Discover the benefits and trade-offs of each, as well as a solution that combines both. People going through treatment for cancer deal with several difficult physical and emotional symptoms, but the one that is especially …
CBD vs Melatonin For Sleep
Of all the over-the-counter natural ingredients for better sleep, melatonin may be the most common. Recently, however, CBD has emerged as a promising solution for a good night’s sleep. Below, we explain the benefits and trade-offs of each, as well as a solution that combines both.
What is CBD?
In order to talk about CBD, we first have to zoom out to cannabinoids, which is a fancy word to describe some of the naturally-occurring, bioactive compounds found in cannabis, including:
- Cannabidiol (CBD): non-psychoactive compound derived from the hemp plant
- Cannabinol (CBN): derived from the oxidation and decomposition of THC from the hemp plant
- Cannabigerol (CBG): the first phytocannabinoid synthesized in the hemp plant that then converts into other cannabinoids
- Tetrahydrocannabinol (THC): the active compound in the cannabis plant responsible for its psychoactive effects (this is what gets you “high”)
Over 140 cannabinoids have been identified in the cannabis plant, as well as in cloves, black pepper, echinacea, broccoli, among others.
Although it’s all grouped under the umbrella of “cannabis,” not all products contain significant amounts of tetrahydrocannabinol (THC).
Who CBD is best for
If you’re finding it difficult to fall or stay asleep due to stress and anxiety (that usually manifests as a racing mind), CBD may be a great alternative to traditional sleep aids.
Different forms of CBD + how to take it
Benefit: Easy to incorporate as part of your wellness supplement routine—and ideal if you’re looking for CBD sleep support.
What to look for: High-quality supplements formulated without added fillers or binders, as well as supplements tested for potency and purity. You should also be able to access the certificate of analysis.
What to look for: CBD products with high-quality hemp extraction methods, which offer the cleanest and most pure ingredients (and thus preserve the cannabinoids and terpenes). Also, make sure your product is infused with CBD rather than simply coated with a CBD isolate/sugar mixture.
What to look for: CBD tinctures that are third-party tested for safety and contain no fillers or isolated plant compounds.
Does CBD help support sleep?
Research on the benefits of CBD is emerging, which means studies are still in progress and information is constantly evolving. But what we know to date is promising.
Insomnia + CBD
Although the term “insomnia” is thrown around quite a bit, by clinical standards it’s defined as trouble falling or staying asleep at least three nights/week for at least one month. CBD may help by addressing the root causes of insomnia, including anxiety and pain.
Anxiety + CBD
Stress and anxiety elevate cortisol levels, which impact melatonin levels, which disrupt our sleep-wake cycle. CBD may work to calm the nervous system and, in a recent study, (1) 80% of participants reported lower anxiety and 65% reported improved sleep.
Also, because insomnia affects daytime wakefulness, concentration, and mood, it can also lead to anxiety come nighttime about getting inadequate sleep—a vicious cycle that CBD may help ease.
Physical Discomfort + CBD
There is evidence (2) showing that CBD may significantly reduce physical discomfort by inhibiting the release of neurotransmitters from nerve endings, modulating neuron excitability, and reducing neural inflammation. Because physical discomfort is a significant culprit of various sleep disorders, researchers conclude that, by reducing discomfort, CBD also supports sleep.
How to select CBD supplements
It’s important to look for CBD supplements with a Certificate of Analysis, which is a document from an accredited third-party or internal cGMP-certified laboratory verifying the cannabinoid quantity in each specific product batch and ensuring labeling accuracy with regards to THC content. Refer to our guide to COAs for more on where to find them, how to read them, and red flags to look out for.
Other things to look for include:
- Hemp sourced from a responsible, vertically-integrated supplier for seed-to-shelf quality control and traceability
- Supplements that are THC-free (this is the substance that gets you “high”)
- Supplements with clinically-studied, non-hemp ingredients at dosage levels proven to promote quality sleep
- Tested for purity and verified free of heavy metals, microbes, and pesticides
- U.S. manufactured and produced in an FDA-approved, “Good Manufacturing Practices”-compliant facility
Side effects of CBD
Outside of drowsiness and fatigue (which some believe is related to the dosage), no notable side effects have been observed, leading researchers to conclude that CBD is well-tolerated among adults.
