There are more than 80 different sleep disorders. Difficulty falling asleep is the most common. About 40 million people in the United States suffer from chronic sleep disorders every year.
Sleep Overview
Sleep is vital to our health, but its biological significance has not been fully understood.
The strange thing is that the seemingly inactive sleep state is a dynamic and critical process. It helps us store memory, restore immunity, repair tissues, regulate metabolism and blood pressure, control appetite and blood sugar, process learning, and other countless physiological processes regulated by the endocannabinoid system (ECS).
According to research conducted by the National Institutes of Health and the Institute of Stroke, Sleep plays the role of a housekeeper.
It can remove toxins that accumulate in your brain when you are awake. Poor sleep is the largest medical complaint received in the United States, Is also a serious public health problem.
On average, adults need 7 to 8 hours of sleep a day. However, between 1 and 30 million Americans often lack sleep.
More than 60% of American adults said they have sleep problems several nights a week. More than 40 million Americans suffer from more than 70 different sleep disorders.
The most common sleep problems include:
- Insomnia-unable to fall asleep or stay asleep.
- Sleep apnea-impaired breathing during sleep.
Restless Legs Syndrome
It is characterized by tingling, discomfort, and even pain in the legs, it worsens at night and is relieved by activities.
Circadian rhythm disorder
The internal biological clock in the body is disrupted, and the sleep pattern is disrupted.
Parasomnia
This includes abnormal movement and activities during sleep, including sleepwalking and nightmares.
Excessive daytime sleepiness
When experiencing constant sleepiness during the day, it may be narcolepsy or other diseases.
Poor sleep is a risk factor for serious diseases. Compared with people who get enough sleep, adults with short sleep time (less than 7 hours per 24 hours) are more likely to suffer from 10 or more chronic diseases, including obesity, heart disease, diabetes, arthritis, stroke, And depression.
People with chronic diseases are at greater risk of insomnia, which exacerbates their discomfort. Comorbidities-including hypoxemia (abnormally low blood oxygen levels) and dyspnea (dyspnea or difficulty), gastroesophageal reflux disease, pain, and neurodegenerative diseases increase the risk of insomnia by 75-95%
Harm from sleeping pills
In 2016, according to industry research firm Markets and Markets, Americans spent $3.38 billion on prescription tranquilizers and sleeping pills, over-the-counter (OTC) sleep medications, and herbal sleep aids.
It is predicted that from now to 2021, the market for such products will grow at a rate of 4.5%. Sleeping pills are harmful to a person’s health. Daniel F. Kripke, MD, sleep expert, and co-founder of the Scripps Clinic’s Viterbi Family Sleep Center Research, in his paper “The Risk of Death, Infection, Depression, and Cancer of Sleeping Pills: But Lack of Benefit” The harm of sleeping pills was discussed.
Amazing data
Another issue worthy of attention is: data from a controlled trial of hypnotic drugs showed that 12 of the hypnotic participants had cancer, while no one in the placebo group had cancer. (When the FDA conducted the same audit, they found 13 types of cancer).
But it is not clear whether sleeping pills are the cause of these cancers or promote the progress of previously undetected cancers. Animal and in vitro (test tube / petri dish) studies have also confirmed the potential carcinogenic effects of hypnotism.
For more information, please visit Dr. Kripke’s website. In addition to these risks, combined data from placebo-controlled randomized clinical trials showed that participants in the hypnosis group had a 44% higher infection rate than the placebo group.
Are over-the-counter sleeping pills better?
These drugs also have side effects. The main ingredient of most over-the-counter sleeping pills (diphenhydramine) is the antihistamine diphenhydramine.
It can make you unconscious, but it is unlikely to provide truly restful sleep. In the e-mail communication of the CBD project, Dr. Kripke wrote: “The use of diphenhydramine is related to the development of Alzheimer’s disease, although the causal relationship is not clear.
As we all know, diphenhydramine has anti-biliary Alkaline energy [blocks the neurotransmitter acetylcholine], and sometimes produces some cardiac symptoms and digestive symptoms such as constipation. In some patients, diphenhydramine at night can cause a lot of daytime sleepiness.
One dose can be used to treat the Effect, but a slight increase in the dose will have a toxic effect on the liver. Under normal circumstances, consumers will not read the warning labels of these drugs, but take them with alcohol and other drugs.
This can lead to hepatotoxicity or fatal respiratory depression. OTC sleep aids are only for occasional or short-term use, and one use should not exceed two weeks. Although this is not typically reported in the published literature, those who use OTC and prescription sleeping pills find it difficult to stop once they start taking it.
Sleep stage
There are two types of sleep: non-rapid eye movement sleep (NREM), which has three stages, and rapid eye movement sleep (REM), which is its sleep stage.
