Although sleep is vital for our health, its biological purpose is not fully understood. Oddly, the seemingly inactive state of sleep is truly a dynamic and critical process that helps us store memories, build immunity, repair tissue, regulate metabolic process and blood pressure, control appetite and blood glucose, and process learning, along with a multitude of other physiological processes – all of which are regulated by the endocannabinoid system (ECS).
Based on the National Institute of Neurological Disorders and Stroke in the National Institute of Health (NIH), new findings suggest “sleep plays a housekeeping role that removes toxins in your brain that build up while you are awake.”
Poor sleep is the number one reported medical complaint inside the Unites States along with a serious public health concern. The average adult needs between seven and eight hours of sleep daily. Yet, 10-30 million Americans regularly don’t get enough sleep.
Those that have chronic illnesses are at higher risk for insomnia, which exacerbates their discomfort. Comorbid medical disorders – including conditions that cause hypoxemia (abnormally low blood oxygen levels) and dyspnea (difficult or labored breathing), gastroesophageal reflux disease, pain, and neurodegenerative diseases – have a 75-95 percent increased risk of insomnia.
In 2016, in accordance with the industry research firm MarketsandMarkets, Americans spent $3.38 billion on prescription sedatives and hypnotics, over-the-counter (OTC) sleep drugs, and herbal sleep aids. It’s projected that the market for such products are experiencing in regards to a 4.5 percent growth rate between now and 2021.
The pursuit of good night’s sleep could be hazardous to one’s health. Daniel F. Kripke, MD, sleep expert and co-founder of Research at Scripps Clinic Vitebri Family Sleep Center, discusses the risks of sleep assists in his paper “Hypnotic drug perils of mortality, infection, depression, and cancer: but insufficient benefit.”
Dr. Kripke reviewed 40 studies conducted on prescription sleeping pills, which include hypnotic drugs including zolpidem (Ambien, Edlmar, Intermezzo and Zolpimist), temazepam (Restoril), eszopiclone (Lunesta), zaleplon (Sonata), triazolam (Halcion), flurazepam (Dalmane and Dalmadorm), quazepam, as well as other barbiturates employed for sleep. Of those 40 studies, thirty-nine learned that consumption of hypnotics is “associated with excess mortality” to the tune of any 4.6 times higher risk of death for hypnotic users.
Grim statistics: 10,000 deaths per year are directly brought on by and attributed to hypnotic drugs, according to medical examiner data. However, large epidemiological studies suggest the quantity of fatalities might actually be nearer to 300,000-500,000 annually. The difference may be attributed to underreported use of hypnotics at the time of death and the reality that prescription hypnotics are rarely listed as the reason for death.
Dr. Kripke concludes that even limited usage of sleeping pills causes “next day functional impairment,” increases chance of “on-the-road driver-at-fault crashes,” increases falls and accidental injuries especially among seniors, is assigned to “2.1 times” as many new depression incidents in comparison to randomized placebo recipients, and increases the chance of suicide. Furthermore, the use of opioids coupled with hypnotics – two known dose-dependent respiratory suppressants – can be very dangerous, specially when mixed with alcohol as well as other drugs.1
Due to the problems with conventional soporifics, medical scientists have been exploring other ways to enhance sleep by targeting the endocannabinoid system (ECS). Because the primary homeostatic regulator of human physiology, the ECS plays a significant role inside the sleep-wake cycle as well as other circadian processes.
Italian scientist Vicenzo DiMarzo summarized the broad regulatory purpose of the endocannabinoid system in the phrase “Eat, sleep, relax, protect and then forget.”
There are two types of sleep: non-rapid eye movement sleep (NREM), that has three stages, and rapid eye-movement (REM) sleep, which is its own stage of sleep. A complete sleep cycle occurs 5 to 6 times per night. The initial full cycle in the night is 70-100 minutes with remaining cycles lasting 90-120 minutes each. The stages of sleep defined by the National Institute of Neurological Disorders & Stroke are the following:
Stage 1 NREM sleep will be the changeover from wakefulness to get to sleep. In this short period (lasting several minutes) of relatively light sleep, your heartbeat, breathing, and eye movements slow, and your muscles relax with occasional twitches. Your mind waves start to slow using their daytime wakefulness patterns.
Stage 2 NREM sleep is a time period of light sleep before you enter deeper sleep. Your heartbeat and breathing slow, and muscles relax even more. Your body temperature drops and eye movements stop. Brain wave activity slows but is marked by brief bursts of electrical activity. You may spend even more of your repeated sleep cycles in stage 2 sleep when compared to other sleep stages.
