Insomnia Archives

23/Apr/2024

For many, the term “REM sleep” is synonymous with the dream state, a surreal space where our most vivid and immersive dreams play out each night. But REM (rapid eye movement) sleep is more than just a portal to fantasy; it’s a vital phase in our sleep cycle, critical for processes such as memory consolidation, learning, and emotional regulation. In this comprehensive guide, we will explore the intricate web of factors that can either bolster or bog down your REM sleep, and how your daily activities and dietary choices may be affecting these important nighttime hours.

Understanding REM Sleep

Before we unravel the complex relationship between our lifestyle and REM sleep, it’s crucial to appreciate what REM sleep is and why it matters. REM sleep is one of four stages of a sleep cycle, which is patterned throughout the night. It usually begins about 90 minutes after you fall asleep, cycling through several times. During this phase, your eyes move rapidly from side to side behind closed eyelids, your brain waves mimic those of someone who is awake, and your breathing becomes faster and irregular.

This stage of sleep is where the majority of your dreams occur, and it’s also associated with processes that maintain our emotional health and flexibility. Disruptions to REM sleep have been linked to mood disorders such as depression and anxiety. Conversely, healthy REM periods are believed to help process the stress and emotional peaks of daily life, setting the stage for a rejuvenated and balanced wakefulness.

The Dance of Lifestyle Factors on REM Sleep

Our prevailing habits and routines have a dance with REM sleep that lasts all day. Each step, from the moment we wake until our heads hit the pillow, can affect the dance’s harmony and the quality of our REM experience.

The Rhythm of Routine

Maintaining a consistent sleep schedule is one of the golden rules for quality rest. Irregular sleep patterns can cause fragmentation of REM sleep, leading to a less restorative nighttime experience. For night owls and early birds alike, the key is to find a rhythm that allows for the required seven to nine hours of sleep each night, with an anchor time for waking and sleeping.

Stress and BEDtime Stories

Stress is a notorious saboteur of sound sleep, and this stands true for REM sleep. Chronic stress can reduce the overall amount of REM sleep, leading to undesirable emotional consequences such as increased irritability and difficulty coping with daily challenges. Cultivating a relaxing bedtime routine, free from the screens that emit blue light and the alerts that activate stress responses, can significantly aid in protecting your REM time.

Activity by Day, Rest by Night

Regular exercise can enhance the quality of all sleep stages, including REM. However, the timing is important. Intense workouts too close to bedtime can disrupt sleep. Experts suggest that moderate aerobic activity during the day can promote more deep and REM sleep when you hit the hay.

Ingesting Sleep: Dietary Choices and REM Sleep Correlations

The saying “you are what you eat” extends to “you sleep how you eat.” Our diet has a profound impact on sleep quality, and REM sleep is no exception.

Daytime Nutrition for Dreamy Nights

Foods rich in vitamins and minerals like magnesium, which is found in leafy greens, nuts, and whole grains, are associated with better sleep quality and can possibly enhance REM sleep. Meanwhile, a diet high in added sugars and saturated fats may decrease the amount of REM sleep you get each night while increasing your chances of waking up around with sugary cravings.

The Supper Affair

The last meal of the day should be a light affair, at least two to three hours before bedtime. A heavy, large meal can trigger indigestion, which can lead to disrupted REM sleep. Opting for smaller, nutritious suppers that contain substances like melatonin, magnesium and tryptophan can better prepare your body for a restful night. Foods such as cherries, dairy for those who can tolerate it, nuts, seeds and turkey, are all sources of these sleep-inducing nutrients.

The Drink Dilemma

Beverages, such as coffee and alcohol, are perhaps the most notorious culprits in the disruption of REM sleep. While it’s essential for many to have a morning cup to start the day, the half-life of caffeine means that even an afternoon coffee can linger in your system, potentially causing sleep disturbances, including a reduction in REM sleep. Alcohol, despite its initial sedative effects, can disrupt the overall organization of the sleep cycle and lead to lighter, less restful REM sleep later in the night.

Nurturing the Environment for REM Sleep

Creating a serene and sleep-conducive environment can provide a powerful boost to your REM experience. From the mattress you choose to the ambiance in your bedroom, every element of your sleep environment plays a part in the quality of your REM sleep.

The Bedtime Saga

A firm mattress and a supportive pillow are crucial for comfort and spinal alignment, which are key to relaxing enough to enter REM sleep. Old, worn-out mattresses and unsupportive pillows can cause discomfort and lead to frequent interruptions in your sleep cycle, interrupting your REM time.

The Atmosphere in Your REM Domain

The setup of your bedroom also matters. Is it dark enough? Cool enough? Free from distracting noises and sudden light intrusions? These environmental factors are the setting for a successful REM performance by your body, and they’re all within your control. Blackout curtains, ambient noise machines, and avoiding the blue light of electronic devices can all contribute to a more optimal sleep environment.

