Pelvic Pain Unpacked, Episode 21 — with Tamar Hill and Robert Welch, PharmD
🌿 Key Takeaways
- THC actually disrupts sleep architecture by suppressing REM sleep — the restorative phase where dreaming occurs — making high-THC products a poor choice for better rest.
- CBD works through a completely different mechanism than THC, and early evidence suggests it supports deeper, more restorative sleep without the drawbacks of prescription sleep aids.
- Poor sleep quality affects up to 80% of women with chronic pelvic discomfort — addressing sleep is not a secondary concern, it’s central to the healing process.
- Dose matters enormously and varies by individual — some people respond dramatically to a very low dose of CBD, while others need significantly more, which is exactly what current research is working to define.
- CBD is not without drug interactions — patients taking benzodiazepines, blood thinners, antidepressants, or anti-seizure medications should consult a pharmacist or provider before adding cannabinoids.
If you’ve ever lain awake at 3 AM, exhausted but unable to sleep, you already know that sleep deprivation compounds everything — discomfort feels sharper, stress feels heavier, and recovery feels impossible. For people managing chronic pelvic conditions, that cycle is especially relentless.
In Episode 21 of Pelvic Pain Unpacked, host Tamar Hill of MedRoots — a company specializing in CBD products for pelvic discomfort relief, better rest, menopause support, muscle discomfort, and overall wellness — sat down with Robert Welch, PharmD, a pharmacist and cannabis researcher at the National Center for Cannabis Research and Education (NCCRE) at the University of Mississippi. The NCCRE is built on over 50 years of cannabis research — longer than any other institution in the country — and Robert has spent years studying how cannabinoids work, what they actually do in the body, and how to separate clinical fact from widespread myth.
What follows is one of the most scientifically grounded, practically useful conversations about CBD and sleep we’ve aired.
Why Sleep Keeps Coming Up in Pelvic Health
Tamar opened with a statistic that reframes the entire conversation: a 2014 case control study found that 80% of women with chronic pelvic discomfort reported poor sleep quality, compared to 55% in the control group.
Tamar Hill: “When we talk about chronic pelvic discomfort, we tend to focus on the discomfort itself — but how important have you found that sleep is to that cycle?”
Robert’s answer is that the relationship almost certainly runs both ways. Discomfort disrupts sleep — that much is clear. And while the specific research on whether sleep deprivation worsens discomfort hasn’t been definitively established, the underlying logic is sound: sleep is when the body repairs, restores, and regulates. Deprive someone of that, and everything downstream suffers.
This is what makes the connection between CBD, better rest, and pelvic health so relevant — and why it’s worth understanding the science carefully rather than reaching for the nearest supplement.
How a Pharmacist Ended Up in Cannabis Research
Robert’s path into cannabinoid medicine is a useful lens for understanding his perspective. He trained as a pharmacist at the University of Mississippi — the very institution with the longest-running cannabis research program in the country — and received essentially no education on cannabinoid science. That gap still exists in most pharmacy and medical training today.
His entry into the field came through his father’s epilepsy and a job that eventually led him to GW Pharmaceuticals, a company developing what would become Epidiolex — a purified CBD oral solution approved by the FDA for severe, treatment-resistant epilepsy syndromes like Dravet syndrome and Lennox-Gastaut syndrome.
Robert Welch: “I would go to the clinical trial sites, and the researchers were saying, ‘We’ve got children who have been non-verbal, and they started on the trial, and they’re starting to speak.’ Not only was it reducing their seizure load — some were having up to 1,200 seizures a month — but other things were changing too.”
That experience gave Robert his foundational framework for looking at cannabinoids: they are not magic bullets, they require careful dosing and management, and they must be understood in the context of everything else a patient is taking. But they can be genuinely, meaningfully effective.
What the Data Actually Shows About Cannabis Use
Through real-world evidence studies conducted in Mississippi — surveys of 300 medical cannabis patients using validated clinical questionnaires — the NCCRE has been gathering ground-level data on why people actually use these products and whether they’re helping.
The results are clear: discomfort is the number one reason, by a significant margin. PTSD is a distant second. These findings align with most other state medical cannabis programs across the country.