Stage 3 NREM sleep will be the duration of deep sleep (slow-wave sleep) that you need to feel refreshed each day. It takes place in longer periods throughout the first one half of the night time. Your heartbeat and breathing slow to their lowest levels while asleep. Your muscle mass are relaxed, your mind waves become even slower, it is not easy to waken in this cycle. This is when our bodies is stimulating development and growth, repairing muscle tissues, boosting the immunity mechanism, and building energy for the following day.
Stage 4 REM sleep initially occurs about 90 minutes after falling asleep. Your eyes move rapidly from side to side behind closed eyelids. Mixed frequency brain wave activity becomes nearer to that seen in wakefulness. Your breathing becomes faster and irregular, as well as your heartrate and blood pressure increase to near waking levels. The majority of your dreaming occurs during REM sleep (although dreams could also happen in non-REM sleep). Your arm and leg muscles become temporarily paralyzed, which prevents from acting out your dreams. This stage is when you process everything you have learned your day before and consolidate memories. As you age, you sleep a smaller amount of your time and effort in REM sleep.
How we get to sleep, stay asleep, wake up, and remain awake is a component of the internal biological process regulated by our circadian rhythms and our endocannabinoid system. Circadian rhythms govern a diverse variety of actions in your body, including hormone production, heart rate, metabolism, so when to visit sleep and wake up.
It’s as though we now have an inside biochemical timer or clock that keeps tabs on our necessity for sleep, guides your body to sleep then influences the intensity of sleep. This biological mechanism is affected by external forces like travel, medication, food, drink, environment, stress and much more. Key question: Does the endocannabinoid system regulate our experience of circadian rhythms or vice versa?
Proof of a powerful relationship between the two is observed within the sleep-wake cycle fluctuations of anandamide and 2-AG (the brain’s own marijuana-like molecules), together with the metabolic enzymes that create and break down these endogenous cannabinoid compounds.
Anandamide is present within the brain at higher levels during the night and it also works together with the endogenous neurotransmitters oleamide and adenosine to produce sleep. Conversely, 2AG is higher throughout the day, suggesting that it is involved in promoting wakefulness.
The highly complex sleep-wake cycle is driven by a variety of neurochemicals and molecular pathways.2 Both anandamide and 2AG activate CB1 cannabinoid receptors which are concentrated inside the nervous system, including areas of the brain connected with regulating sleep.
CB1 receptors modulate neurotransmitter release in a manner that dials back excessive neuronal activity, thereby reducing anxiety, pain, and inflammation. CB1 receptor expression is thus a key element in modulating sleep homeostasis.
This may not be the truth, however, with respect to the CB2, the cannabinoid receptor located primarily in immune cells, the peripheral neurological system, and metabolic tissue. Whereas CB1 receptor expression reflects cyclical circadian rhythms, no such fluctuations happen to be described for that CB2 receptor.
The task of studying and treating sleep disturbances is complicated by the fact that sleep disorders are symptomatic of many chronic illnesses. Most of the time, poor sleep leads to chronic illness, and chronic illness always involves an actual imbalance or dysregulation in the endocannabinoid system. Although we have much to learn about the connection in between the ECS and circadian rhythms, it’s clear that adequate quality sleep is really a critical element of restoring and maintaining one’s health.
Cannabinoids have already been utilized for centuries to promote sleepiness and to help people stay asleep. In the acclaimed medical reference Materia Medica, published in the 18th century, cannabis was listed being a ‘narcotica’ and ‘anodyna’ (pain reliever). Its reintroduction to Western medicine by Sir William B. O’Shaughnessy in 1843 resulted in studies that underscored the remedial properties of “Indian hemp” for sleep disorders.
“Of all anaesthetics ever proposed, Indian hemp is the one that produced a narcotism most closely resembling the natural sleep without causing any extraordinary excitement in the vessels, or any particular suspension of secretions, or without the fear of a dangerous reaction, and consecutive paralysis,” German researcher Bernard Fronmueller observed in 1860. Nine years later Fronmueller reported that in 1000 patients with sleep disturbance, Indian hemp produced cures in 53 percent, partial cure in 21.5 percent, and virtually no effects in 25.5 percent.
Sleep-related problems still drive a large percentage of people to seek relief with cannabis. Poor sleep and insufficient sleep cause physiological changes within the body after just one night, resulting in slower reaction times, deceased cognitive performance, less energy, aggravated pain and vtkvnz inflammation, and even overeating or cravings for high-fat, high-carbohydrate “comfort” foods. A 2014 study by Babson et al notes that approximately 50 percent of long term cannabis consumers (over ten years) report using cannabis as a sleep aid. Among medical marijuana patients, 48 percent report using cannabis to assist with insomnia.