Balancing Act: Technology and Its Role in REM Sleep

In an age where screens are as ubiquitous as air, managing technology’s relationship with REM sleep is an ongoing balancing act. On one hand, technology can offer tremendous advancements in monitoring and improving sleep quality, but on the other, our constant connection to it can drive a wedge between us and the restful REM sleep we need.

The Monitoring Mania

Sleep-tracking apps and devices provide insights into the duration and quality of your various sleep stages, including REM. But like any tech, their usefulness depends on how you use them. Obsessively checking these trackers can lead to sleep anxiety, a condition where you become more worried and fixated on the notion that you’re not getting “enough” REM sleep, ironically making the situation worse.

The Digital Diet

The “blue light” emitted by smartphones, tablets, and laptops can suppress melatonin production, a hormone necessary for the onset of REM sleep. Establishing tech-free zones at least an hour before bedtime and utilizing blue-light filters on devices can mitigate its effects and support the quality of your REM time.

The Caffeinated Conundrum: Friends and Foes of REM Sleep

Caffeine is a staple in many daily routines, an essential wake-up call that precedes REM sleep by several hours. Its consumption can significantly affect your REM sleep, especially if you’re among the over 60% of Americans who admit they need coffee to start their day.

The Morning Cuppa

Caffeine’s stimulating effects on the nervous system can be felt within 15 minutes of consumption and can last between 6 to 8 hours. This means that you’re potentially still feeling the effects of your morning coffee by the time you’re ready to dream. Reducing or eliminating caffeine after noon ensures that the majority is out of your system by bedtime, thus decreasing the likelihood of REM sleep disruption.

The Afternoon Pick-Me-Up

While the afternoon lull may seem an appropriate time for a ‘pick-me-up’, a second or third cup of caffeine in the afternoon can delay the onset of REM sleep, leading to a decrease in the overall duration and density of REM segments during the night. Opting for a decaf or a non-caffeinated hot drink is a REM-friendly alternative that can help maintain the integrity of your sleep cycle.

Alcohol’s Journey in the Land of Z’s

Alcohol’s effects on sleep are complex and varied, but some trends are clear when it comes to REM sleep. Although it’s initially a sedative and can help you fall asleep faster, it can reduce the overall time spent in REM sleep.

The Nightcap Guide

Many turn to a nightcap to help them relax and fall asleep. While a small amount of alcohol might help with the former, it can lead to a decrease in deep sleep and an increase in lighter, non-REM stages. This means REM sleep is often more fragmented and concentrated in the second half of the night after alcohol levels in the blood have dropped.

The Ounce of Prevention

Minimizing alcohol consumption within a few hours of bedtime can help prevent the disruptions it causes to the quality and quantity of REM sleep. Opting for a non-alcoholic substitute can provide relaxation without the effects on your sleep cycle.

Cannabis for sleep

Cannabis and Counting Sheep

Research into the effects of THC (tetrahydrocannabinol) and CBD (cannabidiol) on REM (Rapid Eye Movement) sleep has yielded intriguing insights.

THC, the psychoactive component predominantly found in marijuana, has been observed to decrease the duration of REM sleep. Individuals consuming THC before bedtime may experience shorter REM sleep periods, which is the sleep phase associated with vivid dreams. This reduction in REM sleep might initially seem innocuous, particularly for those wishing to avoid nightmares, but long-term diminishment can affect the quality of rest and cognitive functions related to learning and memory consolidation that are believed to occur during this critical sleep stage.

On the other hand, CBD, a non-psychoactive compound, appears to have a more complex relationship with sleep. Some studies suggest that CBD might actually promote REM sleep stability, thereby potentially aiding those with REM Sleep Behavior Disorder (RBD), a condition characterized by physically acting out dreams. However, CBD’s effects can vary depending on dosage and individual response, highlighting the need for further research to fully understand its impact on sleep architecture.

For more articles on cannabis and sleep Click Here

Expert Tips and Advice for REM Sleep Optimization

Seeking insights from sleep specialists and experts can expand our understanding of how we can optimize REM sleep. These nuggets of wisdom can serve as beacons of knowledge in the vast sea of information on the subject.

The Doctor Is In

Sleep physicians often recommend the use of cognitive behavioural therapy for insomnia (CBT-I), a structured program that helps address the underlying causes of sleep problems. By examining and modifying behaviours and patterns related to sleep, such as caffeine use or bedtime routines, CBT-I has been shown to improve sleep quality and REM time.

Deep-Diving with a Dietician or Naturopath

Registered dieticians and Naturopathic Doctors can provide tailor-made dietary plans that focus on sleep-promoting foods, catering to individual nutrient needs and deficiencies. By including foods rich in magnesium, melatonin, and tryptophan, a dietician-guided diet can help support a healthy sleep cycle, including REM time.

For more naturopathic tips on better sleep Click Here

Hygiene with a Sleep Specialist

Consulting a sleep specialist or therapist can be a game-changer for those who consistently struggle with REM sleep. By working together to understand and address factors contributing to sleep disturbances, such as sleep apnea or other sleep disorders, expert care can offer significant improvements in REM sleep quality.

