photo of frustrated man in bed wondering if CBD is making his IBS worse

IBS and your sleep: Can CBD make things worse?

By Jason Wooden, PhD | November 9, 2023

There’s growing interest in CBD for IBS, insomnia, and other health issues

Would you believe as many as 40% of people with IBS also struggle with poor sleep?

I don’t have IBS but years ago I worked in this field and vividly remember hearing from patients about their day to day frustrations. 

I also struggle with ongoing chronic pain and poor sleep so I know what it’s like to be on the lookout for new ways to get relief that won’t make things worse.

So, I totally get why you would want to know whether taking CBD could make IBS, your sleep, or anything else worse.

After all, living with IBS and poor sleep can be tough enough.

Anything that adds to the misery is to be avoided.

CBD, short for cannabidiol, is showing promise as a natural remedy for a wide variety of aliments including anxiety, inflammation, pain, and insomnia.

photo of hemp plant and CBD oil extract

I’m not surprised people are interested in using it for IBS.

CBD is one of the better known actives along with THC derived from the cannabis plant. Even though both are cannabinoids, they interact with the brain in slightly different ways.

THC is the main psychoactive compound that gives people a “high”.

CBD is made from hemp, a type of cannabis plant that contains very low levels of THC.

CBD and other cannabinoids interact with proteins on the cells in the brain and body called cannabinoid receptors.

It turns out cannabinoid receptors have also been found in the intestinal track so it’s not too crazy that CBD could also help IBS patients struggling with pain and other symptoms.

In fact, early research suggests CBD may be helpful for managing some IBS symptoms.

However, despite the promise, it’s fair to ask if there’s any way CBD could worsen symptoms for IBS patients including poor sleep.

Let’s take a look at what we know.

Can CBD worsen IBS symptoms and sleep?

If you’re taking CBD for IBS or insomnia, it’s important to keep in mind that there is very little direct research looking at the benefits and possible downsides for IBS patients. 

Most of the research showing how CBD could be helpful for IBS involves lab studies and animal studies.

One small study involving 32 female IBS patients tested whether a chewing gum containing 50 mg CBD could help with abdominal pain and well-being.  The study didn’t find that IBS symptoms were worse for any patients who used the chewing gum.

As far as other possible downsides, we do know that CBD can worsen sleep for some individuals.

We are learning that CBD is biphasic.  It affects the body one way at a lower dose and the opposite way at a higher dose.

This means CBD can make some people feel more alert when taken at low or moderate doses while higher dosages promote sleep.

Finally, CBD has been reported to cause diarrhea, drowsiness, and fatigue in some individuals.  It may also interact with some medications.

So, while we don’t know for sure, it is possible CBD could worsen IBS, sleep, and other things for some individuals.

Other ways CBD could make things worse for people with IBS

There are other potential downsides you should be aware of if you’re taking a CBD supplement to help with IBS or sleep:

Poor quality product

Unfortunately, it’s still a bit of the wild west when it comes to CBD products.  It’s hard to know for some products how much CBD you’re actually getting in a dose and how pure it is.

A 2020 FDA survey of 102 CBD products found that 18 had less than the CBD amount indicated and 38 contained more than 120 percent of the CBD amount indicated.  They also found that 49% of the products contained the psychoactive THC.

If the brand you’re using doesn’t have good quality control, you could be unknowingly taking the wrong dose and getting undesired effects.

photo of CBD oil in bottle which can make things worse for IBS patients if of poor quality

Individual differences

Everyone’s body is different.  We’re just beginning to learn about how your genetics can affect what CBD does once it’s in the body.

Also, other things going on in your body such as a health complication could affect what CBD oil does when taken for better or for worse.

Interactions with other substances in the body

There’s still a lot to be learned about what happens when you take CBD and other substances at the same time, including whether there’s an increase in side effects or CBD affects the action of other medications.  Learn more

How best to try out CBD

Even though we don’t know for sure whether CBD can worsen IBS symptoms, it’s best to check with a doctor given all the possible downsides.

You can also check with an alternative medicine practitioner such as an herbalist or naturopathic physician.  They can advise you as to the best dosing for you, how best to take it, and any safety issues.

cartoon drawing show man reading CBD bottle label

Some things to look for in CBD supplement include:

  • A well-known and reputable company with minimal complaints
  • 3rd party testing done to verify CBD amounts and purity
  • A certificate of analysis which you can review

Other natural remedies worth a try if you’re concerned CBD can make IBS worse

If you’re worried CBD could make IBS and other things worse, here’s where we get to the good news.

First, there are standard IBS treatment approaches you should definitely consider if you haven’t already:

Stress and anxiety management – doing whatever you can prevent stress from triggering symptoms

Dietary changes – your doctor and a nutritionist can help you avoid foods that worsen IBS symptoms

Cognitive behavioral therapy – a specialized type of counseling that can help you change the way you cope with IBS and change the stress response in the body that can worsen symptoms

Exercise – some people notice a big difference in their IBS symptoms on the days they do something physical like taking a walk

Your doctor can help you figure this out.

photo of natural supplements

Also, it turns out there’s a wide variety of natural remedies that can help manage IBS symptoms:

1) Peppermint Oil

A recent study looking at the combined data from 12 separate clinical trials concluded that peppermint oil is helpful for managing IBS symptoms.

