The Use of Cannabidiol (CBD) for Insomnia

Introduction

Cannabidiol is a plant extract obtained from the Cannabis sativa plant, which is more commonly considered as an extremely common drug ‘marijuana’. The chemical compounds obtained from the extract of this plant are known as cannabinoids and include cannabigerol, cannabidiol, cannabichromene, and tetrahydrocannabinol (THC) along with some other chemicals.

Among all the cannabinoids, tetrahydrocannabinol (THC) is the most known one and is psychoactive and is used for addictive purposes. The next main constituent of the plant extract other than THC is cannabidiol (CBD), which constitutes about 40 percent of the total extract.

Unlike THC, CBD is not psychoactive and is not used for addiction. The effects of CBD on the brain have been studied extensively and are found to be different than those of the THC. Tetrahydrocannabinol (THC) is the main compound found in cannabis which causes the sensation of getting “high”. However, CBD is not psychoactive.

Effect of Cannabis Extract on Brain

Just like most of the other chemicals, the cannabis extracts affect our brain by binding to a specific type of receptors present on the cells. When these cannabinoids bind to these receptors, they trigger some changes in the metabolic machinery of the cells. These receptors are present on the cells throughout the entirety of our central nervous system, and they are specifically called CB1 and CB2 receptors.

Such receptors are found predominantly in the brain in the hippocampus and cerebellum. Because these receptors directly affect the function of the cell they are on, the psychic effects experienced after consuming marijuana have a rapid onset. The psychoactive cannabinoids such as THC result in euphoria, enhancement of sensory perception, increased heart rate, decreased pain stimuli, and difficulties in concentrating on specific tasks. These effects are due to the relative abundance of CB1 and CB2 receptors in the hippocampus.

The effects may also include short term impairment of memory. These effects are largely due to the psychoactive agents found in cannabis such as tetrahydrocannabinol (THC).

Cannabidiol – It is Different

However, cannabidiol (CBD) differs largely from THC in its psycho-activity. According to some studies, it has been found that CBD may even act to counter the psychoactive effects of THC. Owing to its anti-psychotic effects, this compound has found itself being used for many pharmaceutical purposes.  These effects are possibly caused due to the opposite effects of THC and CBD on brain activity in regions such as the striatum, hippocampus, and prefrontal cortex.

Many studies conducted by laboratories around the world, along with controlled clinical trials, have confirmed that CBD can be adopted as a well-tolerated, safe, and effective drug for antipsychotic purposes. The THC has an impairing effect on the body, while all the effects of CBD are non-impairing. But, CBD in cannabis has some effects on the body where it serves to release overall stress on the body.

These effects are different from the euphoric or ‘high’ sensations induced in our bodies due to THC and serve to alleviate the stress and anxiety. This makes CBD as the best alternate to marijuana to seek an escape from pain and anxiety.  23 states and the District of Columbia have legalized marijuana to be used for a variety of medical conditions. 15 other states have also formed laws that are intended to allow access to CBD oil and strains of marijuana containing high CBD to THC ratio.

The Preparation of CBD Oil

CBD is often used in its oil form. The oil is prepared by infusing CBD extracted from cannabis into some other vegetable oils such as olive oil or coconut oil that contains saturated fat. The oil can be easily prepared at home without sophisticated equipment by infusing the cannabis extracts with vegetable oils, but the homemade CBD oil will never be as powerful or potent as professionally prepared CBD oils made through repeated refining. CBD can be consumed in many forms, but oil is the most common one.

The industrial method of extracting CBD oils is by using carbon dioxide (CO2) for extraction. In recent years, this method has gained immense importance in the industrial preparation, particularly due to the ‘clean’ nature of the process. However, using CO2 for extraction is an industrial method and requires a lot of sophisticated equipment, skilled professionals, and a suitable space to carry out this task.

The CBD oils prepared by home preparations or industrial methods have very small quantities of THC or no THC at all so that all the effects you get are not psychotic, but a very controlled and a mellow feeling that grants the escape from anxiety without going through psychotic delusions or sensory impairments.

