Anxiety and insomnia often go hand-in-hand—each brings out the worst in the other, and it’s nearly impossible to get rid of one without dealing with the other one first. Anxiety is one of the most common causes of insomnia; worrying leads to sleep problems, and yet having problems sleeping can cause a lot of anxiety.

This was exactly the situation Laura Dobratz, 31, from Minneapolis, recently found herself in, after dealing with severe insomnia for years.

Anxiety, insomnia, and doses of CBD

Laying awake, staring at the ceiling, and counting sheep doesn’t even begin to describe the agony of chronic insomnia, Dobratz says. “I would have trouble sleeping pretty much every single night, for years,” she says. “This meant I was always exhausted during the day and never felt well-rested, which took a toll on every aspect of my life.”

Dobratz’s insomnia began when her anxiety spiked during an extra stressful holiday season. “I had some big worries, which made it hard to fall asleep and stay asleep,” Dobratz recalls. But, much to her dismay, when that frantic holiday ended and life returned to normal, the anxiety and insomnia stayed.

It quickly turned into a vicious cycle of worrying, which made her unable to relax enough to fall asleep. The next day, this was followed by more anxiety because she wasn’t sleeping.

Eventually, she sought out a psychiatrist to help with her mental health issues. The doctor felt that they needed to treat her insomnia along with her anxiety to see real improvement. So, her doctor prescribed her a sleep aid.

Dobratz says the prescription sleeping pills helped her stay asleep, but she was still having a tough time turning off the anxious part of her brain and falling asleep. So, her psychiatrist recommended that she try cannabidiol (CBD) oil, taking one dose in the morning to help manage her anxiety throughout the day and then a second dose right before bed.

What is CBD?

CBD is a compound that can be extracted from the cannabis plant. Yes, this is the same plant marijuana comes from, but CBD is not the same as recreational pot or medical marijuana. CBD can be derived from either marijuana or hemp, a related plant that has almost no THC. CBD products—including oils, oral tinctures, lotions, capsules, gum, and inhalants—typically contain only trace amounts of tetrahydrocannabinol, or THC, the compound that makes pot psychoactive.

This means it can’t make you high, isn’t addictive, and is legal in all 50 states.

In 2018, the World Health Organization wrote that CBD is generally safe for most people and shows no abuse or dependence potential or evidence of other public health-related problems. In fact, they found it may be helpful in managing a variety of chronic conditions, including insomnia.

Keep in mind that CBD is classified as a supplement. The U.S. Food and Drug Administration does not regulate CBD products so you should always talk to your doctor before trying any supplement.

CBD for insomnia

CBD may be a natural sleep aid that could help you get more rest. In a 2019 study published in The Permanente Journal, of people taking CBD for sleep problems, 80 percent reported less anxiety and 67 percent showed improved sleep scores. Individual sleep scores did fluctuate over the course of the study, according to the researchers, and they note that the “results must be interpreted very cautiously” because the study was not a randomized, blinded trial. (Check out these other natural sleep aids that may work.)

However, there are some reasons why CBD might help you sleep. “The brain is loaded with cannabinoid receptors that when activated, enhance brain function and produce a calming effect, dialing down stress and inflammation,” says Mary Clifton, MD, a board-certified internal medicine doctor practicing in New York City, a recognized expert in medical marijuana and CBD, and co-author of The Grass is Greener: Medical Marijuana, THC & CBD Oil. “CBD products activate those receptors in the brain and nervous system, which can lead to a sedative effect,” says Dr. Clifton, who is also an advisory board member for ZoneIn CBD, a CBD company.

CBD also may help with depression and physical pain, says Brigitte Zeitlin, RD, who uses CBD products as part of some of her treatment plans and is the owner of BZ Nutrition, a nutrition counseling service.

“CBD can help alleviate some of the main issues that typically cause insomnia; I’ve found most of my clients suffer from insomnia as it relates to their anxiety, PTSD, sometimes depression, and/or physical pain,” she explains. “CBD oil has been shown to help alleviate anxiety, which helps to relax people into slumber a bit more easily. CBD can also help ease some physical pains, which can keep people up too.”

