The popularity of cannabis as medicine continues to increase as more and more U.S. states pass legislation allowing patients to use it to treat a variety of medical complaints. One important benefit of cannabis is its ability to help patients suffering from insomnia and other sleep-related issues. A good night’s sleep is an important component of cannabis therapy for patients with a variety of health concerns. Recent studies have revealed that cannabis may influence not only how we dream but what we may or may not remember about those dreams. If you are interested in learning more about how medical cannabis may work for you, take our eligibility survey to see if you pre-qualify for an Ohio medical marijuana recommendation in 5 minutes or less. At your initial appointment, one of our Ohio Medical Marijuana Doctors can help you determine if cannabis could help treat your medical conditions and improve your quality of life.
People have been fascinated with dreams since the beginning of recorded history. There have been many theories put forward regarding why we dream, what dreams mean, and how we remember them. Some scientists and researchers have suggested dreams can be a way to process and store memories without the extra stimulus, helping us sort through feelings and emotions we may not have had time to deal with while we were in the situation that caused them. We may dream as a way of dealing with things that happen in our everyday lives; you may have a creative flash during the day and not be able to take the time to develop it or even write it down, but while you are sleeping there are no complicating factors, so the idea can take flight and grow. Most recently, studies have shown that our minds may use dreams to help us process the emotions and memories experienced during our waking hours. These can include both good and bad sensations. A person with PTSD may have regular nightmares or even night terrors that interfere with restful sleep as well as causing agitation and panic due to remembering traumatic and/or threatening experiences. (1) A study recently conducted at a sleep lab in the United Kingdom showed the complexity and emotion involved in the daily lives of the participants directly affected the intensity and content of their dreams. It also seemed to confirm that dreams serve to process and store memories related to recent significant events by integrating the emotions and recollections associated with those events. (2)
Patients who use medicate with cannabis before bedtime, whether they are using it as a sleep aid or for another purpose, often find they cannot remember whether they dreamed at all, or may have difficulty recalling what they dreamed about. Sleep involves several different processes and usually follows a predictable cycle. A basic lesson on how and when we dream may help explain why this happens.
- Stage 1 – the brain produces alpha and theta waves, eye movement slows down, and there may be occasional muscle twitches. Stage 1 is referred to as light sleep. It’s easy to wake someone in this stage because they are still somewhat alert. This is a relatively short period, lasting up to about 7 minutes, and is what some people refer to as a “cat nap.”
- Stage 2 – brain waves produce spindles, or sudden increases in frequency, followed by a slowing of brain activity. It is still a relatively light level of sleep, and is sometimes called a “power nap.”
- Stages 3 & 4 – this is the beginning of deep sleep. The brain begins producing slower delta waves. Eye movement and muscle activity stops. People are harder to wake during this stage because they are less responsive to sound and touch. As this stage continues, sleep becomes deeper and more restorative. The body can repair and heal itself during this time, boost immune function, stimulate growth and development, and build up energy for the following day.
- REM stage – Usually beginning around 90 minutes after falling asleep and lasting about an hour, this is where most dreams occur. Most adults go through 5-6 complete cycles each night. Brain activity increases, eyes move rapidly back and forth (REM – Rapid Eye Movement), the heart beats faster, blood pressure increases, and breathing becomes more rapid and shallow. During this time, the brain carries out the important tasks of enhancing memory and learning functions by processing and storing experiences. (3) Around 80% of dreams happen in the REM stage of sleep. REM dreams are often memorable and vivid in addition to being the ones remembered in more detail when compared to dreams experienced during non-REM sleep, which tend to be more about everyday happenings. (4)
THC helps patients fall asleep more quickly. This is especially relevant for those with PTSD, insomnia, pain, multiple sclerosis, or other autoimmune/neuro-spastic conditions since it helps alleviate the symptoms that make relaxing difficult. It also decreases the amount of time spent in REM sleep; as a consequence, dreams occur less frequently and are not as vivid. This decrease in or lack of graphic or realistic dreams is particularly helpful for patients suffering from PTSD because it helps prevent the retrieval of traumatic memories and the nightmares that follow. In addition, THC may stimulate the release of neurotransmitters that elevate mood and promote emotional well-being. It can help prevent feelings of anxiety and fear by helping maintain consistent levels of endocannabinoids such as anandamides. Additionally, a 2002 study showed THC helps regulate the activity of serotonin, helping maintain regular breathing in patients with sleep apnea. (5,6)
Certain terpenes help manage insomnia due to their sedative effects. These include but are not limited to the following:
- Terpinolene, also found in lilacs and apples, is one of the least-common “common” terpenes. Normally present in small amounts, it is more likely to be found in THC-dominant strains and exerts a sedative effect. Strains with a higher concentration of terpinolene include Jack Herer, Orange Cookies, and Dutch Treat. (7)
- Myrcene is common in mangoes, lemongrass and basil. It has sedative, anti-inflammatory, and pain-relieving properties. Some strains high in myrcene are White Widow, Jack Herer, and Pure Kush. (8)
- Caryophyllene is great for helping relieve stress as well as relieving pain and inflammation. It is also present in cloves, rosemary, and hops. This terpene is abundant in strains like Girl Scout Cookies, Sour Diesel, and Bubba Kush. (9)
The effects of medical cannabis on the sleep experience can be influenced by several factors including terpenes and cannabinoids present in the product as well as dose, time, and route used. Someone who smokes or vapes cannabis can begin to feel its effects within 5 minutes, and it will begin to wear off within about 2 hours. Tinctures start working within 15 minutes; the effects can be felt sooner if they are placed under the tongue instead of just swallowed. Effects can last anywhere from 2-6 hours. It can take up to 90 minutes to feel the effects of an edible, but they can last up to 10 hours; this can help patients sleep longer without the need to re-dose. (10, 11)
Patients who use medical cannabis to help them sleep on a regular basis and need to take a tolerance break or stop using their product for some other reason may experience a phenomenon known as REM rebound. When this happens, dreams may become more frequent, vivid, and perhaps even strange as the body compensates for the decrease in REM sleep that happens while using cannabis. Fortunately, other than the increase in dreams, a decrease in REM-cycle sleep has not proven to have a negative effect on the body. (12) If you are concerned about this or another cannabis-related issue, feel free to talk to one of our Medical Cannabis Doctors about it.