Role of CBD in having a good Sleep

Sleep is a decreased state of mind, which is recurring. It is characterized by decreased sensory activity, decreased heart rate, and inhibition of most of the voluntary skeletal muscles of the body. Sleep is the period when growth takes place, sleep is when wounds are healed better, and sleep is the period when your mind gets the much-needed rest after a long day. If one falls short of the required sleep, the effects on the next day are devastating enough to automatically go to bed early the next night.

Factors preventing a good Sleep

To study the effects of cannabidiol on sleep and the advantages of CBD oil for treating insomnia, first, we have to look at the things that hinder a good night’s sleep.

Since the last decade or so, growing interest in using marijuana for recreational purposes as well as an effective anti-anxiety drug, and CBD in particular, has led the scientists to study its effects on the brain during the stress conditions. Anything that haunts one’s mind or preoccupies it with wandering thoughts is considerable enough to prevent one from enjoying a sound sleep. This includes a stressed state of mind, anxiety, and depression.

Moreover, nociception (the sensory system of the body responsible for the perception of pain) is also a major factor that hinders sleep and causes insomnia. The maintenance of steady-state balance in the body, also known as homeostasis, is compulsory for the well-being of the body and maintaining perfectly healthy sleep cycles.

If the sleep cycle is not healthy, the body is never ready to cope with the next day, and the whole day is shrouded by fatigue and a bad sense of illness throughout.

Mechanism of Action of CBD

Cannabidiol (CBD) acts by interacting with the endocannabinoid system of the body. For those who do not know about this system: it is just another neurotransmitter system in our bodies just like the acetylcholine system or adrenaline system.

The endocannabinoid system is composed of neurotransmitters known as endocannabinoids. Endocannabinoids are one of the most widely known, potent, and versatile signaling molecules known up to now. These substances interact with a specific type of receptors which are called cannabinoid receptors which are found throughout the central nervous system (brain and spinal cord).

The extracts of cannabis, or cannabinoids, are the main substances to interact with these receptors. When they bind to these receptors, they have a subsequent effect on a person’s mood and state of mind. All of the senses affected by the endocannabinoid system such as memory, nociception (pain perception), metabolism, appetite, stress, and anxiety, etc. are also affected to a considerable extent.

Administering CBD to treat insomnia can serve to enhance the night’s sleep in the ways described below.

CBD Relieves Chronic Pain to Enhance Sleep

Pain is one of the most primitive senses ever known to organisms dwelling on the Earth. It is often defined as the warning system of our body to potentially disastrous, intense, and damaging stimuli. No doubt, pain is the only way through which one comes to know that something is not right in his or her body and requires attention, but the issue of chronic pain in diseases such as liver inflammation, arthritis, nerve damage, etc. can result in a very unpleasant experience for the victim.

The chronic pain conditions interfere even with the sleep cycle and mess with the body mechanisms as a whole.  Effective therapeutic and pharmaceutical options for patients living with chronic pain due to malignant conditions are very limited. One might resort to traditional analgesics to relieve chronic pain, but the results yielded are not always satisfactory. In some cases, the pain is relieved but generally appears again due to unknown causes.

Historical Research and Findings

The use of Cannabis for therapeutic and analgesic purposes is not new and dates back to as far as 2900 BC. A common form for administering CBD is SATIVEX, which is an oral mixture consisting of THC and CBD. This drug is one of the very few that are approved for use and is used for treating pain in multiple sclerosis. The drug SATIVEX is approved for use in many countries but is not currently recognized by the FDA as an analgesic.

A review was conducted in 2018 to examine the potential of CBD for curing pain. This review consisted of 47 studies, in which many different groups of people were studied who were using cannabidiol as an analgesic for chronic pains other than cancer pains. These studies examined various types of pain, including pain due to multiple sclerosis, fibromyalgia, rheumatoid arthritis, and visceral pain. The studies involved administering cannabidiol to people as an analgesic and also involved people who were administered placebos.

The conclusion was: cannabinoids reduced the pain by 29.0 percent, as compared to 25.9 percent for the placebo. Moreover, because cannabidiol has no psychotic effects, there was no change observed in the psychological, emotional, or physical functioning of the subjects. As a result of a reduced sense of pain, the subjects also experienced improved quality of sleep as compared to the sleep they were having before taking cannabinoids.

