Chronic pain is one of the main causes of sleep disruption. Does cannabis help or make it worse?
Living with chronic pain can make even the simplest aspects of life much more difficult. It can affect a person’s way of life, relationships with other people, and it can have further negative consequences on one’s health. For instance, chronic pain can make getting a good night’s sleep difficult. This is a common challenge that confronts many people as they age — with or without pain. Since chronic pain is one the main causes of sleep disruption will cannabis help or hinder the situation?
Millions of Americans are suffering from chronic pain and insomnia, and the numbers are staggering. Between fifty and seventy million Americans suffer from insomnia, and according to the Center for Disease Control, roughly fifty million experience chronic on a daily basis. We don’t know how many of these numbers overlap, but enough to make the cycle of chronic pain and insomnia a devastating one.
Sleep disruption is often treated with pharmaceutical medications, including benzodiazepines, non-benzodiazepine hypnotics and barbiturates. These can be toxic over time, not to mention addicting. Some sleep medications have even caused strange side effects, which are difficult to explain.
This is where cannabis could be a potential aid. THC for sleep can help, inducing drowsiness and bringing on some much-needed shut-eye. But it’s not the only cannabinoid capable of being a sleep aid. At the right dosage, CBD can help. And newly discovered CBN — a degraded form of THC — also acts as a sedative. However, scientists are asking whether it is one of the causes of sleep disruption over the long term, and if it makes insomnia worse.
New Study Investigates Chronic Pain, Cannabis and Sleep
More and more patients living with chronic pain are turning to cannabis. It’s safer than opioids, and along with its potential to relieve pain, many patients are consuming it to help them sleep. A new study published in BMJ Supportive & Palliative Care (2020)1)Sznitman, Sharon R, et al. “Medical Cannabis and Insomnia in Older Adults with Chronic Pain: a Cross-Sectional Study.” BMJ Supportive & Palliative Care, British Medical Journal Publishing Group, 8 Jan. 2020, spcare.bmj.com/content/early/2020/01/08/bmjspcare-2019-001938.info. researched cannabis consumption among older adults with chronic pain.
The authors gathered information from 128 subjects. They separated into the participants into two groups — patients who were consuming medical cannabis and patients who weren’t. Their research showed that individuals who consumed cannabis were less likely to wake up at night. Which for someone suffering from chronic pain, staying asleep can be extremely difficult. The researchers concluded that cannabis could help some patients, though it might not work for everyone.
And although cannabis could potentially lower the likelihood of waking up at night, it could also contribute to the problem. They discovered that more frequent consumption of cannabis could potentially reverse its sleep-inducing effects. The authors concluded, “Future studies are needed to confirm whether cannabis may have specific effects on particular sleep problems and if so, what the mechanisms of action are.”
How Does Cannabis Help or Hinder Sleep?
The endocannabinoid system (ECS) plays a role in sleep through its influence on the production of melatonin. This hormone helps the body fall asleep and maintain circadian rhythms. This may be one of the ways cannabis interacts with the ECS to help people sleep.
But science is discovering that the composition of the cannabis itself matters. The 2020 study was only able to gather information about the type and dose of cannabis consumed from a sub group of their population. So, while they were able to conclude that more frequent cannabis consumption possibly exacerbated the problem of sleep, they couldn’t say whether it was THC or CBD, or a specific strain.
A study in the Journal of Clinical Pharmacology (1981), 2)Carlini, E A, and J M Cunha. “Hypnotic and Antiepileptic Effects of Cannabidiol.” Journal of Clinical Pharmacology, U.S. National Library of Medicine, 1981, www.ncbi.nlm.nih.gov/pubmed/7028792.
found that a strain high in CBD and low in THC could decrease nocturnal awakenings. Whereas, as another study showed, a strain with a low dose of CBD3)Zuardi, Antonio Waldo. “Cannabidiol: from an Inactive Cannabinoid to a Drug with Wide Spectrum of Action.” Revista Brasileira De Psiquiatria (Sao Paulo, Brazil : 1999), U.S. National Library of Medicine, Sept. 2008, www.ncbi.nlm.nih.gov/pubmed/18833429. would make the consumer more alert.
Dosage and cannabinoids aren’t the only factors that affect cannabis’ sleep-inducing qualities. Terpenes can also help ease the effects of insomnia. These aromatic compounds have medical benefits of their own, which are often overlooked. Both myrcene and terpinolene can also help achieve a good night’s rest.
Choosing the Right Cannabis for Sleep
While cannabis can’t address all of the ways in which sleep problems manifest, it can help with some of the causes of sleep disruption. It’s becoming apparent that cannabis can reduce the likelihood of waking up in the middle of the night, and it can help you stay asleep. And for patients suffering from chronic pain, getting adequate rest could make a huge difference to their quality of life.
Much of the current research on the topic of cannabis and sleep is preliminary and limited. However, it’s paving the way for further investigation into the right dosage and strains of cannabis for sleep. So far, it looks like a high dose of CBD could be the best strategy for slumber. We’re still learning about CBN, but it might be a good candidate for sleep medication as well.
However, in light of this most recent study, it seems we also have much to learn about the long-term effects of cannabis on sleep. And it’s important to note, insomnia is a common withdrawal symptom from quitting cannabis. If long-term, frequent, cannabis consumption contributes to sleep problems, and quitting causes further insomnia issues, this may present problems for some when choosing cannabis as a sleep aid. While it works for some and not others, prescribing cannabis to help someone sleep should be done on a case by case basis.
References [ + ]
|1.||↑||Sznitman, Sharon R, et al. “Medical Cannabis and Insomnia in Older Adults with Chronic Pain: a Cross-Sectional Study.” BMJ Supportive & Palliative Care, British Medical Journal Publishing Group, 8 Jan. 2020, spcare.bmj.com/content/early/2020/01/08/bmjspcare-2019-001938.info.|
|2.||↑||Carlini, E A, and J M Cunha. “Hypnotic and Antiepileptic Effects of Cannabidiol.” Journal of Clinical Pharmacology, U.S. National Library of Medicine, 1981, www.ncbi.nlm.nih.gov/pubmed/7028792.|
|3.||↑||Zuardi, Antonio Waldo. “Cannabidiol: from an Inactive Cannabinoid to a Drug with Wide Spectrum of Action.” Revista Brasileira De Psiquiatria (Sao Paulo, Brazil : 1999), U.S. National Library of Medicine, Sept. 2008, www.ncbi.nlm.nih.gov/pubmed/18833429.|