Marijuana Therapy for Night Terrors & PTSD

Every single one of us has experienced having a nightmare—it can be terrifying, but you usually awake able to remember said nightmare and acknowledge that what you experienced was in fact a nightmare. You go back to sleep and wake up the next morning no worse for the wear. Approximately 2.2% of the adult population experiences something far more unnerving—night terrors. The American Sleep Association defines night terrors as “a parasomnia condition in which the subject reacts to a foreboding sense of fear or terror by screaming, thrashing around or crying. They may also get out of bed and walk or run around, and adults are at a risk of performing violent acts during this time. The subject is still in a sleep like state during night terrors outbursts and cannot be awoken without some difficulty.” Night terrors are considered by many in the medical community to be somewhat of a mystery, so their exact cause isn’t definitively known; however, sleep deprivation and extreme tiredness, stress, sleep schedule disruptions, fever, certain medications and mood disorders such as depression and anxiety have all been linked to night terrors.

Before we move forward, it’s important to distinguish the difference between nightmares and night terrors. Nightmares occur during REM sleep, which is why you’re able to recall imagery, sounds and/or feelings when you wake up from them. Conversely, night terrors occur in phase 3 of the sleep cycle—called NREM or the slow-wave sleep phase, which occurs just before REM sleep. During slow-wave sleep your brain waves slow down, which is why it is so difficult to wake an individual during a night terror. This also accounts for why many night terror sufferers wake up feeling confused or may not even remember having a night terror when they wake up the next morning. While both nightmares and night terrors aren’t pleasant to deal with, night terrors can negatively impact the quality of an individual’s sleep which can be detrimental to their mental and physical health long-term. 

If you think you may be experiencing night terrors, the first thing you should do is speak to your doctor to determine the cause of them. Start keeping track of the nights that you have night terrors (if you can remember them or ask a roommate, partner or family member to let you know when they occur)—this will help you start to see patterns in when the incidents occur and it will greatly help your doctor in pinpointing the potential cause of your night terrors. As night terrors are fairly uncommon in adults, knowing what is causing them is integral to determining what method of treatment (if any) is necessary for the individual. In the event that you are struggling with anxiety, depression or a traumatic experience your doctor may recommend seeing a therapist or psychologist to work on the underlying issues that may be triggering your night terrors. On the other hand, the issue may be that your night terrors occur when you haven’t gotten enough sleep—in this case your doctor will likely instruct you to set a sleep schedule and adhere to it to see if the night terrors go away on their own without any need for medication or additional treatment. The point is, every individual who struggles with night terrors is just that—an individual. No two cases of night terrors will require the exact same treatment. While this can be frustrating when you’re the one experiencing the night terrors, you should also find some comfort in knowing that there is essentially no right or wrong way to handle them—only what works for you and what doesn’t. 

