Written by Angeline A. De Leon, Staff Writer. Study results demonstrate that an anxiety-reducing dose of cannabidiol does not appear to interfere with the sleep cycle of healthy volunteers.
Cannabidiol (CBD) is an active ingredient in cannabis derived from the hemp plant. Associated with various therapeutic effects, including analgesic 1, anti-inflammatory 2, and anti-epileptic 3 properties, CBD also demonstrates a role in sleep regulation 4,5. Recent work indicates that the endocannabinoid system is involved in the government of the circadian sleep-wake cycle, including the induction and maintenance of sleep 6,7. At acute doses (160 mg daily), CBD can increase total sleep time and reduce frequency of nighttime awakenings in individuals with insomnia 8, and at lower doses (15 mg daily, when combined with 15 mg tetrahydrocannabinol), may boost wakefulness in those with normal sleeping patterns 9. More recently, a 6-week trial carried out in patients with Parkinson’s Disease reported that chronic administration of CBD resulted in improvement of sleep-related behaviors associated with rapid eye movement sleep behavior disorder 4. In a 2018 study 10 published in Frontiers in Pharmacology, researchers at the University of Sao Paulo, Brazil conducted the first investigation looking at the impact of CBD on sleep, using cognitive measures as well as polysomnography (diagnostic tool measuring brain wave patterns, heart rate, breathing, and other parameters during sleep).
A total of 27 healthy, non-smoking subjects (mean age = 29.3 years) were enrolled in a randomized, double-blind, crossover study. Prior to the laboratory visit, participants completed a series of subjective assessments (Visual Analog Mood Scale, VAMS; State-Trait Anxiety Inventory, STAI) and were randomly assigned to receive a single 300 mg dose of either CBD (99.9% purity without THC) or matching placebo half an hour before polysomnography recordings were performed over an 8-hour period. On the following morning, participants completed the VAMS and STAI again, along with subtests of the Wechsler Adult Intelligence Scale (WAIS) and Psychomotor Vigilance Test (PVT). Subjects underwent a second laboratory visit within two weeks, repeating the same protocol but using the alternative treatment arm. Both groups were matched for sex, age, and education level.
A comparative analysis between the CBD and placebo groups on polysomnographic results indicates the absence of any significant changes on the parameters evaluated in the study (e.g., total sleep time, sleep onset latency, rapid eye movement onset latency, sleep efficiency, etc.). Likewise, no statistically significant changes were detected between groups on the VAMS, STAI, PVT, or the Digit Symbol Substitution and Symbol Copying Tests of the WAIS. Overall, no significant effects of CBD were observed in the present study.
Current findings based on polysomnography readings indicate that acute doses of CBD may not influence normal sleep architecture in healthy subjects. Unlike other medications for anxiety and depression, such as benzodiazepines and selective serotonin reuptake inhibitors, which are associated with alterations in sleep pattern and reduced restorative sleep 11,12, CBD appears to offer anxiolytic and antidepressant effects without interfering with the normal sleep-wake cycle. Main limitations of the study include a relatively small sample size and the use of only a single dose of CBD, which may have been insufficient to induce a significant change in sleep pattern. Future studies should examine the long-term effects of chronic CBD intake in healthy volunteers as well as patients with sleep disorders.
Source: Linares IMP, Guimaraes FS, Eckeli A, et al. No acute effects of cannabidiol on sleep-wake cycle of healthy subjects: a randomized, double-blind, placebo-controlled crossover study. Front Pharmacol. 2018; 9(315). DOI: 10.3389/fphar.2018.00315.
© 2018 Linares, Guimaraes, Eckeli, Crippa, Zuardi, Souza, Hallak and Crippa. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Click here to read the full text study.
Posted January 7, 2019.
References:
- Boychuk DG, Goddard G, Mauro G, Orellana MF. The effectiveness of cannabinoids in the management of chronic nonmalignant neuropathic pain: a systematic review. J Oral Facial Pain Headache. 2015;29(1):7-14.
- Esposito G, Filippis DD, Cirillo C, et al. Cannabidiol in inflammatory bowel diseases: a brief overview. Phytotherapy Research. 2013;27(5):633-636.
- Devinsky O, Marsh E, Friedman D, et al. Cannabidiol in patients with treatment-resistant epilepsy: an open-label interventional trial. The Lancet Neurology. 2016;15(3):270-278.
- Chagas M, Eckeli A, Zuardi A, et al. Cannabidiol can improve complex sleep‐related behaviours associated with rapid eye movement sleep behaviour disorder in Parkinson’s disease patients: a case series. Journal of clinical pharmacy and therapeutics. 2014;39(5):564-566.
- Babson KA, Sottile J, Morabito D. Cannabis, cannabinoids, and sleep: a review of the literature. Current psychiatry reports. 2017;19(4):23.
- Sanford AE, Castillo E, Gannon RL. Cannabinoids and hamster circadian activity rhythms. Brain research. 2008;1222:141-148.
- Vaughn LK, Denning G, Stuhr KL, De Wit H, Hill MN, Hillard CJ. Endocannabinoid signalling: has it got rhythm? British journal of pharmacology. 2010;160(3):530-543.
- Carlini EA, Cunha JM. Hypnotic and antiepileptic effects of cannabidiol. The Journal of Clinical Pharmacology. 1981;21(S1):417S-427S.
- Nicholson AN, Turner C, Stone BM, Robson PJ. Effect of Δ-9-tetrahydrocannabinol and cannabidiol on nocturnal sleep and early-morning behavior in young adults. Journal of clinical psychopharmacology. 2004;24(3):305-313.
- Linares IM, Guimaraes FS, Eckeli A, et al. No Acute Effects of Cannabidiol on the Sleep-Wake Cycle of Healthy Subjects: A Randomized, Double-Blind, Placebo-Controlled, Crossover Study. Frontiers in pharmacology. 2018;9:315.
- Poyares D, Guilleminault C, Ohayon MM, Tufik S. Chronic benzodiazepine usage and withdrawal in insomnia patients. Journal of psychiatric research. 2004;38(3):327-334.
- Feige B, Voderholzer U, Riemann D, Dittmann R, Hohagen F, Berger M. Fluoxetine and sleep EEG: effects of a single dose, subchronic treatment, and discontinuation in healthy subjects. Neuropsychopharmacology. 2002;26(2):246-258.