A complete sleep cycle occurs five to six times a night. The first full cycle in the evening is 70-100 minutes, and the remaining cycles are 90-120 minutes.
The endocannabinoid system and sleep
Given the problems of traditional hypnotics, medical scientists have been exploring other ways to improve sleep through the endocannabinoid system (ECS).
As the main homeostatic regulator of human physiology, ECS plays an important role in the sleep cycle and other circadian rhythms. Italian scientist Vicenzo DiMarzo summed up the extensive regulation function of the endocannabinoid system as “eat, sleep, relax, protect and forget”.
How we fall asleep, stay asleep, wake up, and stay awake is part of the internal biological process regulated by the circadian rhythm and the endocannabinoid system. The circadian rhythm controls a series of different activities in the body, including hormone production, heart rate, metabolism, and when to sleep and wake up.
It is as if we have a biochemical clock in our body, which records our need for sleep, guides the body to fall asleep, and then determines the intensity of sleep. This biological mechanism is affected by external factors, such as travel, drugs, food, beverages, environment, stress, and so on.
The key issue:
Does the endocannabinoid system regulate our circadian rhythm or vice versa? In the sleep-wake cycle fluctuations of anandamide and 2-AG (cannabis-like molecules in the brain), we can observe the close connection between the two, at the same time, metabolic enzymes that produce and break down endocannabinoid compounds can also be observed.
Anandamide exists at high levels in the brain at night, and it interacts with the endogenous neurotransmitters oleamide and adenosine to produce sleep. On the contrary, 2-AG is higher during the day, which indicates that it is related to promoting wakefulness.
The highly complex sleep-wake cycle is driven by a variety of neurochemical substances and molecular pathways. Both anandamide and 2-AG can activate CB1 cannabinoid receptors concentrated in the central nervous system, including parts of the brain that are related to regulating sleep.
CB1 receptors regulate neurotransmitter release and excessive neuronal activity, thereby reducing anxiety, pain, and inflammation. Therefore, the expression of the CB1 receptor is a key factor in regulating sleep homeostasis.
However, as far as CB2 is concerned, this is not the case. CB2 is a cannabinoid receptor, mainly found in immune cells, peripheral nervous systems, and metabolic tissues. Although the expression of CB1 receptors reflects periodic circadian rhythms, there is no description of such fluctuations for CB2 receptors.
Sleep disorders are a symptom of many chronic diseases, and this fact complicates the challenge of research and treatment of sleep disorders. In many cases, poor sleep can lead to chronic diseases, and chronic diseases are always related to the imbalance or imbalance of the endocannabinoid system.
Although we still need to understand the relationship between ECS and circadian rhythm, it is clear that adequate and high-quality sleep is a key component of recovery and the maintenance of health.
Marijuana and sleep
For centuries, Cannabidiol (CBD) Tells how you fight cancer and helps with sleep disorders and helps people stay asleep.
In 1843, Sir William B. O’Shaughnessy reintroduced cannabis into Western medicine. The results of the study emphasized the therapeutic effect of “Indian hemp” on sleep disorders.
A similar natural sleep that produces the most anesthetic effect of Indian marijuana does not cause any special excitement of blood vessels, or any particular suspension of secretions or fear of dangerous reactions German researcher Bernard Fronmueller observed in 1860.
Nine years later, Fronmueller reported that among 1,000 sleep disorder patients, Indian marijuana treatment accounted for 53%, partial treatment accounted for 21.5%, and 25.5% of patients had almost no effect. Sleep-related problems continue to drive many people to use cannabis for relief.
Poor sleep and lack of sleep can cause physical changes in the body after just one night, leading to slower reaction times, decreased cognitive ability, reduced energy, increased pain and inflammation, and in many cases, overeating or thinking Eat high-fat, high-carbohydrate “comfort” foods.
Babson et al. pointed out in a 2014 study that approximately 50% of long-term cannabis users (over 10 years) reported using cannabis as a sleep aid. Among patients who use medical marijuana, 48% said they use marijuana to treat insomnia.
Another study showed that 40% of patients with insomnia also suffer from anxiety and depression or other mental illnesses. Would you be surprised if you knew that people with mood disorders using marijuana would have 93% of the sleep benefits? “Good sleep can alleviate sadness.
CBD, THC, CBN
What about the specific phytocannabinoids needed for sleep?
Cannabidiol (CBD) is an alert drug, or moderately stimulating, while its psychoactive substance, Delta 9-tetrahydrocannabinol (THC) , tends to calm down.
However, this science is somewhat contradictory. Research data and anecdotal rumors indicate that CBD and THC have different effects on sleep. Depending on the dose, both can have a wake-up or calming effect.
