How can I best use cannabis for insomnia?

I have CFS/ME, FM, RA and I was just diagnosed with lung disease possibly caused by drug toxicity.  I have been vaping for about a year, but now need to switch to tincture due to lung disease.  My primary symptom I need to treat is chronic insomnia.  What strains are best for insomnia and how will I use tinctures to help me sleep?

I will be viewing the sensitization program as I am needing to vape too much and it’s not working anymore.

Kim T.  Age 53

Dr. Sulak’s Answer

Hi Kim,

I’m sorry to hear about your new lung issues on top of everything else you have going on with your health, but I’m glad that you’re ready to start using cannabis more effectively and to prioritize sleep.  When a person gets regular, restorative sleep, and enough of it, everything heals better.

Cannabis can be very helpful with sleep problems, and most patients have the best results when taking it by mouth.  Be sure to explore my program on switching from inhalation to tincture – it will guide you through the transition step by step.  Oral cannabis can also help the lungs by decreasing inflammation and dilating the small airways.

I’ve seen cannabis work for sleep in patients who have failed every prescription and over-the-counter sleeping aid available.  When cannabis works for sleep, it usually does so primarily by addressing the underlying problem that was preventing sleep in the first place, such as pain, anxiety, spasticity, digestive issues, etc.  By finding the right strain, one that’s sedating and not stimulating, you can combine that relief with relaxation and a sleepy, floating feeling that will hopefully carry you off into a peaceful slumber.

I recommend patients avoid strains with CBD for bedtime, because it can be awakening at low doses.  Among the THC-dominant strains, those called “indica” are usually the more relaxing and sedating.  I’m often hesitant to recommend specific strains, because the names and the actual product are often inconsistent from one producer to the next, but I hear patients reporting they sleep well with the Kush strains, Cheese and Blue Cheese, Blueberry, Mother of Berry, and some of the purple strains.  Strains that smell like lavender or fruit often have higher levels of the terpenes linalool and myrcene, both of which enhance the sedating effects of the THC.

Some patients have found that converting some of the THC into cannabinol (CBN) can make a sleep formula work even better.  This can be done by allowing the dried flowers to sit in the sun or under grow lights for a week or two – the UV light is responsible for the conversion.

For a starting dosage, I usually recommend adults begin at approximately 5mg total cannabinoids 1-2 hours before bedtime.  Gradually increase the dose each night until you wake feeling rested.  Many patients do well with 5-20mg.  By using a tincture, you can find the optimal dose by adjusting the number of drops you take.  Capsules, oils, and edible products can also work well for sleep.

Sweet dreams,

Dr. Sulak

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