Sleep in the Time of Cannabis PART ONE: CBD and CBN and the Crimes of Sleeping Pills
OR: A Field Guide to Curiosity, Caution, and Not Losing Our Minds Again
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By David E McCarty MD FAASM (…but you can call me Dave)
19 February 2026
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“People only see what they are prepared to see.”
— Ralph Waldo Emerson [1]
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…an ENLIGHTENING discussion…
The cannabis-derived substances known as cannabidiol (CBD) and cannabinol (CBN) are having a moment.
There is genuine enthusiasm here—hopeful curiosity, even relief. After years of uneasy relationships with traditional sleeping pills, many people are wondering whether these newer, plant-derived compounds might offer something gentler, you know? Something natural…something that helps sleep arrive without force, fog, or fear.
Life-Fans, I can understand that enthusiasm.
I also recognize something else beginning to stir beneath it: a familiar tightening in the cultural chest. A skepticism that feels prudent at first, then hardens into something else. I see the early outlines of a backlash that sounds a little something like this:
Careful…We’ve seen this before…Sleeping pills are dangerous!
Here’s the thing, folks…we have seen this show before.
Emerson’s line is a good reminder of what usually goes wrong when we do: we stop seeing what’s actually in front of us, and start seeing what we’re already prepared to fear.
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A Quick Visit From a Frenemy
A few years ago, I wrote an essay called The Story of Dr. Matthew Walker and the Fear of Sleeping Pills,[2] prompted by the cultural aftershocks of Dr. Matthew Walker’s bestselling book Why We Sleep,[3] a literary frenemy—a beautifully written love letter to sleep science that nonetheless scared people when it came to sleeping pills, and did so on the basis of weak causal evidence.
Sleeping pills—no matter what type—were suddenly framed as existential threats for early death by cancer. The nuance evaporated, the category collapsed, and people panicked.
As it turned out, scaring people has consequences!
Patients stopped medications abruptly. Some were angry at their providers. Many providers stopped refilling prescriptions, thinking it was the right move, risk-management-wise.
For awhile, it seemed that everyone was freaking out in different directions!
The lesson? It wasn’t that sleeping pills are harmless. The lesson was that painting all sleep-promoting agents with the same brush is itself a kind of harm.
CBD and CBN are the newest agents on the market that purport to help you sleep…
…you know what that means?
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Naming the Thing Plainly
CBD and CBN are now being used to help people sleep.
That makes them sleeping pills—not legally, not historically, but practically. People take them at night with the hope that sleep will come more easily.
Once we accept that, two equal and opposite mistakes become predictable anthropologic next steps:
Treating them as exempt from scrutiny because they’re “natural.”
Importing every fear we’ve accumulated about “sleeping pills” (see the section above) and pasting it wholesale onto them.
We’ve all learned, the hard way, that neither move serves patients well.
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Enthusiasm Deserves Respect
There are good reasons people are interested in CBD and CBN.
Though they are derived from the cannabis plant, which is where marijuana (Weed! Pot! Dope!) comes from, these compounds are not intoxicating in the way THC is. Compared with other “sleeping pills”, they don’t seem to “knock people out,” and they don’t show, so far, the dramatic tolerance and withdrawal patterns that defined earlier generations of hypnotics.
For patients who have been burned by the consciousness-snowing effects of zolpidem, dulled and slowed by anticholinergics, or frightened away from care entirely by the conversation about “sleeping pills”, the appeal is obvious.
This isn’t magical thinking; it’s pattern recognition. People are looking for sleep tools that feel less coercive—tools that seem to support sleep rather than overpower it.
That curiosity deserves a careful, adult conversation.
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The Brewing Backlash
Whenever a new sleep aid gains popularity, the same reflex appears:
Does it produce “real” sleep? Will people get hooked or addicted?
Will it cause harm in some way due to over-sedation (e.g.: nocturnal falls).
Is it masking something more important?
These are good questions.
They only become bad when we stop asking them precisely.
Fear has a way of flattening distinctions. CBD becomes “basically THC.” THC becomes “basically a sleeping pill.” And sleeping pills become “basically dangerous.”
This is how we stop seeing what’s actually there—and start seeing only what we were prepared to see.
We’ve seen how this plays out with substances that feel even more benign.
When headlines recently suggested that long-term melatonin use was “linked” to heart failure and death, the cultural reaction was immediate — and familiar. I dug into all of that in The Fear of Sleeping Pills, Part II,[4] unpacking how retrospective data and self-selection can create the illusion of danger where causality hasn’t been shown.
That experience is worth keeping in mind as we turn our attention to CBD and CBN.
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Empowered Talk about “Sleeping Pills”
In the Beautiful Blue Book,[5] we didn’t ask whether sleeping pills were good or bad—we had fun with it! We decided to talk about the specific crimes they’re accused of, one by one, and asked whether those accusations held up—for which agents, in which contexts, for which patients.
Well, now that CBD and CBN are in the club, we felt it would be appropriate to give them their day in court, as well. Let’s hear about it!
Are they guilty or innocent? Let’s take a look!
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Crime 1: “Sleeping pills don’t produce real sleep.”
Some agents deserve this accusation. Many hypnotics suppress consciousness without reliably restoring healthy sleep architecture.
