These side effects can be more confusing given the unreliability of the purity and dosage of CBD in products (which is why purchasing a high-quality product is essential).
Side effects of CBD may inlude:
- Dizziness and lightheadedness
- Dry Mouth
- Increased Appetite
- Lowered blood pressure
The most common side effect is very mild sedation, though that is usually not a problem for those with high anxiety, and may be a welcome effect for those with sleep troubles. Like most things that are calming, adding CBD to other sedating medications, or combining CBD with alcohol, may cause excess sedation.
There is too little information about the safety of CBD during pregnancy or while breastfeeding, so it is not recommended.
Research suggests many side effects that occur with CBD use are likely the result of drug-to-drug interactions between CBD and other medications an individual may be taking. That's why it's so important to speak with your doctor before starting any supplement, and this is particularly true with CBD.
Here's how these interactions occur: CBD is broken down by the body via the same pathway as many prescription drugs. If multiple compounds are competing in this pathway (e.g., CBD and a prescription drug), then something called "altered concentration" can occur. This means that too little or too much of the drug is left in the body. When too little remains, a drug may no longer work as intended. When too much remains, side effects may increase. Penn State College of Medicine has a really handy list of medications that may be impacted by altered concentration due to a combination with cannabinoids. Unfortunately, this list does not make any distinctions between CBD or THC, but it provides some guidance. Bring this list to your doctor before starting any CBD product.
Penn State also found potentially serious interactions between prescription CBD and THC products and the following products:
- Warfarin and other blood thinners
- Amiodarone (heart medication)
- Levothyroxine (thyroid medication)
- Seizure medications (clobazam, lamotrigine, valproate)
CBD Supplements at Natural Mental Health
- Sleep CBD is a blend of broad-spectrum CBD (30 mg per serving) combined with 5 mg of CBN (cannabinol) and 3 mg of melatonin. CBN is a form of phytocannabinoid shown to be more specifically helpful for sleep, and melatonin is nature’s internal timekeeper, helping set a more consistent bedtime. CBD Sleep may improve a variety of challenging sleep issues, and is especially helpful for those who have trouble falling asleep.
- Calm CBD combines 30 mg of broad-spectrum CBD with 200 mg of l-theanine, an amino acid that can also help reduce anxiety and stabilize mood. Together, they may improve stress resilience and calm anxiety without sedation. Taken at bedtime, CBD Calm may also be helpful for those who tend to wake in the middle of the night.
- Restore CBD gummies are infused with the highest quality, all-natural, US-grown hemp. Each gummy offers a precise dose of broad-spectrum CBD to support your endocannabinoid system with naturally occurring, plant-based ingredients. This synergy of multiple cannabinoids work together for the greatest impact to restore your natural resilience.
*Note: Some of the supplements discussed in this article can cause side effects, but many people tolerate them much better than prescription medications. They are generally considered safe, however, they should not be started without your doctor’s knowledge and supervision. If you are taking medication already, be sure to talk with your doctor before adding any of these items. If you are considering going off medication, remember never to stop your medication suddenly—always consult with your doctor about how to safely taper off any psychiatric medication. See terms.
**These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.
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