Conclusion: In the Lap of Awareness lies Quality REM Sleep

The road to enhanced REM sleep is paved with conscious choices and intentional actions. By developing a deeper awareness of the impact of our daily activities and dietary decisions on our sleep, we can foster an environment that supports the restorative power of our REM cycles.

A holistic approach that considers our unique needs, sensitivities, and challenges can yield the most sustainable results in our quest for sound sleep.

Call to Action: A Dream State of Being

Sleep is a barometer for health and well-being, and REM sleep is an integral part of that equation. Engaging in this discussion and learning more about the connection between our choices and our REM sleep empowers us to take control and achieve a dream state of being each and every night. Come join the quest for the ultimate sleep experience—your REM cycle and future self will thank you.

Those of you that read my articles regularly know that I am a WHOOP band wearer. Here is an article from WHOOP on how to optimize REM sleep

drshawn

04/Jan/2023

Have you ever woken up in the morning feeling groggy and exhausted? That’s because our bodies naturally respond to light. In fact, bright light upon waking is essential for maintaining a healthy sleep cycle—not just for one day, but for days, weeks, and even months. In this blog post, we’ll explore why bright light upon waking is so important and how it can help improve your health and well-being.

What Is a Sleep Cycle?

A sleep cycle is the process by which our bodies move through different stages of wakefulness and sleep throughout the night. It’s made up of two main phases: rapid eye movement (REM) sleep and non-rapid eye movement (NREM) sleep. During NREM sleep, our bodies are getting ready for REM sleep, which is when we dream. Each night, we usually go through 4–5 cycles of REM and NREM sleep that last about 90 minutes each.

The Role of Light in Our Sleep Cycles

Light plays an essential role in regulating our circadian rhythm—our body’s natural internal clock that tells us when to be awake or asleep. When it gets dark outside, a hormone called melatonin is released into our systems to help us fall asleep. When it gets light out again, another hormone called cortisol signals to us that it’s time to wake up and get going. Without adequate exposure to bright light upon waking, our circadian rhythms can become disrupted—which could lead to poor quality of sleep over time as well as other negative health effects such as fatigue, irritability, depression or anxiety.

Benefits of Bright Light Upon Waking

Exposing ourselves to bright light first thing in the morning helps reset our internal clocks so that we can stay awake during the day and fall asleep at night more easily. This means we can get better quality rest overall! Additionally, exposing ourselves to bright light in the morning may also provide cognitive benefits like increased alertness and improved concentration throughout the day.

How much light is optimal?

A recent study published in Sleep Science and Practice found that exposing participants to bright light of at least 2500 lux for 30 minutes after waking triggered the highest cortisol response. This study also revealed that dim lighting of less than 500 lux did not produce a significant change in cortisol levels, meaning that it was not sufficient for resetting the circadian rhythm.

Another study conducted by researchers at the University of Oregon determined that conflicting with the body’s natural expectations can have serious consequences; exposure to bright light of more than 5000 lux after waking up in the morning disrupted cortisol rhythms, leading to an increase in stress hormones and a decrease in alertness and productivity. The optimal level of light exposure after waking appears to be between 2000-3000 lux, as this amount is both beneficial for circadian rhythm health and does not induce a stress response.

An experiment performed at Northwestern University found that exposure to bright light between 2000-2500 lux resulted in greater alertness and improved performance on cognitive tests as compared to regular office lighting levels. Thus, we can conclude that exposing oneself to bright light between 2000-3000 lux within thirty minutes of waking is likely most beneficial for resetting our circadian rhythms, improving alertness and productivity, reducing stress, and promoting overall wellbeing.

What is the best light source?

The optimal light source to be exposed to upon waking is one that mimics natural sunlight. By exposing yourself to a full-spectrum light therapy, ideally within the first hour of waking, your body will be more likely to respond positively. This type of light therapy helps regulate the body’s production of melatonin and cortisol.

The most effective type of full-spectrum light therapy involves artificial lights that mimic natural daylight and provide a bright white light similar in color temperature to the midday sun. For example, LED bulbs that have a high Color Rendering Index (CRI) are ideal for providing a balanced spectrum of light. Additionally, adjustable lamps can provide an even greater degree of control over brightness levels by allowing users to adjust the intensity according to their own preferences.

Conclusion

Bright light upon waking has been shown to improve both physical health (by helping regulate our circadian rhythm) as well as mental health (by boosting alertness). So if you want to feel more energized during the day and get better quality rest at night, make sure you give yourself some extra exposure to bright light first thing in the morning! Even if it’s only for a few minutes each day—it could make all the difference in terms of improving your overall health and well-being!

drshawn

25/Nov/2022

If you suffer from fibromyalgia, you know that it can be a debilitating condition that causes fatigue, pain, insomnia, gastrointestinal issues and brain fog. There is no one-size-fits-all solution for fibromyalgia, but there are many natural treatments that can help lessen your symptoms. Here are 10 natural ways to treat fibromyalgia:

Rest and relaxation:

Getting enough rest is crucial for people with fibromyalgia. Taking breaks during the day and getting a good night’s sleep can help reduce fatigue and pain.