What is melatonin?
Melatonin is a hormone produced by the pineal gland in the brain, then released into the bloodstream. Quantities naturally increase as the sun goes down and decrease during daytime hours and exposure to bright light, thus regulating the sleep-wake cycle (aka circadian rhythm).
When it’s produced within our bodies, it goes by the name endogenous melatonin; however, some also choose to supplement their natural levels as a way to effectively adjust and regulate their body’s internal clock.
Who melatonin is best for
Melatonin is best for those suffering from circadian rhythm sleep disorders such as:
Officially known as “Rapid Time Zone Change Syndrome,” jet lag messes with your sleep times and wake times as you cross into new time zones, especially when traveling east.
Does melatonin work?
As is the case with all natural sleep supplements, there’s not a one-size-fits-all answer to this question. Your sleep and overall health must be evaluated holistically to help you understand and solve the issue(s) at hand.
That being said, there is research supporting the efficacy of melatonin. One meta-analysis in particular, (3) which compared melatonin against placebo in improving sleep parameters for patients with primary sleep disorders, showed that the supplement reduced sleep latency (the amount of time it takes to fall asleep) by 7.06 minutes and increased total sleep time by 8.25 minutes. Also promising was the fact that trials with a longer duration and higher doses of melatonin demonstrated greater effects on decreasing sleep latency and increasing total sleep time.
How to select melatonin supplements
It’s important to do your research to ensure your supplement of choice contains what it says it does and is not contaminated with heavy metals or pesticides. Here’s what to look for when selecting a melatonin supplement for short-term or longer-term use:
- Third-party tested for purity and verified free of heavy metals, microbes, and pesticides
- U.S. manufactured and produced in a Food & Drug Administration (FDA)-approved, “Good Manufacturing Practices”-compliant facility
- If the supplement has other ingredients or botanicals, ensure they are standardized to guarantee consistent purity, potency, and efficacy
- Free of artificial colors or binders
- Non-GMO and, if it’s important to you, vegan, gluten/dairy/sugar-free
Side effects of melatonin
A small percentage of melatonin users have been found to experience daytime drowsiness, sleepiness, headaches, and dizziness; however, there is no evidence of a risk for serious, clinically significant adverse events (AEs). (4) As a precautionary measure, it’s recommended that users not drive or use machinery for four to five hours after taking melatonin.
Melatonin + CBD are not mutually exclusive
While it’s important to understand the differences between melatonin and CBD as sleep aids, it’s equally as important to recognize that there are supplements containing both, such as Proper’s Sleep + Restore with CBD formulation which, unlike other CBD supplements, was specifically designed to support sleep.
We started with our Core Sleep foundation of four key clinically-studied ingredients at dosage levels proven to promote sleep: Sensoril® Ashwagandha, GABA, Venetron®, and valerian root extract. From there, we added both standard and MicroActive® extended-release melatonin in order to provide sleep support throughout the night. And finally, we added THC-free broad spectrum hemp extract (CBD), omega-3 oil, and terpenes, which emerging science shows may reduce stress and anxiety to further improve sleep quality.
Considering CBD or Melatonin for Sleep? What to Know
People going through treatment for cancer deal with several difficult physical and emotional symptoms, but the one that is especially frustrating is poor sleep. Not sleeping well leaves you with daytime fatigue, irritability and trouble concentrating long enough to get anything done, which is especially upsetting on days that you have off from medical appointments. Being awake in the middle of the night is psychologically difficult given that the quiet of night hours leave little to distract you from worries about your cancer experience and other life stressors.