CBD oil in pain due to Peripheral Neuropathy

Pain due to peripheral neuropathy significantly impacts the quality of life of the affected. The pain in the lower extremities is often so disturbing that it affects the sleep cycle of the patients. When the sleep cycle is affected, it leads to increased anxiety and stress in the patient.

According to a study published in PubMed, 29 patients with symptomatic peripheral neuropathy were studied for the effects of CBD oil on their chronic pain. 14 people were randomized into the placebo group. The efficacy of topically used CBD oil for treating pain was studied for four weeks. All the participants had a mean age of 68 years. The Neuropathic Pain Scale (NPS) was administered two times a week to assess the average deviation from baseline to the end of the treatment period.

After four weeks, it was found that the patients who were using CBD oil experienced a considerable deduction in sharp and excruciating pain due to the peripheral neuropathy as compared to the placebo group. No adverse events of physical, psychological, or emotional nature were reported in the subjects. CBD oil was provided a promising alternative with minimum side effects when compared to other therapies in the treatment regimen.

The efficacy of cannabidiol (CBD) oil in the management of neuropathic pain was thereby proved from this study, and CBD was established as an efficient analgesic for those suffering from chronic pain due to malignancies such as cancer and neuropathies.

Future Prospects

The National Center for Complementary and Integrative Health (NCCIH) based in the United States is funding new research into cannabinoids to examine their potential in pain management for chronic malignancies. According to this, about three million dollars’ worth of research will be conducted to produce nine papers that comprehensively explore the potential of using CBD oils as an analgesic.

CBD oil Relieves Anxiety to Grant a Good Sleep

According to a definition by the American Psychological Association (APA), anxiety is an emotion that is characterized by feelings of tension accompanied by worried thoughts and physical changes like increased blood pressure and heart rate. Anxiety is not always a medical condition requiring an immediate attention, it is completely normal to have anxious feelings about something on a daily basis.

It is very important to judge the situation when will a person having anxious feelings require medical attention before experiencing aggravated symptoms such as panic attacks due to increased anxiety. The anxiety is medically linked to the brain, or more specifically to the amygdala which controls the fear, thoughts, and emotions and serves as the hub of anxiety.

The anti-anxiety drugs usually work by modifying the levels of certain chemicals in the central nervous system called neurotransmitters. These neurotransmitters are the chemicals which dictate our day to day mood and emotions.

One of the most effective neurotransmitter systems in our body is the endocannabinoid system. The endocannabinoid system, consisting of some particular receptors called cannabinoid receptors, affect the overall mood, stress, anxiety, and metabolism of our bodies.

Effect of CBD oil on Endocannabinoid system

The ability of CBD to affect the endocannabinoid system, which in turn has supernumerary effects on mood, stress, anxiety, and state of mind of a person, has enabled it to become an effective drug to cure long term stress and anxiety that might reduce the quality of lifestyle of any person. Moreover, the quality of CBD oil that does not affect the psychological state of mind of the person who is using it, has granted it the ultimate sweet spot for having all the perks of marijuana without getting the ‘high’ sensation which is the characteristic of marijuana.

CBD oil and Anxiety

There are controversial views about the relationship between cannabis and anxiety.

Some people have reported a decrease in their anxiety after its use, while a considerable class of people reports anxiety as one of the side effects of marijuana. The major cause of anxiety due to the use of marijuana is linked to the presence of tetrahydrocannabinol (THC), the very substance responsible for the characteristic ‘high’ sensation in most of the drugs.

On the other hand, cannabidiol (CBD) has the reverse effect: it acts to counter the effects of THC, and as a result, might reduce the anxiety resulting in increased drug use. It has gained a respectable place along with other anti-anxiety drugs.  The euphoric effects of THC are caused by its major effect on the CB1 receptors in the endocannabinoid system. As compared to THC, CBD has a minor effect, that is, about 100 times lesser.

It is also scientifically proven that CBD also influences other brain signaling systems and receptors, and the effect of CBD on these receptors is thought to be the factor behind relieving anxiety and stress through affecting the brain circuits involved in controlling the mood and emotions of a person.