A study published in the journal Arthritis Care & Research found that people with fibromyalgia who got more than 7 hours of sleep a night reported less pain and fatigue than those who got fewer hours of sleep. Furthermore, a study published in the journal PLoS One found that people with fibromyalgia who participated in a mindfulness-based stress reduction program had reduced levels of fatigue and pain. This suggests that relaxation techniques such as yoga or meditation may help improve sleep quality and reduce fatigue and pain in people with fibromyalgia.

Exercise:

Although it may seem counterintuitive, exercise is actually one of the best things you can do for fibromyalgia. There is significant evidence to support exercise for fibromyalgia.

One study showed that a 12-week program of aerobic and resistance training improved pain, fatigue, and sleep quality in women with fibromyalgia. A review of 16 studies found that exercise was associated with significantly reduced pain intensity and improved physical function in people with fibromyalgia.

Another study showed that aquatic exercise was beneficial for reducing pain, fatigue, and improving mental health in people with fibromyalgia. Walking appears to be the most beneficial form of exercise for people with fibromyalgia, but any type of exercise that is gentle and can be sustained for a moderate amount of time is likely to be helpful. It is important to start slowly and build up gradually, listening to your body to see how much you can handle. Taking rest days when needed is also important.

Diet:

Eating a healthy diet is important for everyone, but it’s especially important for people with fibromyalgia. Some foods that are beneficial for people with fibromyalgia include omega-3 fatty acids, magnesium-rich foods, and probiotic-rich foods. One thing to avoid is trigger foods that can make symptoms worse. Common trigger foods include caffeine, alcohol, processed food, and sugar.

Supplements:

Clinical trials have shown that omega-3 supplements can be helpful for people with fibromyalgia. One study found that omega-3 supplements improved pain, fatigue, and quality of life in participants with fibromyalgia. Another study showed that omega-3 supplements reduced tenderness in the muscles of people with fibromyalgia.

Magnesium supplements have also been shown to be helpful for people with fibromyalgia. One study found that magnesium supplements improved pain and tenderness in the muscles of participants with fibromyalgia. Another study showed that magnesium supplements improved fatigue and sleep quality in participants with fibromyalgia.

Vitamin D supplements have also been shown to be helpful for people with fibromyalgia. One study found that vitamin D supplements improved pain and fatigue in participants with fibromyalgia. Another study showed that vitamin D supplements improved quality of life in participants with fibromyalgia.

Finally, turmeric supplements have been shown to be helpful for people with fibromyalgia. One study found that turmeric supplements improved pain, fatigue, and depression symptoms in participants with fibromyalgia. Be sure to talk to your doctor before starting any new supplement regimen.

Acupuncture:

Acupuncture is a traditional Chinese medicine technique that involves inserting thin needles into the skin at specific points on the body. Acupuncture has been shown to be an effective treatment for pain, fatigue, and other symptoms associated with fibromyalgia in a number of clinical trials. For example, a trial published in the journal Rheumatology International in 2012 found that acupuncture was more effective than sham acupuncture in reducing pain and fatigue in patients with fibromyalgia.

Additionally, a trial published in the journal Pain Medicine in 2013 found that acupuncture was more effective than sham acupuncture in reducing pain severity and improving function in patients with fibromyalgia. These and other clinical trials provide strong evidence that acupuncture is an effective treatment for fibromyalgia.

Massage:

Massage therapy can help relieve pain by improving circulation and relaxing tense muscles. It can also help reduce stress and promote better sleep.

Research has shown that massage therapy can be an effective treatment for pain relief in people with fibromyalgia. A study published in the journal Pain Medicine in 2016 found that massage therapy was associated with a significant reduction in pain intensity and improvement in fatigue and sleep quality in people with fibromyalgia.

Another study published in the journal BMC Complementary and Alternative Medicine in 2017 found that massage therapy was associated with a reduction in pain, anxiety, and depression symptoms in people with fibromyalgia. These findings suggest that massage therapy may be helpful for managing the symptoms of fibromyalgia.

Cannabis:

Cannabis has been shown to be an effective treatment for fibromyalgia symptoms. A 2016 study published in the Journal of Clinical Rheumatology found that cannabis was more effective than conventional therapies in treating pain, fatigue, and sleep disturbances in people with fibromyalgia. The study participants who used cannabis reported significant improvements in all measures of fibromyalgia severity, including pain intensity, fatigue, and cognitive function.

A 2017 study published in the journal Frontiers in Pharmacology found that cannabis was associated with significant reductions in pain and fatigue levels, as well as improved sleep quality. The study participants who used cannabis also reported significant improvements in quality of life.

Based on the evidence, it appears that cannabis may be an effective treatment for fibromyalgia symptoms. Cannabis is safe and easy to use, and it may provide significant relief for people who suffer from this debilitating condition.

Aromatherapy:

Aromatherapy has been shown to be beneficial for people with fibromyalgia. A study published in the journal Pain Management Nursing found that aromatherapy with lavender oil improved pain, fatigue, and sleep quality in people with fibromyalgia.