Learn more:
Peppermint Oil (NCCIH website)
Peppermint Oil for IBS (Healthline)

2) Probiotics

Probiotics are live microorganisms such as bacteria or yeast that are intended to have positive health benefits when consumed.

An American College of Gastroenterology meta-analysis of more than 30 studies concluded that probiotics could be helpful for improving IBS symptoms including abdominal pain.

Learn more:
Probiotics – even inactive ones – may relieve IBS symptoms (Harvard Health Publishing)

3) Melatonin

Melatonin is a hormone that’s involved in regulating the body’s natural sleep-wake cycle. Studies have shown melatonin can help relieve abdominal pain and improve quality of life for IBS patients.

Learn more:
What to know about IBS and melatonin (Medical News Today)
6 Foods High in Melatonin (GoodRx)

4) Turmeric

Famous for its use in Indian curries, turmeric is well-known for its powerful anti-inflammatory and anti-oxidant properties.  It’s been used to help with ailments ranging from arthritis to heart disease.

Early research suggests it may also be beneficial for IBS patients.

Learn more:
Turmeric (NCCIH website)
Turmeric for IBS (MedicalNewsToday)

5) Acupuncture

Acupuncture, derived from traditional Chinese medicine, works by stimulating specific points on the body with thin needles.  It’s been shown to be useful for a wide variety of ailments including pain.

Studies have confirmed that acupuncture can be helpful for treating pain and other symptoms for some IBS patients.

Lean more:
Acupuncture (John Hopkins Medicine)
Can acupuncture treat irritable bowel syndrome? (Medical News Today)

6) Music therapy

Studies have shown that music can promote relaxation and help relieve pain.  It alleviates anxiety and stress which can contribute to pain.

Learn more:
Music Therapy for Pain Management Fact Sheet (American Music Therapy Association)

Before trying out a natural remedy, it’s strongly recommended that you check with your doctor and an alternative medicine specialist such as a naturopathic physician.


Sleep and IBS – 40% of Patients Report Issue, International Foundation for Gastrointestinal Disorders website (source)

Cannabidiol (CBD): What we know and what we don’t, 2021, Harvard Health Publishing (source)

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Irritable Bowel Syndrome: Manipulating the Endocannabinoid System as First-Line Treatment. Front Neurosci. 2020; 14: 371. (source)

Can people use CBD for irritable bowel syndrome?, 2023, MedicalNewsToday (source)

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Cannabidiol, extracted from Cannabis sativa, selectively inhibits inflammatory hypermotility in mice. Br J Pharmacol. 2008 Jul;154(5):1001-8. doi: 10.1038/bjp.2008.177. Epub 2008 May 12. (source)

Effects of Cannabidiol Chewing Gum on Perceived Pain and Well-Being of Irritable Bowel Syndrome Patients: A Placebo-Controlled Crossover Exploratory Intervention Study with Symptom-Driven Dosing. Cannabis Cannabinoid Res. 2022 Aug;7(4):436-444. (source)

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Safety of low dose cannabidiol, 2020 TGA Health Safet Regulation (source)

Medical Fraud, Mislabeling, Contamination: All Common in CBD Products. Mo Med. 2020 Sep-Oct; 117(5): 394–399. (source)

Pharmacogenetics of Cannabinoids. Eur J Drug Metab Pharmacokinet. 2018; 43(1): 1–12. (source)

Pharmacogenetic Predictors of Cannabidiol Response and Tolerability in Treatment-Resistant Epilepsy. Clin Pharmacol Ther. 2021 Nov;110(5):1368-1380. (source)

CBD and Drug Interactions: What You Need to Know, 2019, healthline (source)

The impact of peppermint oil on the irritable bowel syndrome: a meta-analysis of the pooled clinical data. BMC Complement Altern Med. 2019; 19: 21. (source)

American College of Gastroenterology Monograph on Management of Irritable Bowel Syndrome. American Journal of Gastroenterology 113():p 1-18, June 2018. (source)

Melatonin for the treatment of irritable bowel syndrome. World J Gastroenterol. 2014 Mar 14; 20(10): 2492–2498. (source)

A Meta-Analysis of the Clinical Use of Curcumin for Irritable Bowel Syndrome (IBS). J Clin Med. 2018 Oct; 7(10): 298. (source)

Can acupuncture treat irritable bowel syndrome?, 2022, MedicalNewsToday (source)

Can music improve sleep quality in adults with primary insomnia? A systematic review and network meta-analysis. International Journal of Nursing Studies Volume 77, January 2018, Pages 189-196 (source)


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