The anxiolytic properties of CBD oil have also been studied extensively through research. Particularly, the results of using CBD to relieve Social Anxiety Disorder (SAD) are fascinating. In 2011, a study examined the effect of CBD given to patients with a control group which was given a placebo. The administration involved giving 400 milligrams (mg) of CBD or placebo to the subjects. The results of the study were largely in favor of CBD treating anxiety. The subjects who were given CBD reported a considerable decrease in their anxiety levels.

This study reports that administering CBD to patients reduces anxiety in SAD, particularly due to the effects of CBD on activity in limbic and paralimbic brain areas and related circuits involving the amygdala that control mood and emotions.

CBD oil in Post-Traumatic Stress Disorder

Studies also show that CBD appears to be promising in treating Post Traumatic Stress Disorder (PTSD). Post-traumatic stress disorder usually affects a person after an intensely traumatic event, be it physical or sexual abuse, an accident, or other natural causes. Studies indicate that this disorder affects about 10 percent of the people at some point in their lives.

PTSD messes with the natural reflexes of the body, particularly with the natural response of the body towards an emergency also known as the ‘fight or flight’ response. The victims suffering from PTSD report heightened fear levels even when they are in suitable environments.

Since the studies have reported the effect of the endocannabinoid system in emotions and memory processing related to those emotions, it is hypothesized that CBD can help with the elimination of traumatic memories and block their reconsolidation later at some point in life. CBD acts on 65 molecular targets involved in the reconsolidation of those memories, and thus helps the elimination of those traumatic memories. This ultimately helps the victims to attain a calm feeling, which helps treat PTSD.

Among the brain areas that are affected by the effects of administered CBD, the amygdala is also particularly important, as it serves to be hyperactive in patients with PTSD. The hyperactivity of the amygdala and its role in controlling the mood and emotions of the patient is related to the severity of the symptoms in patients with PTSD. As CBD acts to decrease the activity of this brain part due to its therapeutic effects, it may be established that CBD is helpful against the symptoms caused by PTSD. Resultantly, it can also provide a calm state of mind to the patients suffering from PTSD which helps to improve the quality of sleep of those patients, thereby proving to help treat their insomnia.

CBD oil to treat Insomnia in Schizophrenia Patients

Schizophrenia is a mental condition that involves disturbing the perception of reality. Symptoms include delusions, disturbing hallucinations, and disordered behavior that might result in disability. Schizophrenia usually hits in late adolescence or early adulthood in people in their twenties and thirties. It might also affect speech and thinking of the subject.

Although schizophrenia is rare, people suffering from this disturbing mental disease experience an extremely disturbed lifestyle, that primarily causes major disturbances in the sleep patterns.

As it is a mental disorder, schizophrenia is vigorously treated with the use of antipsychotic drugs such as aripiprazole and risperidone. But, due to the recent examinations that reveal the potential involvement of the endocannabinoid system in treating mental disorders, researchers are attracted to using CBD for treating this disorder.

Because it is not psychoactive, CBD has fewer extrapyramidal side effects than other anti-psychotic agents used to treat schizophrenia. A small study was conducted to examine the therapeutic effects of CBD for treating schizophrenia that reported positive results.

CBD Cures Insomnia Due to Epilepsy

Epilepsy, most commonly characterized by photo-sensitive seizures, is a mental disorder that involves abnormal brain activity in the central nervous system. The most common signs are seizures and periods of abnormal behavior and loss of awareness. The epileptic seizures are prone to hit anytime in the affected persons and are the major cause of insomnia in epileptic patients.

Currently, a large percentage of people affected by epilepsy, around 40 to 51 percent of the patients are suffering from insomnia due to epileptic symptoms. The sleep deprivation due to these symptoms triggers more seizures, which further aggravates the condition. Moreover, there are certain seizures called ‘sleep seizures’ that are triggered due to brain activity during sleeping and waking. These periodic seizures are the major reason for sleep deprivation in epileptic patients.

There is a form of epilepsy known as treatment-resistant epilepsy, which is not affected by conventional anti-epileptic drugs. The result is, severely increased seizures and even death in aggravated cases of treatment-resistant epilepsy. Under these conditions, recommendations were generated to use cannabidiol alongside anti-epileptic drugs to relieve the seizures due to treatment-resistant epilepsy.