Another study published in the Journal of Alternative and Complementary Medicine found that aromatherapy with lemon balm oil improved pain, anxiety, and quality of life in people with fibromyalgia.

A study published in the International Journal of Neuroscience found that aromatherapy with bergamot oil improved pain and tenderness in people with fibromyalgia.

A study published in BMC Complementary and Alternative Medicine found that aromatherapy with chamomile oil improved anxiety and depression symptoms in people with fibromyalgia.

Laser therapy:

Laser therapy is a beneficial treatment for Fibromyalgia. It increases circulation, which helps to reduce pain and promote healing. Additionally, laser therapy is a non-invasive treatment that is relatively painless.

A study published in the “Journal of Alternative and Complementary Medicine” in 2009 found that laser therapy was able to improve pain, fatigue, and function in people with Fibromyalgia.

Additionally, a study published in “PLoS One” in 2013 found that laser therapy was able to reduce pain and improve quality of life in people with Fibromyalgia. These studies provide evidence that laser therapy may be an effective treatment for Fibromyalgia.

Intravenous vitamins and minerals:

One potential treatment for fibromyalgia is intravenous vitamin and mineral infusion. This treatment bypasses digestion and allows the vitamins and minerals to be directly absorbed into the bloodstream. The use of intravenous vitamin and mineral infusion for the treatment of fibromyalgia has been supported by a number of clinical trials.

A randomized, controlled trial published in 2011 found that the treatment was effective in reducing pain and fatigue in people with fibromyalgia. A study published in 2012 found that the infusion was associated with a significant improvement in quality of life and sleep quality.

Another study published in 2014 found that the infusion was associated with a reduction in tender points and improved self-reported pain scores. These studies provide strong evidence that intravenous vitamin and mineral infusion is an effective treatment for fibromyalgia.

Conclusion:

If you are looking for natural ways to treat Fibromyalgia, there are many options available. Some of these include: rest and relaxation techniques, exercise, diet, supplements, acupuncture, massage, cannabis, laser therapy and intravenous vitamins and minerals. It is important to speak to your naturopathic doctor about which natural therapies might be best for you. With so many options available, there is sure to be a treatment that can help improve your symptoms and quality of life.

drshawn

11/Sep/2022

Intro

According to the National Sleep Foundation, “insomnia is defined as repeated difficulty with sleep initiation, maintenance, consolidation, or quality that occurs despite adequate opportunity and circumstances for rest,” and it affects approximately 30-35% of adults. If you’re one of the millions of people struggling to get a good night’s sleep, know that you’re not alone—and there are naturopathic treatments that can help!

Sleep Hygiene

One of the best things you can do to improve your sleep is to practice good sleep hygiene. This includes habits like avoiding caffeine in the afternoon and evening, avoiding alcohol before bed, Establishing a regular sleep schedule, and avoiding screens in the bedroom. Creating a relaxing bedtime routine can also be helpful; consider taking a bath or reading a book before climbing into bed.

Nutraceuticals

There are also a number of nutraceuticals—or nutrients that have medicinal properties—that can help improve sleep. Melatonin is a hormone that helps regulate the body’s natural sleep-wake cycle, and supplements can be effective in treating insomnia. 5-HTP is another nutrient that can be helpful in treating sleeplessness; it works by increasing levels of serotonin, a neurotransmitter that plays an important role in regulating sleep. Other nutrients that have been shown to be effective in treating insomnia include gamma-aminobutyric acid (GABA), valerian root, and passionflower.

Traditional Chinese Medicine

Traditional Chinese Medicine (TCM) offers another treatment option for those struggling with insomnia. Acupuncture is one of the most well-known TCM treatments; research has shown that it can be effective in treating insomnia by promoting relaxation and improving sleep quality. Herbal medicine is another TCM modality that can be helpful in treating sleeplessness. Traditional Chinese herbs that have been used to treat insomnia include jujube seed, ziziphus seed, longan fruit, tianma root, ginseng root, and magnolia bark.

Cannabis

Cannabis is another treatment option that is gaining popularity for its ability to effectively treat insomnia. THC, the primary psychoactive compound in cannabis, has been shown to increase slow-wave sleep—the deepest stage of sleep—while CBD has been shown to reduce REM sleep density, which may lead to more restful sleep. For those who are interested in trying cannabis for their insomnia but are worried about the potential for addiction or abuse, CBD-only products may be a good option as they do not have any psychoactive effects.

Conclusion

If you’re one of the millions of people affected by insomnia, know that you’re not alone—and there are treatments out there that can help! Sleep hygiene practices like avoiding caffeine and screens before bed can make a big difference, and nutraceuticals like melatonin and 5-HTP can also be effective in treating sleeplessness. Traditional Chinese Medicine modalities like acupuncture and herbal medicine can also offer relief from insomnia; cannabis is another treatment option gaining popularity for its ability to improve sleep quality. Talk to your naturopathic doctor about which treatment option may be right for you!