Where does cannabis come into play? Despite the fact that there are no published studies that examine the effects of cannabis on night terrors, what we do know about cannabis and sleep leads me to believe that there could be something there worth looking at. One of the main treatment plans for those experiencing night terrors is stress management—especially reducing stress before going to bed. It’s no secret that medical cannabis patients have cited cannabis’ ability to help them unwind and fall asleep faster for years. Could this be beneficial for an individual with night terrors? Potentially. It’s important to be conscious of selecting cannabis products that will in fact decrease your anxiety and not cause more stress, so you’ll likely want to avoid sativas (which are better suited to daytime use and exercise) and instead opt for an indica high in the terpene myrcene (which contributes to the sedative effects of certain strains) or something high in CBD. If you decide to go with CBD be aware that studies indicate that in low doses, CBD actually makes the user more alert, so you’ll want to take more milligrams of CBD to achieve a relaxed, sedative feeling. Edibles can be another good option as they last longer and in turn can help you stay asleep longer, but a word to the wise—if you aren’t comfortable with taking edibles we recommend sticking with vaping, smoking or a tincture since the anxiety of not knowing how an edible will make you feel is counterproductive when you’re trying to eliminate stress. Doctors aren’t quick to prescribe medication for individuals with night terrors (especially children), but in some cases benzodiazepines or antidepressants are recommended for adults. In order to avoid the dependency issues or negative side effects of pharmaceuticals, cannabis could be a viable alternative. Again, it’s all about finding the right combination for you and your body—if you prefer to avoid THC, using a high dose of CBD (around 160 milligrams according to one study) can help you reduce stress prior to falling asleep and help you stay asleep longer. An article on Project CBD states that frequent cannabis users “may begin to experience a reduction in slow-wave deep sleep.” While the article presents this as an issue, I’m curious if it could actually be beneficial for an individual specifically struggling with night terrors as they occur during the phase of slow-wave deep sleep. Night terrors are essentially disruptions that occur during slow-wave deep sleep, so by lessening the time that an individual spends in the phase where night terrors occur, would the amount of night terrors they experience decrease? Unfortunately, without a published study, we have no way of knowing for sure. I hope that as the stigma surrounding cannabis use continues to change, that we’ll start seeing scientific studies that can back up what many cannabis users have continued to describe anecdotally over the years.

What I can speak to in all of this is that cannabis has helped my night terrors immensely. Prior to using cannabis for sleep, I had tried meditating, cutting caffeine out before bed, not eating too late at night, melatonin supplements and even a prescription to help with sleep—nothing ever worked for long though. To be honest, I didn’t notice how much cannabis was helping my night terrors until recently. Using cannabis to help with my insomnia is something I’ve done pretty consistently over the years, but recently I’ve noticed that I need less and less help falling asleep (adulting is tiring!) and so I’ll often fall asleep without using cannabis first. It’s on these nights that my night terrors tend to occur most. Like I said, at first I didn’t notice a correlation, but once I started keeping a journal of when my night terrors were happening I was able to put two and two together—when I didn’t use cannabis before bed, my night terrors were more frequent. I know that another one of my night terror triggers is definitely lack of sleep, but the journal actually helped me see that sleep deprivation wasn’t the most consistent factor. Now that I know that cannabis has been helpful for me in a general sense, I’m interested in keeping track of more specifics like strains, terpene profiles and methods of medicating to better understand exactly which elements are working and why. For now, I’m happy to know that something is actually working and improving my quality of sleep—but I’d also be remiss not to continue to develop my understanding of what works for me as a patient. Even though it’s 2018 and cannabis is more widely accepted than ever, we as patients still very much rely on one another and our personal experiences as a guide when it comes to using cannabis medicinally. 

If you think that you may be experiencing night terrors that are affecting your ability to get quality sleep, first and foremost we recommend talking to your doctor. This article is in no way meant to diagnose or treat night terrors and we always advise seeking the advice of a medical professional before beginning any treatment regimen. Once you’ve been diagnosed, you can talk to your doctor about if medical cannabis is an option for you or you can find a doctor that specializes in medical cannabis by using the Hopegrown search bar at the top of the page if you reside in a state where medical cannabis is legal. Most importantly, be patient with yourself. Our brains and bodies are complicated—it will take time to find the right combination for you and you shouldn’t feel discouraged if you don’t find the right product or dose on the first try. Stick with it and continue to educate yourself so that you can advocate for what you need, whether what you need includes cannabis or not!

DISCLAIMER: This article is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

1. Mayo Clinic: Sleep Terrors (Night Terrors)
2. American Sleep Association: What Are Night Terrors?
3. Cannabis and Sleep: 10 Things to Know About Your Herbal Nightcap
4. Project CBD: Cannabis & Sleep Disturbances
5. Effectiveness of Cannabidiol Oil for Pediatric Anxiety and Insomnia as Part of Posttraumatic Stress Disorder: A Case Report
6. Night Terrors In Adults: When Sleeping Turns To Terror After Dark