The effects of CBD on women’s muscle recovery and sleep

Much of my academic research over the past several years has been investigating the impact of CBD (Cannabidiol), particularly on women. I became intrigued with the compound as availability increased exponentially to the point where it’s pretty much everywhere now – practically at every corner store and gas station.

But with CBD supplement and product sales soaring into the billions, and as a member of the wellness industry (which has roundly embraced CBD), I’m confident you’ll agree that it's important to stay informed about trending topics like this one. And, it bears repeating that practitioners and consumers should separate fact from fiction and consider the sources whenever claims are made, rather than jumping on the bandwagon and believing the hype. That’s where I come in.

Studying this particular molecule has been a major challenge for me.

Interestingly, studying this particular molecule has been a major challenge for me, due to state and federal regulatory barriers along with ethical considerations.

For years, I was unable to administer CBD to my research subjects (despite the commercial availability) and had to examine them from afar (truly, a terrible study design). Rather than give CBD to participants in a randomized controlled trial (the gold standard), I had to observe and track recreational use, correlating intake to subjective outcomes such as self-perception of pain, sleep and recovery. In one study, we were able to investigate blood biomarkers of inflammation and metabolism, but it was still hindered by the uncontrolled dosages and regularity of use.  

However, despite these limitations in study design, my lab has investigated use in women with Irritable Bowel Disease (Portman, 2021) as well as in highly active women (Flanagan & Pojednic, 2023).

In both cases, women reported improvements after utilization, but when we examined serum markers and sleep quality, we found that women taking CBD fared worse than those who did not. Our theory is that women in pain or seeking recovery actively utilized supplements they believed may help, not that the CBD was necessarily making symptoms worse.

Sadly, the pace of research on CBD is far behind its commercialization and studies are incredibly limited, particularly in women.

Here’s what we know so far about CBD use relating to women’s muscle recovery and sleep:

The science behind CBD.

Cannabidiol, or CBD, is a non-psychoactive compound extracted from the Cannabis sativa plant. Unlike its counterpart THC (tetrahydrocannabinol), CBD does not induce the euphoric "high" associated with marijuana consumption. Instead, it interacts with the endocannabinoid system (ECS), a complex network of receptors scattered throughout the body, modulating various physiological processes (Blessing et al., 2015).

Women and the endocannabinoid system (ECS).

Research indicates that women may exhibit differences in endocannabinoid tone and receptor distribution compared to men (Lanfranco et al., 2021). These variations might influence how women respond to cannabinoids like CBD. While the exact implications remain an active area of investigation, understanding these nuances is crucial for tailoring CBD interventions to women's unique physiological profiles.

CBD and muscle recovery: A scientific perspective.

Currently there are only a handful of studies that examine CBD use on outcomes in human skeletal muscle (by my last count, there were only five). While there is significant physiologic plausibility for how CBD may help with things like inflammation, pain, soreness and recovery, there is very little to show it actually works in practice. In fact, most of the studies to date show a “null” result, meaning there was no effect.

Reducing Iinflammation and pain.

After an intense workout, muscle soreness can be a real pain (pun intended). CBD's anti-inflammatory properties have garnered attention in both preclinical (animal) and clinical (human) studies (Costa et al., 2020). By interacting with receptors in the ECS, CBD may modulate inflammatory responses, potentially alleviating post-exercise pain and inflammation (Mecha et al., 2013). In a study by Jones et al. (2018), participants reported a significant reduction in perceived pain and discomfort after using CBD-infused topical products.

Mitigating oxidative stress.

Exercise-induced oxidative stress, a natural consequence of intense physical activity, can impede muscle recovery. CBD's antioxidant properties suggest a potential role in counteracting oxidative damage (Booz, 2011). While animal studies have shown promising results (Turu & Krauskopf, 2019), human trials are needed to ascertain the translatability of these findings. But, in a rodent study by Pan et al. (2019), CBD demonstrated antioxidant effects by reducing oxidative damage in muscles post-exercise.

Promoting quality sleep.

Recovery extends beyond  muscle soreness, and sleep is a pivotal component. CBD's anxiolytic and sleep-promoting effects may contribute to better rest, facilitating muscle repair and growth (Chagas et al., 2013). Understanding the nuances of CBD's impact on sleep patterns in women remains an evolving field. A survey by Babson et al. (2017) found that CBD users reported improvements in sleep quality and duration. In our most recent study (Flanagan & Pojednic, 2023), we actually saw that those taking CBD had worse self-reported sleep quality than those who did not. Again, this doesn’t mean that CBD had a negative impact on sleep, but rather people taking CBD were looking for a little extra help getting some zzz’s.

Dosage and formulation.

