cartoon drawing of Marijuana plant and CBD that people are wondering whether they help sleep apnea

Can CBD really help sleep apnea? – What we know and 4 ways it might help

By Jason Wooden, PhD | August 7, 2022

While cannabinoids have been found to reduce apnea events in animal studies, there’s currently no direct evidence that CBD can be used to treat sleep apnea.  However, CBD may help with other underlying causes of insomnia such as anxiety and pain which can help sleep apnea patients sleep better.

Why we’re considering giving CBD a try for sleep apnea…

If you’re seriously thinking about giving CBD a try to help your sleep apnea, you’re likely not the only one.  After all, nearly a billion people worldwide struggle with sleep apnea to varying degrees.

That’s a lot of people waking up feeling as if they haven’t slept at all…

Struggling with morning headaches…

Spending their waking hours as a sleep-deprived zombie…

And it’s all because their breathing is getting repeatedly interrupted and every time it happens it arouses them out of deep sleep into a lighter sleep.  (You can get more on the basics of sleep apnea here.)

Unfortunately, as effective as CPAP is, many patients stop using their CPAP machines within the first year of treatment.  Some find the mask uncomfortable while others complain about the blowing air, system leaks, dry nose, red eye, or nasal congestion.

I remember how miserable and desperate I was before I got my sleep apnea under control.

It totally makes sense why people are what to learn more about their options including natural remedies.

CBD, short for cannabidiol, 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.

There’s certainly been a lot of buzz (no pun intended) around cannabinoid products. 

CBD is being looked at for a wide range of health benefits including anxiety and mood disorders, pain relief, and managing symptoms of neurological disorders such as Parkinson’s disease.

Maybe for you’ve been struggling with CPAP or perhaps you’re just looking for anything that can make your nights easier…

Regardless, we’re going to take a look at what we know and then you can decide whether CBD makes sense for you.

How CBD could affect sleep apnea

The way CBD affects the body and the way it could affect sleep apnea is through it’s effects on the brain.

CBD and other cannabinoids interact with proteins on the cells in the brain called cannabinoid receptors.  These receptors are part of the endocannabinoid system, a complex signaling system in the body that has been linked to appetite, mood, stress, learning and memory, inflammation, and pain.

Evidence is growing that the endocannabinoid system is also involved with regulating circadian rhythms and sleep too.

So, it’s not so crazy that CBD could affect sleep apnea too.

Can CBD really help with sleep apnea?

While cannabinoids haven been found to reduce apneas in animal studies, the effects of CBD on sleep apnea in humans hasn’t been well-studied.  So, there’s currently no direct evidence that CBD can be used to treat sleep apnea.

This doesn’t mean CBD can’t help with sleep apnea, just that we won’t know the answer until the right studies are done.

 

However, initial research does suggest that CBD may support the sleep and health of sleep apnea patients in other ways:

1) Improved sleep

Many sleep apnea patients struggle with falling asleep and staying asleep.  There’s growing evidence that CBD can help with insomnia.

2) Stress and anxiety

Stress and anxiety are among the most common challenges for sleep.  In addition to anxiety surrounding life and sleep, an additional challenge for some sleep apnea patients is that they experience anxiety and panic attacks from CPAP.

CBD has been found to be helpful for anxiety in clinical studies.

3) Inflammation

Patients with obstructive sleep apnea, the most common sleep apnea type, have upper airway and systemic inflammation.

In fact, sleep apnea severity has been found to correlate with high levels of inflammation – the worse your sleep apnea is the more inflammation found in the body.

CBD has anti-inflammatory and antioxidant effects that could be beneficial for fighting obstructive sleep apnea inflammation.

4) Pain

Pain and body aches is another common cause of poor sleep for millions of people.  Unfortunately, studies show that obstructive sleep apnea patients are more likely to experience chronic pain which is an added challenge for their sleep.

While there’s still a lot of research to be done, the evidence is growing showing the benefits of CDB for pain.   In fact, a recent meta-analysis of the combined data from 25 clinical studies found that CBD could be helpful for pain management.