This kind of research — called real-world evidence or Phase IV post-marketing study — doesn’t have the controls of a randomized trial, but it captures what’s actually happening with real patients taking real products in their real lives. The NCCRE is expanding this work through a partnership with a Pennsylvania company called More Better, which has developed an app that pushes daily questions to patients, tracks product type and dose via QR code, monitors effectiveness and side effects, and allows patients to be followed for two years or more. The goal is to eventually build a database of thousands of patients that can be segmented by specific conditions — including, potentially, pelvic discomfort as its own data subset.
Why THC Is the Wrong Tool for Better Rest
Here’s something that surprises many people: THC, despite being sedating, is actually counterproductive for quality sleep.
Robert Welch: “THC really blunts REM sleep — the rapid eye movement sleep where you get your restorative rest. A lot of people anecdotally report that they don’t dream when they take THC, at least in certain quantities. And in some people, THC causes increased tension and a kind of paranoia — if you already have a predilection for that, it can make you nervous and restless, and that’s not good sleep.”
REM sleep is not optional. It’s the stage where memory consolidation happens, emotional regulation gets processed, and the brain does its deepest restoration work. Consistently suppressing it — even while falling asleep more easily — means waking up less recovered than you should be.
This is a dose-dependent relationship. A very small amount of THC may behave differently than a large dose — and Tamar noted that MedRoots’ gummies contain less than one milligram of THC alongside 25 milligrams of CBD, which is in line with research suggesting low-dose, full-spectrum formulations may outperform high-THC products for sleep. But the overall picture from the literature is consistent: for better rest, CBD is the more appropriate cannabinoid, not THC.
How CBD Supports Sleep — The Mechanism
CBD works through a fundamentally different pathway. One key mechanism involves TRP channels — transient receptor potential channels — a system throughout the body that regulates sensations, discomfort signaling, and inflammation. CBD activates and desensitizes these channels, reducing the inflammatory signaling that keeps the nervous system activated at night.
Robert Welch: “If you’ve ever used capsaicin cream or Icy Hot on your muscles, you know how it feels cool and then warm — it activates and desensitizes that area locally. That’s what CBD is doing in the body, we think. That’s one mechanism that’s thought to be helpful as an anti-inflammatory and for discomfort relief.”
That same anti-inflammatory, calming effect on the nervous system is what makes CBD a candidate for improving sleep — particularly for people whose disrupted rest is driven by chronic discomfort or a nervous system that won’t fully down-regulate at night.
Equally important: CBD does not suppress REM sleep the way THC does. It appears to support deeper, more restorative rest without disrupting sleep architecture — which is precisely why the NCCRE chose CBD as the focus of their upcoming sleep study.
The NCCRE’s Upcoming CBD Sleep Study
The NCCRE was formally tasked by the Mississippi Department of Health with reviewing the evidence on whether insomnia should be added as a qualifying condition for the state’s medical cannabis program. After a thorough literature review, insomnia is the only condition NCCRE has recommended adding — and they did so with specific stipulations: high-CBD or CBN products, with THC as low as possible.
That recommendation led directly to a formal clinical study now in late preparation:
- 50 patients enrolled at the University of Mississippi Medical Center in Jackson
- Three CBD doses tested: 50 mg, 100 mg, and 150 mg of purified CBD isolate versus placebo
- CBD isolate only for this phase — no other cannabinoids, to eliminate synergistic variables
- Validated sleep measurements: the Insomnia Severity Index (ISI) and the Pittsburgh Sleep Quality Index (PSQI), both widely used in clinical sleep research
- Wearable actigraphy monitors to capture objective sleep data — not just self-reported perception, but actual wake frequency, total sleep time, and sleep quality throughout the night
One significant challenge: patients who are currently using prescription sleep aids — benzos, Ambien, Lunesta — would need to taper off before enrolling. Tapering benzodiazepines can take months and must be done carefully under medical supervision.
Robert Welch: “We’re trying to reduce as many variables as possible and just focus on what we hypothesize: that CBD is going to help sleep quality and length of sleep. And hopefully those wearables will give us some more objective data alongside the questionnaires.”