What type of CBD is best for insomnia?

There are hundreds of different brands of CBD, all with different formulations and promises, and they are not all created equal, says McKenzie Mann, hemp researcher and product development manager for Blue Forest Farms, a farm that grows high-CBD hemp and sells CBD products.

“CBD is kind of the wild west these days,” Mann says. “Anyone can get in the business and there are a lot of so-called CBD products with little or no actual cannabidiol in them,” he explains. Mann adds that there’s a big difference between a bottle you grab at the gas station and a high-quality, independently tested product.

In addition, different strains of hemp plants have different chemical makeups, making some better suited for helping with insomnia than others, Mann says. “Look for a strain higher in terpenes, a compound that has been shown to improve sleep,” he recommends, adding that a tiny amount of THC will compound the sleep-promoting effects (as long as it’s legal where you live).

Another option Mann suggests is to look for cannabinol (CBN) oil. CBN is a compound extracted from the hemp plant, similar to CBD oil, but has an even more powerful sleep-promoting effect.

“A full-spectrum oil will give you the CBN and terpenes along with the CBD so that’s always my first recommendation,” Mann says.

Types of CBD extracts

There are actually four types of CBD extracts, according to Mann.

• Full spectrum. This is the most natural oil. It’s extracted raw from the plant and contains a full spectrum of compounds, including CBD, CBN, THC, terpenes, chlorophyll, minerals, and other parts of the hemp plant. “This is usually the best for most people and what we recommend—it’s the ‘entourage effect’, all the compounds in the plant work best when they are together,” he explains. Mann adds that this is what he recommends first for insomnia, but because it does contain some THC, it may not be legal where you live.
• Full spectrum isolate. This CBD contains just the cannabinoids (CBD, THC, and others). The other compounds, including terpenes, chlorophyll, and minerals, are removed, which also mellows out the flavor. So, if you don’t like the strong flavor of a full spectrum, this might be a good option for you, Mann says.
• Broad spectrum. For places that do not allow THC, this is basically a full spectrum product, but with the THC removed. CBD products need to contain less than 0.3 percent THC to be sold anywhere in the U.S., according to the 2014 U.S. Farm Bill. A higher amount of THC in the CBD product will make it more effective for insomnia. However, if you live in a state where marijuana is not legal, this is a good option, he says.
• “Pure” CBD isolate. These products are 99 percent straight CBD with all other compounds removed. But, while this might look like what you want—especially as it’s often labeled “pure CBD”—it’s the least effective form, Mann says. However, it still can have some effect on insomnia so it’s worth trying.

For the best results treating insomnia, Mann recommends looking for a full-spectrum CBD product with 3:1 or even 5:1 ratio of CBD to THC.

How to use CBD for insomnia

“I recommend starting with 20mg taken one hour before bedtime, many people will see improvements just at this starting dose,” Dr. Clifton says, adding that if you aren’t seeing an effect after two weeks, you can start to increase the dose incrementally.

Dobratz has found that two doses per day, one in the morning and one at bedtime, is her sweet spot. However, there’s a huge variation in how people react to CBD and underdosing is a common issue, so work with your doctor to find what works for you. Know that it may require some experimenting to find what works, Dr. Clifton says. (Here’s what doctors wish you knew about CBD.)

Another factor to consider is the method for taking it. CBD is most often found as an oral tincture or oil, and you use a dropper to place it under your tongue, allowing it to absorb slowly. But, you can also find CBD lotions, capsules, gum, edibles, and inhalants. “Using sublingual drops is the most common method for treating insomnia but many people prefer capsules, because the sedation associated with the oral therapy is a little more intense than when the product is taken sublingually for some people,” Dr. Clifton says.

“If one type doesn’t work for you, it’s worth trying a different method to see how you respond,” Mann adds.

