Cannabis and Insomnia: The Story So Far

For decades, the declaration “I’ll sleep when I’m dead” was seen as virtuous, until an outpouring of scientific studies proved just how valuable restful sleep is to the bodies and minds of all individuals. Yet about 10-30 million Americans alone report not getting enough sleep, and globally, the problem is so severe that the World Health Organization now considers the lack of sleep a global health epidemic. Existing medications like Ambien carry hazards like increased susceptibility to cancer, depression and infection. Enter cannabis, which depending on the specific chemovar has helped plenty of people on their way to snoozeville — so much so that many strains, derivatives and tinctures are directly marketed for their soporific qualities. Just in the field of CBD products alone, 49% of all users in the last four months of 2020 reported better sleep as the primary purchasing decision.

But what works for them? A recent paper published in the Journal of Medical Internet Research analyzed data posted by cannabis users on the Strainprint app, selecting for 991 Canadian medical cannabis patients who were using cannabis products specifically for insomnia. Researchers broke down and traced subjective effects of a wide variety of cannabis products. The results were futher categorized by age, race, gender identity and location. This resulted in valuable insights on what seemed to work best for each group.

• Both males and females most frequently used cannabis flower in each of the self-reported “sessions” the respondents documented on Strainprint. Women far outpaced men as users of oils and capsules (oils 70.2% vs. 28.9%, and capsules a whopping 94.5% vs 5.2%). Overall, relatively few were smoking the cannabis flower as compared to vaping.
• Those using cannabis for sleep benefits seem to get what they pay for. Strainprint users were asked to rate their symptom severity on a scale of 0 to 10. On average, the 991 survey users rated their symptoms at 7.35. After their medication, the average was 3.2. Its effectiveness was noted among both genders and across all age groups as well.
• Also, according to the data, it also didn’t matter what time of the day cannabis was used. Cannabis was used to reduce insomnia symptoms at all hours of the day, and no matter the hour, cannabis products were perceived as evenly efficacious.
• In spite of whether the medical patients chose capsules, edible, flower or oil, patients rated them all evenly in terms of relieving insomnia symptoms.
• The biggest surprises came with rating cannabis strains for their efficacy. Strains labeled as predominantly indica and indica hybrid apparently trumped CBD as well as sativa strains. However, all strains helped with symptoms, though some strains worked better than others.

There is currently a lack of consensus over whether the indica or sativa is more helpful for sleep, and the paper asserts, “Years of breeding and hybridization have rendered potential distinctions often meaningless.” Plus, there’s no placebo group in this study to compare the effects these patients are getting. Yet no matter how they’re using it, when they’re using it or for the most part what they’re using, cannabis seems to be doing the trick for the patients in this study.

Is The Jury Still Out?

If you were to ask an authority such as the Mayo Clinic, they would not likely point clinically diagnosed insomnia to medications, but, instead to the behavioral intervention Cognitive Behavioral Therapy for Insomnia, or CBT-I, for short. This involves setting patients to a regimen of behaviors that encourage better, more consistent slumber, such as sleeping and waking at the same hours every day and improving one’s sleep environment. “Sleep medications can be an effective short-term treatment — for example, they can provide immediate relief during a period of high stress or grief,” their website says, “But they may not be the best long-term insomnia treatment.” A recently completed study at the University of Michigan which pairs CBT-I with medical cannabis patients aims to determine how CBT-I may influence the usage of medical cannabis for insomnia.

Not all insomnia sufferers, however, have consistent schedules or rooms whose temperatures can be reliably calibrated between 65-69° Fahrenheit nightly. And research still continues, even outside of the academic realm. The cannabis R&D company LEVEL recently partnered up with the clinical study platform Curebase to study the efficacy of the trace cannabinoid CBG in 109 veterans and observe them virtually using Fitbits. In the meantime, regardless of the findings, it would appear that the Strainprint users will continue to sleep soundly.