Future phases of the research will likely add CBN — another non-intoxicating cannabinoid also thought to support sleep — and possibly a low-dose THC component for comparison.
A Story That’s Hard to Dismiss
Clinical research is methodical by necessity. But sometimes a single anecdote cuts right to the point.
Tamar shared one that has stayed with her: at a medical conference, a practitioner walked up to the MedRoots booth the morning after receiving a sample gummy, with tears in her eyes. She had slept through the night. Not just slept — really slept, in a hotel room, for the first time in eight years.
Tamar Hill: “She said, ‘I don’t think you understand. I haven’t slept through the night in eight years. And I slept.’ She was just like, ‘It’s a miracle.'”
Robert’s response was measured but affirming — individual biochemistry varies enormously, and some people have what appears to be a genuine depletion of cannabinoid signaling that makes them highly responsive even to low doses. Others need significantly more. That variability is exactly what a dose-ranging clinical study is designed to map.
The story is also a good illustration of why Tamar has made a habit of giving out gummy samples at conferences — people traveling, sleeping in unfamiliar hotels, flying across time zones, are a natural population for testing whether CBD actually helps with sleep in real-world conditions.
What CBD Users Need to Know About Drug Interactions
Robert was direct about something that often gets glossed over in consumer CBD content: cannabinoids have real drug interactions, and patients on certain medications need to know about them before adding CBD.
The most clinically significant ones:
Benzodiazepines: CBD is a potent inhibitor of liver enzymes that break down benzos. Combining them can cause the benzo to accumulate, leading to excessive sedation and lethargy. Dose adjustment of the benzo is typically needed.
Valproic acid / Depakote: Some liver enzyme elevations have been observed when combined with CBD — not permanent damage, but worth monitoring with a provider.
Alcohol and opioids: CBD has synergistic CNS-depressant effects with these substances — the combined effect is amplified and must be accounted for.
Blood thinners (Warfarin/Coumadin): Risk of increased bleeding when combined with CBD.
SSRIs and antidepressants: Interactions exist in the literature; careful dose management is required.
The good news, as Robert put it: compared to opioids and many prescription drugs, cannabinoids generally have a cleaner side effect profile. CBD can also potentially help patients reduce their reliance on prescription sleep aids and heavier pharmaceutical options — something Tamar hears regularly from MedRoots customers who have been able to reduce or discontinue Valium and diazepam after finding CBD effective.
Not All CBD Products Are the Same
Robert raised a concern that Tamar echoes constantly: the CBD and cannabis marketplace is largely unregulated, and many products don’t contain what they claim.
The NCCRE tested Delta-8 products purchased online and found that the actual cannabinoid content was wildly different from what the label and Certificate of Analysis stated. Unknown cannabinoids were present that were never disclosed. Heavy metals, impurities, and inaccurate potencies are real risks in products sold without proper oversight.
Robert Welch: “You have no clue what’s in there because it’s not enforced or regulated. It’s kind of the Wild West. And it makes it difficult for companies like MedRoots because you’re actually trying to help people.”
What to look for: a third-party Certificate of Analysis (COA) available on the company’s website, verified purity testing, and transparent cannabinoid ratios. If a company doesn’t publish those, that’s a meaningful red flag.
Ready to Support Your Sleep Naturally?
If disrupted sleep is part of what you’re navigating — whether from chronic discomfort, menopause, stress, or simply a nervous system that won’t quiet down — MedRoots has CBD products formulated to help. Our full-spectrum gummies, suppositories, and wellness supplements are third-party tested, carefully dosed, and designed to work with your body rather than override it.
📞 Call us: 833-797-7576
🌐 Contact us online: medroots.com/pages/contact
Better rest is possible. Let’s help you get there.
This article is based on Episode 21 of Pelvic Pain Unpacked featuring Robert Welch, PharmD, cannabis researcher at the National Center for Cannabis Research and Education (NCCRE), University of Mississippi. It is for informational purposes only and does not constitute medical advice. Please consult your healthcare provider or pharmacist before adding any cannabinoid product to your health regimen, especially if you are currently taking prescription medications.