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