Where to buy CBD for insomnia

“A good CBD supplier should be able to tell you exactly where their product comes from, what types of strains they have, and what they are good for,” Mann explains. “If they can’t answer your questions, chances are it’s not a good product.” If you don’t have a physical store available you should purchase directly from a high-quality store online (not Amazon) and they should provide a phone number or email for you to ask questions, he adds.

You should also expect to pay more for a high-quality, effective product—but it doesn’t have to break the bank. However, CBD is expensive, so if you find a super cheap deal, there’s a good chance it doesn’t have much, if any, real CBD in it, he says.

Dobratz found a CBD oil, Relive Everyday, through a homeopathic doctor’s office. She opted for one without THC. “It costs $100 a bottle, but it’s worth it because it works so well for me,” she says. “I’m so glad my psychiatrist recommended it or I probably wouldn’t have tried it.” (Here’s are vitamins and supplements doctors take every day.)

Seeing improvements in insomnia with CBD

Dobratz says she saw an immediate improvement in her ability to fall asleep after starting CBD oil. According to Dr. Clifton, this isn’t uncommon.

“Many people see improvement with their first administration, but it’s wise to set aside two weeks to see if it’s effective for you,” Dr. Clifton says. “Everyone’s endocannabinoid system is a little bit different in how it responds,” she says,  “so, one patient may feel a difference after the first dose, but others may need several days or weeks to build up enough to where you feel it.”

You also need to be consistent with your dosing, taking the same amount at the same time every day and not skipping doses, Mann says. (Here are 11 “harmless” habits that can cause insomnia.)

What are the side effects of CBD?

The most commonly reported side effects of CBD are diarrhea, changes of appetite/weight, and tiredness (which could actually be considered a benefit for insomniacs), according to a 2017 study published in Cannabis and Cannabinoid Research.

“Luckily, the biggest side effect of CBD is a feeling of sedation, which suits the insomniac just fine,” says Dr. Clifton. While most of her patients feel more sleepy and less anxious after taking CBD, it’s not for everyone, she says.

“It may be due to individual differences in levels of receptors or enzymes but we’ve found that about 20 percent of people don’t get the expected results,” Dr. Clifton explains. (If you find out you’re one of them, try these 10 weird tricks that worked for people with insomnia.)

Severe side effects from CBD are rare, and it isn’t known to interact with any medications. However, there isn’t a lot of research in this area yet, so talk to your doctor first, and proceed with caution if you have other chronic conditions, Dr. Clifton says.

Dr. Clifton does note that with any supplement, allergies are always possible. So, if you experience a rash, hives, or swelling, stop taking it and call your doctor; if you have trouble breathing, get emergency care immediately, she says.

You may also experience side effects from other ingredients added to the CBD, like a carrier oil or filler in capsules, depending on the manufacturer.

Practice good sleep hygiene

What else should you do to improve the sleep-enhancing effects of the CBD?

Having good sleep hygiene is incredibly important to anyone dealing with insomnia and you should do everything you can to create a good sleep environment, Dr. Clifton says.

“I tell my patients that the CBD on its own won’t be as effective without implementing other healthy changes,” she explains. “Keep your bedroom cool, dark, and quiet. No screens at least an hour before bedtime. Get exercise during the day. And don’t use your bedroom as an office or for other purposes—your bedroom should be used exclusively for sleep and sex.”

As for Dobratz, she says CBD has helped her become less anxious and improve her sleep. “It really just makes me feel relaxed and tired when I take it,” Dobratz says. “It helps me chill out and not continuously worry about things when I’m trying to go to sleep. It does not, in any way, make me feel high.”

Plus, it doesn’t have any lingering effects in the morning, unlike some sleeping medications, she adds.

Little changes you can make to sleep better in just one day (The Healthy) 

WHAT YOU CAN DO NOW TO IMPROVE SLEEP LATER

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Further to the findings, the Health Survey for England (HSE) revealed that 17% of men and 18% of women had ever had asthma diagnosed, and that as many as 27% of adults reported less than 30 minutes of moderate or vigorous physical activity per week – officially classifying them as “inactive”.