CBD is not a sedative-hypnotic. It does not reliably induce unconsciousness. In preclinical behavioral models, CBD does not substitute for THC, suggesting a fundamentally different subjective and neurobiological profile. CBN shows only partial substitution for THC, consistent with weaker psychoactive effects and a lower likelihood of sedation masquerading as sleep.[6]
Verdict: Not guilty of this crime in the classic sense.
Whether these compounds improve sleep physiology directly, or instead reduce barriers to sleep such as anxiety or hyperarousal, remains an open question.
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Crime 2: “Sleeping pills cause tolerance and dependence.”
This accusation is very real for some drugs.
Benzodiazepines and related hypnotics produce tolerance and rebound insomnia through well-described neuroadaptations.[6]
The preclinical literature on cannabinoid tolerance and dependence, however, focuses almost entirely on potent CB1 receptor agonists, such as THC and synthetic cannabinoids.[7,8] CBD does not act as a CB1 agonist, and CBN shows weak or partial agonist behavior in available models.
Importantly, there is no established withdrawal syndrome for CBD, and no clear tolerance signal demanding attention. For CBN, there are no dedicated animal studies demonstrating tolerance or withdrawal, in sharp contrast to THC, where these effects were obvious early and repeatedly.[7,8]
Verdict: No clear evidence of guilt at this time.
This does not prove absence of risk—but it matters that the usual warning sirens are quiet.
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Crime 3: “Sleeping pills make you groggy, uncoordinated, and stupid.”
This accusation has always been dose- and context-dependent.
CBD can cause daytime sleepiness in some individuals, particularly at higher doses or when combined with other sedating medications. Similar concerns may apply to CBN, though data are limited.
Verdict: Potentially guilty in certain doses, in certain people.
This is a monitoring issue, not a categorical indictment.
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Crime 4: “Sleeping pills mask the real problem.”
This one sticks.
CBD and CBN do not treat obstructive sleep apnea or fix a leaking mask. They do not realign circadian rhythms. They do not resolve iron deficiency, depression, or chronic pain. They can quiet symptoms.
But here’s the uncomfortable truth: this accusation applies to nearly every symptom-directed sleep intervention we use.
Verdict: Guilty by misuse, not by nature.
The crime belongs to forgetting to keep asking why someone isn’t sleeping—and psst! If you’re guilty of this crime, The Five Finger Approach[9] is your “Get Out Of Jail Free” Card!
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Crime 5: “Sleeping pills cause cancer.”
This claim has been addressed elsewhere.
In The Fear of Sleeping Pills [2] essay, we saw how the assertion that sleeping pills “cause cancer” rested on retrospective, self-selected data that couldn’t establish causality, and how the findings were heavily confounded by underlying illness and probable unrecognized Sleep Apnea.
That conclusion stands.
There is no evidence supporting this claim for traditional hypnotics, and none whatsoever for CBD or CBN.
Verdict: Debunked previously. Not relitigated here.
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Saying the Thing
All of this brings me back to Emerson.
(We only see what we are prepared to see).
If we are prepared only for enthusiasm, we can’t have a real discussion about risks and benefits.
If we are prepared only for fear, we may lose a valuable tool.
So, congratulations, fellas! CBD and CBN are in the Sleeping Pills club—and like all Sleeping Pills, they’ll be helpful for some people, neutral for others, inappropriate in certain contexts. The point here, Life-Fans? Recognizing this doesn’t make them failures, it makes them medicine. As I said, welcome to the club!
See, folks, in my view, the real danger is not that these compounds will disappoint us.
The real danger is that we’ll repeat the same old mistakes—letting fear erase nuance, if not avoiding the conversation altogether.
We’ve seen this show before.
This time, we have a chance to watch it with calmer eyes and a clearer lens.
Need I mention?
Empowerment saves!
Kind mojo,
Dave
David E McCarty MD FAASM
Boulder, Colorado
19 February 2026
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References
Emerson RW. Journals of Ralph Waldo Emerson. Vol IX. Boston: Houghton Mifflin; 1909. p. 548.
McCarty, DE. The Story of Dr. Matthew Walker and the Fear of Sleeping Pills. Published online 6/15/22 In: Dave’s Notes (official Blog of Empowered Sleep Apnea)
Walker M. Why We Sleep: The New Science of Sleep and Dreams. New York: Scribner; 2017. ISBN: 978-1-5011-4431-8.
McCarty DE. The Fear of Sleeping Pills Part II: Melatonin, Heart Failure, and the Subtle Art of Not Panicking. Published online 17 November 2025 in: Dave’s Notes (official blog of Empowered Sleep Apnea).
Wiley JL, Marusich JA, Blough BE, et al. Evaluation of cannabimimetic effects of selected minor cannabinoids and terpenoids in mice. Progress in Neuro-Psychopharmacology & Biological Psychiatry. 2024;132:110984.
González S, Cebeira M, Fernández-Ruiz J. Cannabinoid tolerance and dependence: a review of studies in laboratory animals. Pharmacology, Biochemistry, and Behavior. 2005;81(2):300–318.
Lichtman AH, Martin BR. Cannabinoid tolerance and dependence. Handbook of Experimental Pharmacology. 2005;(168):691–717