In summary, while there’s little direct evidence that CBD can be used to treat sleep apnea, it may help with managing some of the symptoms and underlying causes of poor sleep in sleep apnea patients.  This could make it easier for them to sleep.

Can I put CBD in my CPAP machine to help my sleep apnea?

This is likely a bad idea for multiple reasons.

First, there’s the risk of damaging your CPAP machine which can be costly.  In fact, your user manuals give explicit warnings not to put anything in the humidifier tank except distilled water. 

At a minimum it can create a mess.

photo of CBD oil in droplet which you may be tempted to add to your machine to help your sleep apnea

Second, there’s no evidence that this would do anything beneficial.  Also, CPAP machines are not designed to deliver therapeutic doses of actives such as CBD oil in a vapor.

Lastly, you could be exposing yourself to potential safety risks from inhaling pure CBD.

Don’t forget anyone nearby could potentially be exposed to CBD-laced air coming from your CPAP setup.

Is there a cannabinoid-based drug to treat sleep apnea?

There are currently no cannabinoid-based drugs approved by FDA to treat sleep apnea.

EPIDIOLEX is a drug that contains a highly purified form of cannabidiol (CBD).  It’s been approved by FDA for the treatment of seizures associated with Lennox-Gastaut syndrome (LGS), Dravet syndrome, and tuberous sclerosis complex (TSC).

It has not been tested clinically as a treatment for sleep apnea.

Dronabinol, a drug based on synthetic versions of THC, has attracted interest as a potential sleep apnea therapy.  It’s currently approved as a treatment for nausea and vomiting in chemotherapy patients.  It’s also approved for appetite and weightloss in people with AIDS.

It was tested in a small study involving 73 adults with moderate to severe sleep apnea and found to reduce the number of sleep apnea events.  However, while the results were encouraging, the researchers said that larger scale clinical trials were needed to validate it’s usefulness.

In a 2018 position statement, the American Academy of Sleep Medicine advised against the routine use of medical cannabis and synthetic marijuana extracts for obstructive sleep apnea treatment until there is sufficient scientific evidence of safety and efficacy.

Can CBD worsen sleep apnea?

Since this issue hasn’t been specifically studied in patients, we don’t know definitively whether CBD can worsen sleep apnea.

However, CBD is known to cause some individuals to feel more awake and make it harder to fall asleep sleep.  In fact, in various online forums you will find individuals complaining about sleep difficulties after taking CBD oil.

So, what’s going on?

Researchers are learning that CBD is biphasic.  It’s effects the body one way at a lower amount and the opposite way at a higher amount.

At low or moderate dosages, CBD appears to make some people feel more alert while higher dosages are associated with improved sleep.

Other reasons it may keep you awake include poor product quality, individual differences, and interactions with other substances.

So, the short answer to whether CBD can worsen sleep apnea is maybe.

Learn more

How best to try out CBD for sleep apnea

If you decide you want to give CBD a try for your sleep apnea, there’s a couple of things to keep in mind:

It’s a good idea to check with a doctor

Keep in mind that natural actives such as CBD haven’t been as well-researched as pharmaceuticals.  Consequently, there’s less known about side effects and possible interactions with other substances such as medications.

It’s a good idea to check with your doctor first, especially if you’re dealing specific health challenges and taking other medications.

An alternative medicine practitioner such as an herbalist or naturopathic physician can advise you on dosing and safety issues.

Get your CBD from a good source

There are plenty of places you can get your CBD from, some good and some not as good.

Unfortunately, the CBD industry is growing like crazy and there’s currently a bit of the wild west out there.  It’s hard to know with some CBD products how pure it is and how much CBD you’re actually getting in a dose.

Some things to look for are:

  • 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

If you’re looking for options, here’s a high quality CBD oil provider I use which I recently reviewed here.

Try taking it with food for better results

A University of Minnesota study found that high fat foods can increase the absorption of bioavailability of CBD.  Compared to people who fasted, subjects who took their CBD with food increased the amount of CBD in the body by 4-times and the maximum amount recorded in blood by 14-times.