The nation-wide study, which consisted of 8,178 adults and 2,072 children, also found that 10% of men and 5% of women drink alcohol nearly every day, with older age groups more likely to drink regularly.

Caroline Cerny, alliance lead at the Obesity Health Alliance said that the consistently high rate of obesity is “sadly reflective of the environment we live in – one that is flooded with unhealthy food and drinks and relentless marketing to tell us to buy and eat more and more.”

She went on to say that “it doesn’t have to be like this,” as “25 years ago, rates of adult obesity were almost half what they are today. The Government can play a vital role in shaping our food environment to help us all be healthy.”

The sugar tax, or soft drink industry levy, was introduced on 6 April 2018 by the UK Government, as UK Ministers believe that the levy will help to reduce sugar in soft drinks and tackle childhood obesity, and according to HMRC, sugar tax receipts were £153.8 million to year end in October 2018.

Caroline continued: “This is why we need the next Government to urgently bring in new regulations to restrict the marketing of junk food and compel the food industry to make everyday food less sugary and calorific.”

Back in August the Scottish Obesity Alliance called on first minister, Nicola Sturgeon, to introduce regulation to restrict price promotions and hopefully help “curb the obesity crisis.” The letter reminded that “whilst the rate of childhood obesity levels has slowed down, it has not stopped or started to decline”, before going on to call the situation a “major public health crisis.”

Also earlier this year, analysis from Cancer Research UK found that excess weight causes more cases of certain cancers than smoking, and that the number of people who are obese now outnumbers those who smoke two to one in the UK.

The data show that excess weight causes around 1,900 more cases of bowel cancer than smoking in the UK each year, while the same “worrying pattern” is seen in cancer in the kidneys (1,400 more cases caused by excess weight than by smoking each year), ovaries (460) and liver (180), the charity warned.

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India aims to treat at least 150 million people with high blood pressure (BP) across 100 districts in all the states over the next few years.

The Indian Council of Medical Research (ICMR), along with World Health Organization (WHO), has launched the India Hypertension Control Initiative (IHCI) in 25 districts across five states, which will be expanded to 100 districts by 2025.

“The national action plan targets reducing the number of people with uncontrolled hypertension by 25% by the year 2025. The IHCI is a model initiative towards that as prevention and treatment is far safer and less expensive than bypass surgery and regular dialysis,” ICMR director-general Dr Balram Bhargava said.

“It will strengthen the cardiovascular component of the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke,” Dr Bhargava said.

Under the IHCI, every person above 30 years of age will be screened for high blood pressure in a primary health centre or sub-centre and also health and wellness centres.

Uncontrolled hypertension or high blood pressure is a leading risk factor for heart attack, stroke and kidney failure. According to government data, 200 million adults have high blood pressure, and 50% of them do not know about it.

“India has a huge disease burden wherein one in four suffers from hypertension. What’s worse, however, is that only one in 10 of those has blood pressure under control. It puts a large number of people under the risk of sudden heart attacks and strokes,” Dr Meenakshi Sharma, ICMR scientist who is involved with the project, said.

Telangana, Punjab, Madhya Pradesh, Maharashtra and Kerala are already screening people under the programme and have registered about 300,000 hypertensive people in the last one year.

As part of the project, health workers at primary health centres and subcentres have been extensively trained in screening people above 30 years using professional digital monitors.

People with blood pressure readings of 140/90mmHg or above are being put on blood pressure medicines on the basis of a standard treatment protocol that the states have designed with the help of experts from ICMR and WHO. The expansion plan targets at least two districts in each state.

“Putting almost 180 million people on treatment is a huge task. There will be challenges like stopping patients from dropping out of the programme etc., so the staff has also been trained to counsel patients,” Dr Prabhdeep Kaur, head of non-communicable diseases division at National Institute of Epidemiology, said.

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