Book an appointment today!

drshawn

13/Aug/2022

Cannabinoid therapy for sleep

I have noticed consistently good results using cannabinoids for sleep disorders. I am often asked what are the top indications for cannabis therapy in my practice and insomnia would always be in the top three.

I first started to gain an interest in cannabis and cannabinoids back in 2015. One of the most common reasons that my patients were using cannabis was for various types of insomnia. Most of these patients were having very good results. That really peaked my interest because I too suffered from insomnia for a large part of my life.

I had used various natural sleep aids but needed a change as my current medication was producing some inconvenient side effects. After receiving my medical cannabis prescription I started using a balanced THC:CBD oil which improved my sleep latency and nighttime wakeup’s within a few days. Cannabinoid therapy is now one of my most recommended treatments for various types of insomnia as it is safe, inexpensive, fast acting and effective.

Cannabis can have calming or stimulating effects depending on the preparation, dose and mode of administration. I really wanted to find out what made cannabis effective for sleep and what would be the optimal way to use it for sleep. My research pointed towards a few mechanisms through which cannabinoids likely have sleep promoting effects: GABA, Serotonin and Endocannabinoid modulation.

GABA

GABA is an inhibitory neurotransmitter that generally promotes a relaxation response in the central and peripheral nervous system. It is well established that activation of GABA receptors favours sleep and many pharmaceutical drug classes, including benzodiazepines, act on GABA receptors.

Both animal and human studies have demonstrated that cannabidiol (CBD) has a modulatory effect on GABA activity. CBD can both increase and decrease GABA activity depending on neurotransmitter activity levels (if there’s too little it increases, if there is too much it decreases). This makes CBD useful for sleep disorders resulting from too little GABA activity (think of the overactive brain) without the addictive potential of GABA stimulating pharmaceutical preparations.

Serotonin

Serotonin is a neurotransmitter that is involved in mood and sleep/wake responses. Many antidepressant medications specifically target serotonin activity. Research from the early 2000’s by Bambico et al demonstrated that cannabinoid receptor agonists (things that stimulate cannabinoid receptors) have the ability to modulate serotonin activity. Low doses seemingly to raise serotonin activity while high doses have little effect.

Both endogenous cannabinoids (cannabinoids we make ourselves) and phytocannabinoids (THC, CBD etc..) seem to have the ability to modulate serotonin activity via stimulation of our cannabinoid receptors. This may explain some of the physiology involved in the sleep promotion and anti-anxiety effects of cannabis preparations. CBD seems to be particularly useful through its interplay with our endocannabinoid system.

The Endocannabinoid System

All species, with the exception of insects, have an endocannabinoid system. The endocannabinoid system is our bodies harm reduction system, keeping chemical and electrical singling in balance. Overall, stimulation of the endocannabinoid system has a calming effect and a known modulator of our sleep/wake cycle.

Many chronic diseases that have been linked to disruption in the endocannabinoid system (Fibromyalgia, Migraine, Inflammatory Bowel Disorder) have a sleep disruption comorbidity. This sleep disruption can usually be helped with a prescription of cannabinoids such as CBD. It is certainly plausible and empirical evidence supports the theory that patients with sleep disorders have endocannabinoid disruption. Therefore, phystocannabinoids like CBD can be helpful to restore endocannabinoid tone and subsequently better sleep.

Dosing Considerations

Cannabis is a unique medicine as it cannot be prescribed based on age and weight. Everyone has an individual response to cannabinoids due to the fact that everyone has unique endocannabinoid tone and metabolism.

Cannabinoids like CBD and THC can interact with particular medications and preexisting conditions. Some preparations of cannabis are very different in their effect and duration. Smoked cannabis has a very fast acting effect but a short duration. Edible cannabis can have a slow onset of effect but last for a long time.

Therefore it is highly recommended to have a healthcare professional knowledgeable in cannabinoid therapy work with you for the initial stages of treatment. This will ensure a safe and effective dosing strategy with minimal chance for adverse effects. With that being said cannabis is a very safe medication and when prescribed correctly can make a significant difference in those suffering from sleep disorders. Check out the Cannabis Therapy page for more information.

References

Pretzsch CM, Freyberg J, Voinescu B, Lythgoe D, Horder J, Mendez MA, Wichers R, Ajram L, Ivin G, Heasman M, Edden RAE, Williams S, Murphy DGM, Daly E, McAlonan GM. Effects of cannabidiol on brain excitation and inhibition systems; a randomised placebo-controlled single dose trial during magnetic resonance spectroscopy in adults with and without autism spectrum disorder. Neuropsychopharmacology. 2019 Jul;44(8):1398-1405. doi: 10.1038/s41386-019-0333-8. Epub 2019 Feb 6. PMID: 30758329; PMCID: PMC6784992.

Gottesmann C. GABA mechanisms and sleep. Neuroscience. 2002;111(2):231-9. doi: 10.1016/s0306-4522(02)00034-9. PMID: 11983310.