Given the distress of not sleeping, of course people are going to look for relief. Just one Google search, conversation with a friend, or inquiry about insomnia at the pharmacy will likely bring up the suggestion of using CBD (cannabidiol) or melatonin. Both supplements are widely marketed and promise to help people rest well without the trouble of a prescription. They are both considered “natural” remedies, which appeals to people.
If you’re considering one of these options, the most important thing to know is that since supplements are not regulated by the Food and Drug Administration there is no quality control or oversight of these products. In fact, studies have shown that in a high percentage of cases, what is in the supplement is not exactly what is on the label. Supplement contamination with other sedatives or added chemicals to help with shelf life, smell, consistency, etc. may come serious side effects such a lung injury as the recent news about vaping harms demonstrated.
CBD can legally be obtained from the hemp plant (a cousin of the marijuana plant) since the passage of the Farm Bill in 2018. However, regulation of the hemp growing industry is not widely done, and what is sold as CBD may actually have more THC (the psychoactive part of the marijuana plant) than you want, which could cause an abrupt change in thinking which is very anxiety provoking for some people (and not good for sleep!). The CBD products are so new to the market that we have almost no research into whether or not CBD helps insomnia in patients with cancer, or is safe during cancer treatment. Be sure to talk to your oncologist if you are planning to use a CBD supplement.
There has been more use of melatonin in medical care, primarily because it has always been legal, but also because there is research to support the use of melatonin to correct circadian rhythm disorders, situations when people have their days and nights reversed because of jet lag or night shift work. If melatonin is used for insomnia, the recommendation is to take it 2 hours before bed, because the goal is not to feel sleepy right away, but to reset your circadian rhythm, meaning the melatonin in your body gets released at the right time in the day night cycle.
Is it better to take one of these supplements than a prescription sleep aide like Ambien or Lunesta? Supplements still come with side effects (sedation, confusion, falls, and medication interactions), they may be more expensive than prescriptions (so no financial savings) and there is no guarantee “natural” is better. Actually, the best medicine for insomnia is not a medication or supplement at all, but a type of therapy called “cognitive behavioral therapy for insomnia” (CBT-I). This therapy, backed by research, is administered by a professional therapist and emphasizes healthy sleep hygiene. If you do not have access to CBT-I therapy, you can still make changes to your sleep hygiene – and improve your sleep – on your own.
For better sleep, set up your daily schedule so that you are primed for restorative rest at night:
- Get out of bed at the same time every single day (alarms are helpful), and let your eyes be exposed to morning light. The morning light will reset the melatonin already in your body.
- If you drink any caffeine, only drink it at breakfast (the half-life is long, it will be in your system at night).
- Get outside and walk daily – exercise is literally medicine for your sleep.
- Schedule time to manage cancer (scheduling appointments, research, bills) early in the day, and no cancer talk after dinner (so you are not thinking about it when you try to sleep).
- Put a paper and pen by the bed, and if you have a worry or question pop up, jot it down, better on the paper than in your head.
- Sleep ina cold, dark, quiet room and turn off all screens at least one hour before bed (the light will disrupt your day night cycle).
Talk to your doctor about your sleep and whether you might need an appointment with a specialist. If your sleep is disrupted by clinical depression or an anxiety disorder, then treating the mood and worry will be the appropriate sleep medicine.
Having cancer is hard enough, and then trying to manage sleep disturbances on top of that does not seem fair. However, the payoff for working on your sleep is so worth it! Feeling rested in the morning makes the day feel like something you can handle. Patients in survivorship have commented that the skills that they developed during cancer treatment are useful long after treatment ends. “I did not want to deal with cancer, but it taught me a lot about really taking care of myself,” “if I pay attention to my sleep habits, my energy is so much better” and “there is no perfect pill for sleep, but I know I will eventually sleep, especially if my days are busy.”
Wendy Baer, MD, is the medical director of psychiatric oncology at the Winship Cancer Institute of Emory University in Atlanta. Dr. Baer helps patients and their families deal with the stress of receiving a cancer diagnosis and going through treatment. Her expertise in treating clinical depression and anxiety helps people manage emotions, behaviors and relationships during difficult times.
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