Other natural sleep aids besides CBD worth a try

CBD isn’t the only natural option that may help support the sleep of sleep apnea patients.  Other natural aids worth a try include:

photo of turmeric

Turmeric

Inflammation has been found to play a role in many health conditions including heart disease, diabetes, cancer, arthritis, and digestive disorders.  I’ve already mentioned the link between inflammation and obstructive sleep apnea.

Turmeric is well know for it’s anti-inflammatory properties.  While it hasn’t been directly tested for sleep apnea, promising results have been seen for other medical conditions linked to inflammation.

Learn more

photo of patient getting acupuncture which an alternative to CBD which may help sleep apnea

Acupuncture

Acupuncture is derived from Chinese traditional medicine and has been developed over a period of more than 2000 years.  It works by stimulating specific points on the body and has been used to treat a variety of ailments.

Evidence is growing it can reduce breathing interruptions in obstructive sleep apnea patients.

Learn more

photo of healthy breakfast

Dietary changes

While the link between food and sleep apnea hasn’t been well-studied, a healthier diet may help you lose weight which is one of recommended remedies for obstructive sleep apnea.

Also, similar to turmeric, eating an anti-inflammatory diet may help.  Among the things to avoid are excessive sugar, refined carbs, processed foods, and trans-fat.

Learn more

photo of wedge pillow which is an alternative to CBD which may help sleep apnea

Try sleeping upright with a wedge pillow

Recent research has found that elevating your head can help improve symptoms in some sleep apnea patients.  You can try doubling up with a couple pillows.

However, for better results try this foam wedge pillow listed here(I sleep with this pillow every night to help keep my sleep apnea under control.)

It’s more comfortable and designed to elevate your head at the right angle.

Learn more

Sources:

1. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis, Lancet Respir Med. 2019 Aug; 7(8): 687–698.

2. “A comparison of CBD and THC”, 2019, Medical News Today

3. CBD Oil — Are the Benefits Claimed Too Good To Be True?, 2021, Cleveland Clinic

4. Cannabinoid Receptors and the Endocannabinoid System: Signaling and Function in the Central Nervous System. Int J Mol Sci. 2018 Mar; 19(3): 833.

5. CBD: For Sleep and Insomnia, American Sleep Association website

6. Effects of Cannabinoids on Sleep and their Therapeutic Potential for Sleep Disorders. Neurotherapeutics. 2021 Jan; 18(1): 217–227.

7. Cannabis, Cannabinoids, and Sleep: a Review of the Literature. Curr Psychiatry Rep. 2017 Apr;19(4):23.

8. Cannabidiol: A Potential New Alternative for the Treatment of Anxiety, Depression, and Psychotic Disorders. Biomolecules. 2020 Nov; 10(11): 1575.

9. Upper airway and systemic inflammation in obstructive sleep apnoea. European Respiratory Journal 2016 48: 1108-1117

10. Antioxidative and Anti-Inflammatory Properties of Cannabidiol. Antioxidants (Basel). 2020 Jan; 9(1): 21.

11. Research shows pain relieving effects of CBD, 2021, ScienceDaily

12. Effects of Cannabinoid Administration for Pain: A Meta-Analysis and Meta-Regression. Exp Clin Psychopharmacol. 2019 Aug;27(4):370-382.

13. FDA Approves First Drug Comprised of an Active Ingredient Derived from Marijuana to Treat Rare, Severe Forms of Epilepsy, 2018, FDA website

14. Dronabinol, MedlinePlus

15. Cannabinoid May Be First Drug for Sleep Apnea, 2018, Medscape

16. Position statement: Avoid using medical marijuana to treat sleep apnea, 2018, American Academy of Sleep Medicine website

17. Biphasic Effects of Cannabinoids in Anxiety Responses: CB1 and GABAB Receptors in the Balance of GABAergic and Glutamatergic Neurotransmission. Neuropsychopharmacology. 2012 Nov; 37(12): 2624–2634.

18. High fat foods can increase CBD absorption into the body, 2019, University of Minnesota website

19. Food effect on pharmacokinetics of cannabidiol oral capsules in adult patients with refractory epilepsy. Epilepsia. 2019 Aug;60(8):1586-1592.

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