source:- msncom
Anxiety and insomnia often go hand-in-hand—each brings out the worst in the other, and it’s nearly impossible to get rid of one without dealing with the other one first. Anxiety is one of the most common causes of insomnia; worrying leads to sleep problems, and yet having problems sleeping can cause a lot of anxiety.
This was exactly the situation Laura Dobratz, 31, from Minneapolis, recently found herself in, after dealing with severe insomnia for years.
Anxiety, insomnia, and doses of CBD
Laying awake, staring at the ceiling, and counting sheep doesn’t even begin to describe the agony of chronic insomnia, Dobratz says. “I would have trouble sleeping pretty much every single night, for years,” she says. “This meant I was always exhausted during the day and never felt well-rested, which took a toll on every aspect of my life.”
Dobratz’s insomnia began when her anxiety spiked during an extra stressful holiday season. “I had some big worries, which made it hard to fall asleep and stay asleep,” Dobratz recalls. But, much to her dismay, when that frantic holiday ended and life returned to normal, the anxiety and insomnia stayed.
It quickly turned into a vicious cycle of worrying, which made her unable to relax enough to fall asleep. The next day, this was followed by more anxiety because she wasn’t sleeping.
Eventually, she sought out a psychiatrist to help with her mental health issues. The doctor felt that they needed to treat her insomnia along with her anxiety to see real improvement. So, her doctor prescribed her a sleep aid.
Dobratz says the prescription sleeping pills helped her stay asleep, but she was still having a tough time turning off the anxious part of her brain and falling asleep. So, her psychiatrist recommended that she try cannabidiol (CBD) oil, taking one dose in the morning to help manage her anxiety throughout the day and then a second dose right before bed.
What is CBD?
CBD is a compound that can be extracted from the cannabis plant. Yes, this is the same plant marijuana comes from, but CBD is not the same as recreational pot or medical marijuana. CBD can be derived from either marijuana or hemp, a related plant that has almost no THC. CBD products—including oils, oral tinctures, lotions, capsules, gum, and inhalants—typically contain only trace amounts of tetrahydrocannabinol, or THC, the compound that makes pot psychoactive.
This means it can’t make you high, isn’t addictive, and is legal in all 50 states.
In 2018, the World Health Organization wrote that CBD is generally safe for most people and shows no abuse or dependence potential or evidence of other public health-related problems. In fact, they found it may be helpful in managing a variety of chronic conditions, including insomnia.
Keep in mind that CBD is classified as a supplement. The U.S. Food and Drug Administration does not regulate CBD products so you should always talk to your doctor before trying any supplement.
CBD for insomnia
CBD may be a natural sleep aid that could help you get more rest. In a 2019 study published in The Permanente Journal, of people taking CBD for sleep problems, 80 percent reported less anxiety and 67 percent showed improved sleep scores. Individual sleep scores did fluctuate over the course of the study, according to the researchers, and they note that the “results must be interpreted very cautiously” because the study was not a randomized, blinded trial. (Check out these other natural sleep aids that may work.)
However, there are some reasons why CBD might help you sleep. “The brain is loaded with cannabinoid receptors that when activated, enhance brain function and produce a calming effect, dialing down stress and inflammation,” says Mary Clifton, MD, a board-certified internal medicine doctor practicing in New York City, a recognized expert in medical marijuana and CBD, and co-author of The Grass is Greener: Medical Marijuana, THC & CBD Oil. “CBD products activate those receptors in the brain and nervous system, which can lead to a sedative effect,” says Dr. Clifton, who is also an advisory board member for ZoneIn CBD, a CBD company.
CBD also may help with depression and physical pain, says Brigitte Zeitlin, RD, who uses CBD products as part of some of her treatment plans and is the owner of BZ Nutrition, a nutrition counseling service.
“CBD can help alleviate some of the main issues that typically cause insomnia; I’ve found most of my clients suffer from insomnia as it relates to their anxiety, PTSD, sometimes depression, and/or physical pain,” she explains. “CBD oil has been shown to help alleviate anxiety, which helps to relax people into slumber a bit more easily. CBD can also help ease some physical pains, which can keep people up too.”
What type of CBD is best for insomnia?
There are hundreds of different brands of CBD, all with different formulations and promises, and they are not all created equal, says McKenzie Mann, hemp researcher and product development manager for Blue Forest Farms, a farm that grows high-CBD hemp and sells CBD products.
“CBD is kind of the wild west these days,” Mann says. “Anyone can get in the business and there are a lot of so-called CBD products with little or no actual cannabidiol in them,” he explains. Mann adds that there’s a big difference between a bottle you grab at the gas station and a high-quality, independently tested product.
In addition, different strains of hemp plants have different chemical makeups, making some better suited for helping with insomnia than others, Mann says. “Look for a strain higher in terpenes, a compound that has been shown to improve sleep,” he recommends, adding that a tiny amount of THC will compound the sleep-promoting effects (as long as it’s legal where you live).
Another option Mann suggests is to look for cannabinol (CBN) oil. CBN is a compound extracted from the hemp plant, similar to CBD oil, but has an even more powerful sleep-promoting effect.
“A full-spectrum oil will give you the CBN and terpenes along with the CBD so that’s always my first recommendation,” Mann says.
Types of CBD extracts
There are actually four types of CBD extracts, according to Mann.
- Full spectrum. This is the most natural oil. It’s extracted raw from the plant and contains a full spectrum of compounds, including CBD, CBN, THC, terpenes, chlorophyll, minerals, and other parts of the hemp plant. “This is usually the best for most people and what we recommend—it’s the ‘entourage effect’, all the compounds in the plant work best when they are together,” he explains. Mann adds that this is what he recommends first for insomnia, but because it does contain some THC, it may not be legal where you live.
- Full spectrum isolate. This CBD contains just the cannabinoids (CBD, THC, and others). The other compounds, including terpenes, chlorophyll, and minerals, are removed, which also mellows out the flavor. So, if you don’t like the strong flavor of a full spectrum, this might be a good option for you, Mann says.
- Broad spectrum. For places that do not allow THC, this is basically a full spectrum product, but with the THC removed. CBD products need to contain less than 0.3 percent THC to be sold anywhere in the U.S., according to the 2014 U.S. Farm Bill. A higher amount of THC in the CBD product will make it more effective for insomnia. However, if you live in a state where marijuana is not legal, this is a good option, he says.
- “Pure” CBD isolate. These products are 99 percent straight CBD with all other compounds removed. But, while this might look like what you want—especially as it’s often labeled “pure CBD”—it’s the least effective form, Mann says. However, it still can have some effect on insomnia so it’s worth trying.
For the best results treating insomnia, Mann recommends looking for a full-spectrum CBD product with 3:1 or even 5:1 ratio of CBD to THC.
How to use CBD for insomnia
“I recommend starting with 20mg taken one hour before bedtime, many people will see improvements just at this starting dose,” Dr. Clifton says, adding that if you aren’t seeing an effect after two weeks, you can start to increase the dose incrementally.
Dobratz has found that two doses per day, one in the morning and one at bedtime, is her sweet spot. However, there’s a huge variation in how people react to CBD and underdosing is a common issue, so work with your doctor to find what works for you. Know that it may require some experimenting to find what works, Dr. Clifton says. (Here’s what doctors wish you knew about CBD.)
Another factor to consider is the method for taking it. CBD is most often found as an oral tincture or oil, and you use a dropper to place it under your tongue, allowing it to absorb slowly. But, you can also find CBD lotions, capsules, gum, edibles, and inhalants. “Using sublingual drops is the most common method for treating insomnia but many people prefer capsules, because the sedation associated with the oral therapy is a little more intense than when the product is taken sublingually for some people,” Dr. Clifton says.
“If one type doesn’t work for you, it’s worth trying a different method to see how you respond,” Mann adds.
Where to buy CBD for insomnia
“A good CBD supplier should be able to tell you exactly where their product comes from, what types of strains they have, and what they are good for,” Mann explains. “If they can’t answer your questions, chances are it’s not a good product.” If you don’t have a physical store available you should purchase directly from a high-quality store online (not Amazon) and they should provide a phone number or email for you to ask questions, he adds.
You should also expect to pay more for a high-quality, effective product—but it doesn’t have to break the bank. However, CBD is expensive, so if you find a super cheap deal, there’s a good chance it doesn’t have much, if any, real CBD in it, he says.
Dobratz found a CBD oil, Relive Everyday, through a homeopathic doctor’s office. She opted for one without THC. “It costs $100 a bottle, but it’s worth it because it works so well for me,” she says. “I’m so glad my psychiatrist recommended it or I probably wouldn’t have tried it.” (Here’s are vitamins and supplements doctors take every day.)
Seeing improvements in insomnia with CBD
Dobratz says she saw an immediate improvement in her ability to fall asleep after starting CBD oil. According to Dr. Clifton, this isn’t uncommon.
“Many people see improvement with their first administration, but it’s wise to set aside two weeks to see if it’s effective for you,” Dr. Clifton says. “Everyone’s endocannabinoid system is a little bit different in how it responds,” she says, “so, one patient may feel a difference after the first dose, but others may need several days or weeks to build up enough to where you feel it.”
You also need to be consistent with your dosing, taking the same amount at the same time every day and not skipping doses, Mann says. (Here are 11 “harmless” habits that can cause insomnia.)
What are the side effects of CBD?
The most commonly reported side effects of CBD are diarrhea, changes of appetite/weight, and tiredness (which could actually be considered a benefit for insomniacs), according to a 2017 study published in Cannabis and Cannabinoid Research.
“Luckily, the biggest side effect of CBD is a feeling of sedation, which suits the insomniac just fine,” says Dr. Clifton. While most of her patients feel more sleepy and less anxious after taking CBD, it’s not for everyone, she says.
“It may be due to individual differences in levels of receptors or enzymes but we’ve found that about 20 percent of people don’t get the expected results,” Dr. Clifton explains. (If you find out you’re one of them, try these 10 weird tricks that worked for people with insomnia.)
Severe side effects from CBD are rare, and it isn’t known to interact with any medications. However, there isn’t a lot of research in this area yet, so talk to your doctor first, and proceed with caution if you have other chronic conditions, Dr. Clifton says.
Dr. Clifton does note that with any supplement, allergies are always possible. So, if you experience a rash, hives, or swelling, stop taking it and call your doctor; if you have trouble breathing, get emergency care immediately, she says.
You may also experience side effects from other ingredients added to the CBD, like a carrier oil or filler in capsules, depending on the manufacturer.
Practice good sleep hygiene
What else should you do to improve the sleep-enhancing effects of the CBD?
Having good sleep hygiene is incredibly important to anyone dealing with insomnia and you should do everything you can to create a good sleep environment, Dr. Clifton says.
“I tell my patients that the CBD on its own won’t be as effective without implementing other healthy changes,” she explains. “Keep your bedroom cool, dark, and quiet. No screens at least an hour before bedtime. Get exercise during the day. And don’t use your bedroom as an office or for other purposes—your bedroom should be used exclusively for sleep and sex.”
As for Dobratz, she says CBD has helped her become less anxious and improve her sleep. “It really just makes me feel relaxed and tired when I take it,” Dobratz says. “It helps me chill out and not continuously worry about things when I’m trying to go to sleep. It does not, in any way, make me feel high.”
Plus, it doesn’t have any lingering effects in the morning, unlike some sleeping medications, she adds.
Little changes you can make to sleep better in just one day (The Healthy)
WHAT YOU CAN DO NOW TO IMPROVE SLEEP LATER
Not sleeping is the worst, and there can be plenty of reasons why you can’t drift off including sleep disorders (besides sleep apnea). If you’ve already tried doing some stretches before bed to help sleep better, limiting your caffeine, and sipping on chamomile tea to no avail you might want to work on getting better slumber from the moment you wake up.
TRY SOME REVERSE PSYCHOLOGYIf
you want to fall asleep faster, think about staying awake. “It sounds counter-intuitive, but for those who find it difficult to sleep because they keep worrying about not falling asleep, do the opposite,” says Sujay Kansagra, MD, director of Duke University’s Sleep Medicine program and Mattress Firm’s sleep health consultant. Most of the time falling asleep is an involuntary process that takes virtually no effort on our part but if we’re anxious, we do things like looking at the clock and calculating how little sleep we’re going to get, which then causes sleep performance anxiety. “Instead of worrying about falling asleep, think about staying awake instead. This often lessens anxiety and gives your mind a chance to relax enough to fall asleep. It’s a technique known as paradoxical intent, a cognitive behavioral therapy technique used to lessen the anxiety around falling asleep.