A research paper published on PubMed Central reports a study that was conducted to examine whether the addition of cannabidiol in the list of existing anti-epileptic drugs would be safe. The subjects were administered 2-5 milligrams of cannabidiol per kilogram of body weight, increased to a maximum of 25 mg per kilogram of body weight. The clinical trial, which lasted for a year between 2014 and 2015, reported that there was a median reduction of 36.5 percent in monthly motor seizures in the treatment of resistant epileptic patients.

These findings openly stated that cannabidiol, when employed to treat motor seizures in treatment-resistant epilepsy, might decrease seizure frequency to a considerable extent and might have an adequately safe to use in children and young adults suffering from treatment-resistant epilepsy.

CBD in Insomnia Due to Withdrawal of Abusive Substance

Drug addiction, no doubt, is one of the biggest issues faced by almost every country in the world today. Annually, humongous amounts of every type of drug are consumed everywhere around the globe. The difficulty in resisting the relapse is more dangerous than treating the symptoms of drug addiction itself. The loss of control over the consumption of a specific type of drug takes the body to a point where it is very difficult to overcome the compulsive use.

Of all the symptoms of withdrawal, insomnia is one of the most important ones. The desire to use substances again to seek escape haunts the mind of the addict virtually any time of the day. This prevents the victim from having a good night’s sleep, which further aggravates the symptoms of addiction and indulges the victim in a never-ending cycle.

Owing to the origin of cannabidiol and its effects on the endocannabinoid system of the victim’s body, it promises as an effective treatment for the people suffering from aggravated symptoms of withdrawal from drugs. The anxiolytic properties of CBD further enhance its potential in this regard. As it is not psychoactive, CBD oil can safely be used for treating the symptoms of withdrawal in drug addicts.

A study published in PubMed in 2015 indicates the potential of using CBD for this purpose. The study was aimed at evaluating the effects of CBD in any of the 3 phases of addiction, which are intoxication, withdrawal, and relapse. It included studying all major types of abuse. The study involved a 19-year-old marijuana addict, who experienced severe withdrawal use when she tried to cease marijuana use. CBD was administered to the aforementioned subject for 11 days as a counter to withdrawal symptoms.

The results using the Withdrawal Discomfort Score showed a fascinating decrease in the withdrawal and anxiety symptoms: the symptoms fell to zero by day 6 of the administration of CBD.

This study proves the ability of CBD to tackle the withdrawal effects due to substance abuse, thus appears to be promising in treating insomnia in the drug addicts due to the withdrawal and anxiety experienced by them.

CBD Relieves Insomnia due to Parkinsonism

Parkinson’s disease is a brain disorder caused due to a decrease in a substance called dopamine, which is released from a part of the brain called the substantia nigra. This disease is characterized by the presence of stiffness, shaking, and difficulty in walking and balance throughout the whole body. The disease is progressive: it worsens over time and as it worsens, it leads to extreme difficulty in walking and talking.

Insomnia and sleep pattern disturbances are one of the most common non-motor symptoms of Parkinson’s disease. As the disease progresses, the sleep disturbances gradually increase in frequency. The insomnia is probably due to the changes in the brain that cause the disease. Some of the drugs used for treating the symptoms of Parkinsonism are found to be the culprit in disturbing the sleep patterns.

The use of CBD to treat Parkinsonism and resulting insomnia due to this disease has been studied extensively. Parkinsonism affects the ability of the brain to produce dopamine.

A study conducted at the University of Louisville, Kentucky shows that CBD acts as an inverse agonist on the CPR6 receptors that are found in the brainstem and are responsible for controlling movement, emotions, and learning - all of which are affected by Parkinsonism.

This means that CBD responds to these receptors and can act as a therapeutic agent in relieving the symptoms of this disease. Studies also show a promising effect of CBD in treating psychosis and resulting in insomnia due to Parkinsonism’s Disease Dementia (PDD).

Summary

The potential of cannabidiol in treating insomnia due to various disorders is scientifically proven and is thus resulting in increased public awareness about its benefits. CBD is generally considered safe. However, it may have side effects such as diarrhea, fatigue, and changes in appetite in some people. CBD can also interact with some medications, so it is recommended to consult a doctor before using CBD.

References

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