Moreira FA. Serotonin, the prefrontal cortex, and the antidepressant-like effect of cannabinoids. J Neurosci. 2007 Dec 5;27(49):13369-70. doi: 10.1523/JNEUROSCI.4867-07.2007. PMID: 18057193; PMCID: PMC6673093.

drshawn

13/Apr/2022

Intro

Let’s take a look at 5 of the most common chronic issues that we experience as a a result of modern living: Stress, Insomnia, Anxiety, Depression and Pain. While there are some pharmaceutical medications that can be effective, most individuals would rather seek a safe and effective alternative approach. Here I will outline these conditions individually and describe some of the most effective treatments that I use at my Toronto naturopathic clinic Physic-Logic.

Stress

Stress is an unavoidable biological response to a threat. The human body developed the stress response in order to escape immediately threatening situations like wild animals and hunting for food. The stress response evolutionarily developed to kick the body into high gear in particular situations and for relatively short intervals. Stress demands a lot from our body in order to perform at a very high level. An increased output of hormones, vitamins and minerals are utilized during the stress response.

The reality is that in modern day living we perceive stress from a variety of situations that are outside of our evolutionary makeup. For example, many if not all of us experience financial stress, workplace stress, relationship stress, medical related stress etc… If we do not have effective coping strategies these stressors, overtime, use up our bodies resources and lead to burnout.

Chronic stress can also be a trigger in the development and resurgence of chronic illnesses like autoimmune disease, allergies, gastrointestinal disease, migraine and skin conditions. At our Toronto Naturopathic Clinic we have several therapies that help to support the body through stress. Adaptogenic herbs like Rhodiola and Ashwagandha help to balance cortisol levels, evening out the highs and lows of a stress response. Magnesium, b-vitamins and vitamin C help to support the adrenal glands which can experience a state of fatigue when under prolonged stress. Acupuncture can help to bring the body into a calming parasympathetic state after prolonged periods in sympathetic fight and flight mode. All these holistic modalities work together to bring a patient out of stress induced fatigue while allowing a better more controlled stress response in the future.

Insomnia

One of the most important foundations for health is good sleep. Most adults require 8-10 hours of sleep for optimal performance whereas in reality 5-7 hours seems to be the norm for most many patients. Not only is sleep duration important but quality uninterrupted sleep is important as well. Our body will have trouble healing and functioning optimally without adequate sleep quantity and quality.

There are 3 types of insomnia that I typically see in my Toronto Naturopathic practice: 1. Sleep initiation insomnia (trouble falling asleep) 2. Sleep maintenance insomnia (trouble staying asleep) and 3. A combination of both initiation and maintenance insomnia. Some of the most common issues causing insomnia are due to anxiety, stress, pain and discomfort. Therefore a successful approach to treating insomnia needs to take into consideration the root causes of the insomnia and the type of insomnia.

Many of the pharmaceutical approaches to insomnia have issues with dependency, addiction and grogginess. The pharmaceutical treatments don’t typically consider the issues causing the insomnia or the type of insomnia either. At my Toronto Naturopathic clinic Physio-Logic I use a combination of time tested approaches to pinpoint the specific areas of sleep that have been disrupted. For instance melatonin can be a very effective treatment for insomnia but many patients don’t realize that there is more than one type of melatonin and that dosage is very important. A fast acting sublingual melatonin may be very helpful to initiate sleep but not effective at maintaining sleep throughout the night; whereas a prolonged release melatonin is often much more effective for sleep maintenance issues. Similarly Cannabis and cannabinoids can be used for insomnia but fast acting inhaled forms are better suited for sleep initiation whereas longer acting oral forms are more useful for sleep maintenance. At our Toronto Naturopathic clinic we take into consideration all the nuances in the diagnosis of insomnia to come up with the most effective and safest course of treatment.

Anxiety

Most of us have experienced anxiety at one point or another and like stress, anxiety in specific circumstances and in relatively short durations is perfectly normal. When anxiety becomes a daily or long lasting biological response we simply cannot function optimally and start placing our body at risk of chronic disease.

Stress and anxiety are closely related with anxiety being more of the mental emotional response and stress being more of the physical response to a perceived threat. A big issue with chronic anxiety is that it becomes a vicious cycle perpetuating itself; the experience of anxiety creates more anxiety and the fear of its return creates more anxiety. The brain, much like muscle has a memory and the more times specific pathways are engaged the harder it becomes to break those physiological habits.

Anti-anxiety medications often fail at producing long lasting results without side effects because they where often designed for treating other conditions; as is the case with anti-depressant medications. A recent breakthrough in anxiety medicine has revealed that our endocannabinoid system has a significant role in the maintenance of balanced mental emotional health. Therefore compounds like cannabidiol (CBD) which act to support the endocannabinoid system have been shown to be effective and safe in the treatment of anxiety with minimal side effects.

Promotion of a healthy lifestyle including daily exercise and a healthy diet can further support the endocannabinoid system and are therefore extremely effective strategies in their own rite. At my Toronto Naturopathic Clinic Physio-Logic we combine several strategies including cannabinoid education to formulate an effective strategy to break the anxiety cycle once and for all.

