Which help is available for sleep problems during withdrawal?

Sleep problems are a familiar pattern when people stop using cannabis. The Arbeitsgemeinschaft Cannabis als Medizin e.V. (ACM) describes sleep disturbances and unusually intense dreams for patients who stop taking cannabis as medicine. The drugcom addiction information also lists sleep problems and strange dreams as withdrawal symptoms when stopping use. That you sleep badly is therefore a familiar pattern and no sign that you are doing something wrong.

Why sleep is disturbed during withdrawal

Anyone who uses cannabis regularly adjusts physically to it. If the substance suddenly goes missing or is clearly reduced, the balance can be temporarily disturbed. The ACM explains it this way: the body becomes used to THC, and when it is missing, complaints appear.

This does not mean that you have to solve the problem alone. Withdrawal complaints are unpleasant but, in most cases they are not serious, as the ACM emphasises. They subside after days to weeks.

How long the sleep problems can last

The information on duration differs by source and by pattern of use. The drugcom FAQ states that withdrawal symptoms usually last up to a week and at most up to 14 days. Another drugcom page cites about three to four weeks until withdrawal has largely passed. For people who have taken cannabis as medicine for a long time and at high doses, the ACM describes a longer course of two to three weeks or more.

The table shows the typical course according to the ACM:

Time since the last use	Typical course
Day 1 to 2	The complaints begin
Day 2 to 6	The complaints are at their strongest
After long, high-dose use	The complaints can last two to three weeks or longer

What you can do yourself about sleep problems

Several steps often help without medication. They do not replace medical advice. They can, however, make everyday life easier:

• Keep fixed times for getting up and going to bed, including at weekends.
• Avoid caffeine, nicotine and alcohol in the evening.
• Air the bedroom and make sure it is quiet and dark.
• Move during the day, even if it is only a walk.
• Keep a short sleep diary so that you can spot patterns.

Research on sport and recovery after stopping is still small. One drugcom study reports that participants who took exercise showed better brain performance. This is a pointer, but it proves nothing about a solution to your sleep problem.

Sleep aids only after consultation

The ACM advises discussing the approach to stopping with your doctor beforehand. This also applies to medicines for sleep problems. Some preparations affect sleep but have their own side effects, and they can interact unfavourably with other medicines. Therefore, ask your practice for advice before you take anything. This also applies to over-the-counter products.

If you already take cannabis as medicine, never change the dose on your own initiative. The ACM stresses that stopping abruptly should not happen without coordination.

When to get help straight away

If you feel severely low, have suicidal thoughts, hallucinations or confusion, get help immediately. That is the clear recommendation of the ACM. Then contact the emergency number 112, the out-of-hours medical service or a crisis service near you. Do not wait for the sleep problems to improve by themselves. For a conversation about your withdrawal, the Sucht & Drogen Hotline can be reached on 01806 313031 (20 cents per call, according to the federal drug commissioner). Counselling centres on site are listed in the DHS addiction services directory.

Prevention: going into withdrawal prepared

Plan stopping with some lead time. Speak to your practice beforehand, arrange support in your surroundings and note down dates for conversations. If you stop at home, make sure there is a contact person who can reach you. More on this step is in the article Can you get through cannabis withdrawal at home?

Why a sleep diary helps

A sleep diary records when you go to bed, how long it takes you to fall asleep, when you wake up and how you feel during the day. After about a week you often recognise patterns, such as stress in the evening or naps that are too long. Take the diary to your next appointment. That way the practice can better judge whether and how the complaints should be treated.

Your next steps

1. Speak to your doctor about the approach before you stop.
2. Keep a sleep diary and keep fixed sleep times.
3. If you are under strong strain, get help immediately and use addiction counselling for further support.

The symptoms at a glance are in the article What symptoms does cannabis withdrawal have? An overview of all offers is on the page Help and counselling.