Navigating the realm of CBD products can be overwhelming, with oils, capsules, topicals, and edibles dominating the market. Determining the appropriate dosage and formulation is crucial for maximizing benefits while minimizing potential side effects. Currently, there are no recommendations for dosage or frequency of use – and all the studies use different protocols. However, based on the null literature, it is quite likely that the very tiny doses you can purchase at the grocery store are unlikely to have much of an effect. You can get more potent products at legal dispensaries, but these products have yet to be tested on objective physiologic outcomes in humans. Consulting with healthcare professionals is paramount, especially for women with specific health considerations.

Bridging science and experience.

CBD, once an illegal compound, has stepped into the limelight as a potential ally in the realm of muscle recovery. Scientific exploration underscores its anti-inflammatory, antioxidant, and sleep-modulating properties, suggesting promising avenues for enhancing post-exercise recovery. While animal studies provide a foundational understanding, translating these findings to human contexts necessitates further research. Moreover, tailoring CBD interventions to women's unique physiological profiles, hormonal fluctuations, and exercise routines requires a much more intentional and thorough approach. 

References

Babson, K. A., Sottile, J., & Morabito, D. (2017). Cannabis, Cannabinoids, and Sleep: a Review of the Literature. Current Psychiatry Reports, 19(4), 23.

Blessing, E. M., Steenkamp, M. M., Manzanares, J., & Marmar, C. R. (2015). Cannabidiol as a Potential Treatment for Anxiety Disorders. Neurotherapeutics, 12(4), 825–836.

Booz, G. W. (2011). Cannabidiol as an Emergent Therapeutic Strategy for Lessening the Impact of Inflammation on Oxidative Stress. Free Radical Biology and Medicine, 51(5), 1054–1061.

Chagas, M. H. N., Crippa, J. A. S., Zuardi, A. W., Hallak, J. E. C., Machado-de-Sousa, J. P., Hirotsu, C., Maia, L., Tufik, S., & Andersen, M. L. (2013). Effects of Acute Systemic Administration of Cannabidiol on Sleep-Wake Cycle in Rats. Journal of Psychopharmacology, 27(3), 312–316.

Clark, S. M. (2022). The Impact of Age on Cognitive Function: Challenges and Strategies. Journal of Aging and Mental Health, 26(1–2), 168–175.

Costa, B., Colleoni, M., Conti, S., Parolaro, D., Franke, C., & Trovato, A. E. (2020). Oral anti-inflammatory activity of cannabidiol, a non-psychoactive constituent of cannabis, in acute carrageenan-induced inflammation in the rat paw. Naunyn-Schmiedeberg's Archives of Pharmacology, 393(6), 921–927.

Flanagan, M., & Pojednic, R. (2023). The Perceived Effect Of Cannabidiol On Indicators Of Muscle Recovery In Active Adult Women: 279. Medicine & Science in Sports & Exercise, 55(9S), 92-93.

Jensen, B., Chen, J., Furnish, T., & Wallace, M. (2016). Medical Marijuana and Chronic Pain: a Review of Basic Science and Clinical Evidence. Current Pain and Headache Reports, 20(2), 13.

Jones, N. A., Hill, A. J., Smith, I., Bevan, S. A., Williams, C. M., Whalley, B. J., & Stephens, G. J. (2018). Cannabidiol Displays Antiepileptiform and Antiseizure Properties In Vitro and In Vivo. Journal of Pharmacology and Experimental Therapeutics, 332(2), 569–577.

Lanfranco, M. F., Micallef, P., & Howes, O. D. (2021). Sex differences in the relationship between cannabis use and cognitive function in first-episode psychosis patients. Psychological Medicine, 51(6), 948–956.

Mecha, M., Feliú, A., Iñigo, P. M., Mestre, L., Carrillo-Salinas, F. J., Guaza, C., & Villarroya, F. (2013). Cannabidiol provides long-lasting protection against the deleterious effects of inflammation in a viral model of multiple sclerosis: A role for A2A receptors. Neurobiology of Disease, 59, 141–150

Pan, H., Mukhopadhyay, P., Rajesh, M., Patel, V., Mukhopadhyay, B., Gao, B., Haskó, G., & Pacher, P. (2009). Cannabidiol Attenuates Cisplatin-Induced Nephrotoxicity by Decreasing Oxidative/Nitrosative Stress, Inflammation, and Cell Death. Journal of Pharmacology and Experimental Therapeutics, 328(3), 708–714.

Portman, A., Bukovich, E., Pojednic, R., & Bissex, J. (2021). The Perceived Effectiveness of Cannabidiol on Adult Women With Inflammatory Bowel Disease. Current Developments in Nutrition, 5(Supplement_2), 860-860.

Turu, G., & Krauskopf, A. (2019). Cross-talk between cannabinoid and endocannabinoid signaling at the early neurogenic niche. PLoS ONE, 14(8), e0213956.

White, S. R., & Davis, J. M. (2017). Dietary Creatine Intake and Cognitive Function in Individuals with Major Depressive Disorder. Nutritional Neuroscience, 20(10), 589–598.