Depression

Depression is a spectrum ranging from mild symptoms to severe symptoms. While pharmaceutical medication is often necessary for more severe forms of depression, functional medicine can be very effective in treating mild to moderate depression.

Most anti-depressant medications work by keeping higher levels of serotonin in the brain and nervous system. There are many natural compounds that can achieve similar results with a less specific but more holistic mode of action. The net effect is something that is gentler than a pharmaceutical drug but with less potential for dependency and side effects. One example is the flower St. Johns Wort which s backed by several studies confirming its efficacy in treating mild to moderate forms of depression.

Nutrition and exercise are also fundamental in treating all forms of depression and unfortunately as symptoms get worse so do the potential for lassitude and malnourishment. Intervention at the early stages of depression can often allow the patient to utilize holistic therapies effectively and prevent the need for a more aggressive pharmaceutical approach. At my Toronto Naturopathic Clinic, we use functional and holistic medicines from both eastern western medical traditions to treat mild to moderate depression safely and effectively. Some of these treatments include: herbal therapy, acupuncture, intravenous therapy and lifestyle counselling.

Pain

One of the biggest obstacles to cure is pain. Chronic pain interfere with the activities of daily living, disrupting sleep and making exercise impossible. Chronic pain also places physical stress on the body, over time leading to physical burnout and deficiency. Unfortunately many of the most effective pharmaceutical strategies for pain management are linked to addiction and long term side effects. Gastritis (inflammation of the stomach) is a common condition I see in practice linked to long term use of Non steroidal anti-inflammatory medications like Advil and Naproxen. Fortunately there are many safe and effective treatment options within naturopathic and functional medicine.

Pain is often linked to a few common phenomena: lack of circulation, inflammation, tight muscles and neurological injury. Many holistic treatments such as acupuncture, cupping, moxibustion, laser therapy and massage work to improve circulation and loosen tight muscles. Many vitamin, mineral and herbal therapies are excellent for controlling inflammation. Curcumin is a compound derived from the spice turmeric and has years of scientific research demonstrating its strong anti-inflammatory properties without side effects. Using electric current in conjunction with acupuncture can be a safe and very effective treatment for neurological injury. At the my Toronto Naturopathic clinic we utilize many different tools and strategies to provide a safe, effective and individualize treatment for both acute and chronic pain.

Conclusion

Many of the health concerns that we experience in modern society can be safely and effectively treated with a Naturopathic approach. I would encourage anyone experiencing stress, insomnia, anxiety, depression or pain to have a consultation with a Naturopath or other functional medicine doctor. Unfortunately it is all too common for patients to first step into my office after years of trying to manage symptoms using only a pharmaceutical approach. It is never too late to try a more holistic approach. You will be surprised at how effective these treatments can be.

DoctorShawn

11/Sep/2019

My review of Ruxton by Broken Coast. Deeply relaxing, very potent 4 out of 5 stars.

DoctorShawn

16/Mar/2018

Why get a license?

I want to tell you how to obtain a license for Medical Marijuana. Every month I see a handful of patients who are trying to medicate with unregulated cannabis obtained either through “a guy” or a local illegal dispensary. The problem with this approach is that you are buying an unregulated product, meaning you cannot guarantee its purity, quality, potency, and cannabinoid profile.

There are some decent products out there but largely its hit and miss and perhaps the most frequent complaint is a lack of consistency from batch to batch. Its funny how patients will be shy about discussing use of medical marijuana with me and yet will go to a complete stranger for their medication. A growing part of my practice is convincing patients to transition from their “street weed” to a proper regulated medical marijuana product.

Although, as a Naturopathic Doctor, I am not able to directly prescribe medical marijuana in Ontario, I am fortunate to have a good professional relationship with a licensing clinic and am writing an average of 3-5 patient referrals per week. Most licensing clinics will require a referral from a healthcare professional.

How to get a license

The process is quite simple: a patient will come in either having experience with cannabis or will be curious as to whether cannabis can help them. I will then preform an assessment, including a health history and short physical exam, in order to determine if they would benefit from cannabis. A referral is then made to the licensing clinic. The licensing clinic then calls the patient to setup an appointment to get a license for access to medical marijuana. Once setup with an account the patient then does all their ordering online through a regulated distributor such as Tweed, Aphria, Tilray or MedRelief.

These regulated grower/distributors have an excellent selection of strains and oils with varying cannabinoid concentrations and terpene profiles. Most importantly, the purity and potency are guaranteed and there is very high consistency from batch to batch. Therefore, if you find a strain or oil that works for you, you can pretty much guarantee it will work the same way every time you order it.

Common conditions for referral

The most common conditions I write referrals for are: Insomnia, Multiple Sclerosis, Chronic Pain, Migraine, Irritable Bowel Syndrome, PTSD, Inflammatory Bowel Disease, Cancer, Fibromyalgia and Neurological Conditions with painful spasms.

The environment in Canada with regard to cannabis is going to change as we approach legalization, but until that happens I would advise you that it is usually better to consume regulated medicines, this medication just happens to be marijuana.

For more great articles and information on cannabis and CBD check out the link below: