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

The post How One Woman Used CBD Oil to Sleep Better and Beat Insomnia appeared first on MyMedicPlus.

Turn your bedroom into a “sleep sanctuary,” consider buying a white noise machine, and stop checking your phone before bed.

On a recent FaceTime call, my friend Jon told me that he hadn’t had a satisfyingly restful night of sleep since March, before the stay-at-home orders and the wave of coronavirus cases hit the US. He’s taken sleeping aids, exercised before bed, and listened to ASMR videos but to no avail; he couldn’t manage to turn his brain off until 2 or 3 am on most nights.

Jon isn’t alone in his sleeplessness. While many people have anecdotally reported having startlingly vivid dreams in quarantine, some are struggling with what feels like incurable insomnia, whether that manifests as difficulty falling asleep, trouble staying asleep through the night, or waking up too early.

A survey of nearly 1,000 people by SleepHelp.org found that 22 percent of responders have had poorer quality sleep due to the pandemic, and a third said their sleep troubles stemmed from the news coverage they consumed. In China, health care workers were reportedly prone to sleeplessness and experienced feelings of depression, anxiousness, and stress-based trauma. The coronavirus, it seems, has conjured up “a perfect storm of sleep problems,” according to one Stanford sleep researcher.

In pre-pandemic times, about 30 to 35 percent of adults suffer from insomnia, and most are short-term conditions that can be resolved without professional help. (Medical professionals and sleep experts generally recommend about seven to nine hours of sleep each night.) The inability to fall asleep can be frustrating, especially in the midst of a pandemic with no end in sight. If you’re an insomniac, you’ve probably spent at least one night Googling something along the lines of “How to fall asleep” instead of actually falling asleep.

I spoke to Bill Fish, a certified sleep specialist and managing editor at SleepFoundation.org, about those struggling with sleep and lifestyle changes. Here is his best advice to achieve more restful nights.

How has staying inside affected our sleep patterns?

It’s interesting to see a progression of the pandemic from a mental health and sleep perspective. Within the first three weeks, starting in early to mid-March, there wasn’t a lot of talk about sleep, but as we got into the stay-at-home orders for two to three weeks, people have really started to notice they weren’t sleeping as well and have had trouble sleeping. There are all kinds of factors at play that cause insomnia in people. For those of us who are fortunate to be working from home, we’ve lost the structure of our daily lives. We don’t have an external reality, so to speak.

What a lot of people have started doing, instead of going to bed at 10:30 and getting up at 6:30, there’s no longer a big motivator to get up at 6:30. While that can be good to some extent, at the end of the day, all adults should be getting between seven to nine hours of sleep on a nightly basis.

If you’re getting any more than that, you could wake up feeling lethargic and not really yourself. Our bodies have become trained to know and prepare for the sleep process. With more people staying up at night and sleeping later in the morning, their bodies after about two to three weeks have redialed, and that doesn’t even take into consideration the health and the financial stress the pandemic has caused.

What tips do you have for people struggling with insomnia?

My biggest thing is schedule — encouraging someone to get back to a sense of normalcy. I have two sons who just want to stay up all night and play video games because they can’t see their friends. I have to explain to them that it’s not healthy for them to stay up. If your body is used to you waking up early, consider adopting that habit again. All of us, and our bodies, are trying to figure out what this “new normal” is, and what I push for is to try and do everything you can to get back to your old bedtime. If you’ve messed up your sleep pattern, I’d recommend trying to change it in increments of 10 or 15 minutes a night until you get back to where you were before.

At one point, kids are going to go back to school and people are going to go back to work, so we can train our bodies by the repetition of going to sleep at the same time and waking up at the same time. It might not cure all insomnia, but it’ll give you a better chance of success.

That’s why I suggest not watching television or scrolling on your phone in your bed. It’s about creating that separation in your waking and sleeping environments between sleep, leisure, and work that’s now occurring in the same building. It’s hard, though. Even my wife does it; she sits with her headphones on and watches a show in bed.

Can you explain how a lack of sleep affects a person’s immunity?

Sleep is considered the third pillar of wellness along with diet and exercise. Those are the three most important factors to keep us healthy. When we get ready to sleep, our body produces melatonin, which causes us to tire. When we aren’t getting that full night of sleep, our immune system isn’t producing as much of an effective response to fight against other infections or viruses. We really want people to get those seven to nine hours of sleep to stay as healthy as they can.

What tips do you have to improve a person’s quality of sleep, not just the duration of sleep?

I’m a believer that people should turn their bedrooms into a sleep sanctuary. Create a separation of your bedroom from the rest of your life. Set up your bedroom so that it’s intended for sleep. Clean up around your sleeping area, since your mind might race if there’s clutter in the room. Consider charging your phone in another room, and don’t watch television before bed.

Give yourself at least 45 minutes away from screens before you go to bed, so maybe read a book or keep a journal — just something to allow your mind to calm down before bed. Make sure that your room is cool and that it’s as dark as possible. I’m a fan of a white noise machine; you can buy it online for $20 and plug it in beside your bed to create a steady stream of white noise, which can mask any external sound that might jolt you out of sleep. The machine can help you stay in sleep and help you feel more refreshed when you wake up in the morning.

Since more people are staying home and, as a result, are more sedentary, how does that affect our sleep?

The key is to get 30 minutes of some form of cardio movement or even just walking. The human body is not meant to sit at a desk all day. Think about it like how a dog needs to be walked every day. We have to get this energy out of our bodies so we are physically tired by the time we get to bed each night.

I do get the question a lot of when you should be exercising, and there are a bunch of studies, but none of them are really conclusive as to what point of the day you should be exercising. You should have your body temperature back to normal, and not be out of breath at least 45 minutes before bed. It doesn’t make sense to run a few miles right before your bedtime.

Are there certain foods or substances like caffeine that might affect a person’s sleep?

You shouldn’t have any caffeine at least three to four hours before bed so it’s out of your system, and really, you shouldn’t be eating anything within an hour of going to bed because your body needs to digest your food and makes it more difficult for you to fall asleep. Eating spicy foods that could possibly cause indigestion doesn’t make a lot of sense. I would stay away from caffeine, and I’ve read a lot of stories that people are drinking more during the pandemic. That’s really not good for your sleep. While alcohol might help you get to sleep a little quicker, the quality of sleep you want, as the alcohol leaves your system, a lot of people tend to wake up in the middle of the night.

As the pandemic becomes the “new normal,” how do you think it will affect our sleeping habits?

It gives us the opportunity to get the recommended amount of sleep. The vast majority of people have a commute, and they used to spend a lot of time in the car, in the subway, or on a train. Now that’s gone. While we will go back to work eventually, we don’t know how quickly that’ll be and whether it’ll be five days a week or less. It takes away the excuse of saying, “Well, I don’t have the ability to get eight hours of sleep a night.”

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(HealthDay)—Insomnia may significantly increase the risk that older adults will be unable to shake off depression, researchers say.

For the study, the investigators analyzed data on nearly 600 people over age 60 who visited primary care centers in New York City, Philadelphia and Pittsburgh. All had some level of depression.

Compared to patients whose sleep improved, those with worsening sleep problems were about 28 times more likely to be diagnosed with major depression at the end of the 12-month study.

Patients whose sleep worsened also had nearly 12 times the odds of minor depression and were 10% more likely to report having suicidal thoughts, according to the Johns Hopkins Bloomberg School of Public Health study.

The report was recently published online in the journal Sleep.

Compared to patients whose sleep improved, those with persistent, but not worsening, insomnia were more likely to have lasting depression. But their risk was not as high as patients whose sleep got worse.

“These results suggest that, among older adults with depression, insomnia symptoms offer an important clue to their risks for persistent depression and suicidal ideation,” said study senior author Adam Spira, a professor of mental health at Johns Hopkins in Baltimore.

“We can’t say that the sleep disturbances we’re seeing are necessarily causing the poor depression outcomes,” he said in a Hopkins news release. “But the results suggest that older adults who are being treated for depression and whose sleep problems are persistent or worsening need further clinical attention.”

Spira said the findings also suggest that treatment of sleep problems should be explored as a way to improve depression symptoms in older adults, as well as poor mental and health outcomes related to disturbed sleep.

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