The two-phase dose-response caused by cannabidiol and tetrahydrocannabinol may be one of the factors leading to the conflicting results of cannabinoid and sleep research. The link between low-dose cannabidiol and increased wakefulness highlights the potential of CBD as a treatment for narcolepsy and other variants of excessive daytime sleepiness.
The strange thing is that CBD can help people fall asleep while staying awake. An insomnia study showed that taking 160 mg of CBD can reduce night sleep disruption and increase total sleep time, which shows that high-dose CBD therapy can improve sleep quality and duration.
In addition to being a safe and effective alternative to traditional psychotherapy for insomnia, cannabidiol can also alleviate the symptoms of rapid eye movement behavior disorder (RBD), which is characterized by vivid, nervous, and sometimes intense dreams.
A preliminary study tested the efficacy of CBD in patients with Parkinson’s disease and RBD. Obstructive sleep apnea (OSA) is a common sleep disorder that affects 9% of American adults. Animal model studies have shown that tetrahydrocannabinol and endocannabinoid oleamide can effectively reduce sleep apnea events.
Human studies have shown that dronabinol, a synthetic version of THC approved by the FDA, can reduce sleep apnea and is safe and well-tolerated. In addition, cannabinol (CBN) is often associated with the aging of cannabis. It is said that when these two cannabinoids are used at the same time, cannabinol can enhance the sedative effect of THC.
Pain and sleep
In addition to the craving for good sleep, treating pain is another common reason for using marijuana.
Chronic pain is a major public health problem that directly affects about 20% of American adults, many of whom also suffer from insufficient sleep. Sometimes it is difficult to know whether the pain caused insomnia or insomnia caused the pain.
Patients seeking to relieve pain and improve sleep can achieve great results with cannabinoids and other cannabis ingredients. Russo et al. summarized 13 studies in their paper Cannabis, Pain, and Sleep. These studies examined the effects of cannabis preparations on pain and sleep. Influences 15 mg each of CBD and THC, synergistically improves sleep. Particularly interesting is a phase II study involving 24 patients with refractory multiple sclerosis.
Different ratios of cannabinoids have different effects: “Compared with placebo, CBD-based extracts can significantly improve pain, and THC-based extracts can significantly improve pain, muscle cramps, cramps, and appetite, while THC: Combination of CBD extract (Sativex) can significantly improve muscle cramps and sleep.”
The author concludes that the combination of CBD disorder and THC (15 mg each) “synergy improves sleep.” Of the 13 studies presented in this paper, 7 showed improvements in sleep. Six of the seven studies were conducted using Sativex, a 1:1 CBD: THC sublingual spray, which shows that balanced cannabinoids can help improve sleep in patients with chronic pain.
The story about swapping your ibuprofen for a forgotten gift of marijuana cannabis use is common among people with post-traumatic stress disorder (PTSD). A small public trial conducted in Israel showed that 5 mg of THC twice a day can improve the sleep of PTSD patients and reduce the frequency of nightmares.
This is directly related to similar test results of a synthetic drug similar to THC, nabilone. Memory processing occurs when we sleep, so people with post-traumatic stress disorder, especially those who have nightmares, use marijuana or cannabinoids to improve sleep as a matter of course.
At first glance, cannabis seems to be just a coping mechanism for PTSD patients; In medical literature, such negative descriptions sometimes appear. So far, most studies involving cannabinoids and PTSD have been conducted from the perspective of addiction “Does cannabis harm PTSD patients and make them addicted?”
But this situation may be changing. More and more researchers are aware of the limitations of the addiction framework, which ignores the key role of the endocannabinoid system in helping us forget painful memories.
This is a normal process, but when a person experiences trauma In post-stress disorder (PTSD), this process will be deregulated to some extent. In some cases, THC and other phytocannabinoids can provide sufficient relief to enable patients with post-traumatic stress disorder to begin to understand the task of their trauma memory and begin the healing process. Without quality sleep, none of this can happen.
“If you can’t sleep, your world will soon go to hell in your shopping basket,” said Al Byrne, a U.S. Navy veteran and medical marijuana advocate. Many veterans and victims of sexual abuse are using cannabis to treat their PTSD-related symptoms.
A 2016 case study provided clinical data that confirmed that the use of CBD-rich oil is a safe and effective treatment that can reduce anxiety and improve a young girl suffering from post-traumatic stress disorder (PTSD) Sleep.
The medication had a minimal relieving effect on a 10-year-old girl who had been sexually assaulted in her childhood. And her medicine caused serious side effects. But oil therapy rich in CBD can continuously reduce the anxiety of patients and steadily improve the quality of patients’ sleep.
