From the Research
Cannabis, specifically indica strains with high THC (15-25%) and significant myrcene content, can be considered for treating insomnia, but only when other treatments like cognitive behavioral therapy for insomnia (CBT-I) have been tried or are not suitable, due to its potential to reduce REM sleep and cause dependence. The most effective non-pharmacological treatment for chronic insomnia is CBT-I, which produces results equivalent to sleep medication with no side effects and fewer episodes of relapse 1. CBT-I should be the first line of treatment, and its five key components are sleep consolidation, stimulus control, cognitive restructuring, sleep hygiene, and relaxation techniques. Some studies suggest that group CBT-I can be an efficacious treatment for insomnia, with medium to large effect sizes for sleep onset latency, sleep efficiency, and wake after sleep onset 2. When considering pharmacological treatments, eszopiclone can be used, and its combination with CBT-I may be more effective than eszopiclone alone in treating sleep disorders in patients transferred out of the intensive care unit 3. However, cannabis can be considered as an alternative treatment for insomnia, particularly for patients who have not responded to other treatments, due to its sedative properties and ability to interact with the endocannabinoid system, particularly binding to CB1 receptors in the brain. Popular indica strains for insomnia include Northern Lights, Granddaddy Purple, and Purple Kush. Start with a low dose (5-10mg THC) about 1-2 hours before bedtime, using methods like smoking, vaporizing, or edibles (though edibles take longer to work but last longer). It is essential to be aware of the potential risks and side effects of cannabis use, including reduced REM sleep, dependence, and "hangover" effects the next morning, and to carefully consider the timing and dosage to avoid morning grogginess. In conclusion, while cannabis can be considered for treating insomnia, it is crucial to prioritize CBT-I and other established treatments, and to carefully weigh the potential benefits and risks of cannabis use on a case-by-case basis.