STOP SNACKING IN BED
Noshing in bed is not great for getting for sleeping. “Eating in the bedroom, especially right before bedtime, can be very disruptive to sleep,” says Robert I. Danoff, DO, family physician and program director, Aria Health System. Salt-filled snacks could make you thirsty, drinking too much fluid prior to bedtime may cause extra trips to the bathroom, and any caffeine within four hours of sleep may keep you awake or cause disrupted sleep. Caffeine can also make you feel anxious and jittery. Eating before bed is also one of the many nighttime habits that can lead to weight gain.
LISTEN TO THESE GROWN-UP LULLABIESEven if our parents couldn’t carry a tune, a lullaby was a soothing way to get us to sleep. They knew then what science has found: that certain kinds of music can improve the quality of your sleep. Research published in 2019 in Scientific Reports found that relaxing music improves sleep quality. They also found that those who listened to music transitioned from wake to sleep more quickly. Other research has found that music may even benefit people with insomnia.
PUT IT IN NEUTRAL
Ever watch a dog before he lays down to sleep? He circles for a bit, lands, adjusts his position a few times and finally heads to snooze town. He must know what his neutral position is. “Just as important as the quantity of sleep is the quality of sleep, and a large aspect of this is posture,” says Param Dedhia, MD director of Sleep Medicine at Canyon Ranch in Tucson, Arizona. “A neutral spine can be on the back and it can be on the side. The positioning with pillows is key. When our body is neutral with an aligned spine, it allows our musculoskeletal and neurological system to be with less twisting, pushing and pulling. Neck, shoulder, low back and hip pain are less aggravated with a neutral spine,” says Dr. Dedhia. Even when you shift positions in the night, you can still maintain a neutral position by using your pillow to readjust and align the spine to be comfier. Check out 13 other secrets sleep doctors want you to know.)
TALK TO YOUR DOCTOR ABOUT MAGNESIUM
If you want to improve your sleep tonight, you may want to consider a magnesium boost. A magnesium deficiency can contribute to insomnia and other health problems. The recommended daily intake for magnesium for adults ranges from 310 mg to 420 mg, depending on sex and age. Talk to your doctor about whether a supplement is right for you.
KICK YOUR POOCH OUT OF BED
If you’re having trouble sleeping and have checked off the common culprits, the answer could be co-sleeping with your furry friend. “The movements and breathing of a pet may be somewhat distracting and disrupt falling back to sleep,” says Mark Buchfuhrer, MD, medical director of the Comprehensive Sleep Center at Good Samaritan Hospital in Los Angeles. “In addition, patients with allergies to pets may have increased allergic symptoms such as the runny nose or nasal congestion that may interfere with sleep.” Watch out for these other bad insomnia habits that are keeping you up.
GO FOR THE EARPLUGS OR SLEEPING MASK
Making your bedroom the ultimate sleep oasis isn’t too difficult with a few simple tips. Dr. Buchfuhrer has a nifty checklist to make it happen: Random noises can interrupt light sleepers. Earplugs or white noise from a fan can help keep a constant hum going. We’ve all heard by now about how “blue light” from our devices, TV’s and other electronics can mess with melatonin production, a sleep hormone. “Avoid watching LCD TV or computer screens for a few hours before bedtime as they emit higher frequencies of light similar to daylight.” Dr. Buchfuhrer suggests downloading FLUX to adjust your computer screen to emit light that is appropriate for the time of day. Blackout curtains and sleeping masks are essential if you suspect your suspect light is keeping your awake. You may even want to switch out your bulbs tonight. Regular bulbs suppress melatonin but these bulbs filter out the “blue light,” which could help you fall asleep faster.
WRITE IT OUT
Your head finally hits the pillow and you let out a soft yawn before you drift off—until you remember all the things you have to do tomorrow. If you want to fall asleep faster tonight, try Dr. Kansagra’s suggestion and create a list of tasks, worries, chores or whatever is keeping your awake. This technique is ideal for those who mentally work through their list of pending responsibilities before bed. “You can prevent yourself from thinking about it excessively just before bed,” says Dr. Kansagra. If all these sleep tips don’t work, try the tricks that worked for these former insomniacs.