Although sleep is important for the health, its biological purpose is not fully understood. Oddly, the seemingly inactive state of sleep is really a dynamic and critical procedure that allows us to store memories, build immunity, repair tissue, regulate metabolic process blood pressure, control appetite and blood glucose, and process learning, along with a number of other physiological processes – all of which are regulated by the endocannabinoid system (ECS).
In accordance with 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 inside your brain that build-up while you are awake.”
Poor sleep is the main reported medical complaint inside the Unites States as well as a serious public health concern. The typical adult needs between seven and eight hours of sleep daily. Yet, 10-30 million Americans regularly don’t get enough sleep.
Those with chronic illnesses are at greater risk for insomnia, which exacerbates their discomfort. Comorbid medical disorders – including issues 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 chance of insomnia.
In 2016, according to 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 about a 4.5 percent growth rate between now and 2021.
The quest for good night’s sleep may be hazardous to one’s health. Daniel F. Kripke, MD, sleep expert and co-founding father of Research at Scripps Clinic Vitebri Family Sleep Center, discusses the hazards of sleep assists in his paper “Hypnotic drug risks of mortality, infection, depression, and cancer: but insufficient benefit.”
Dr. Kripke reviewed 40 studies conducted on prescription sleeping pills, including hypnotic drugs including zolpidem (Ambien, Edlmar, Intermezzo and Zolpimist), temazepam (Restoril), eszopiclone (Lunesta), zaleplon (Sonata), triazolam (Halcion), flurazepam (Dalmane and Dalmadorm), quazepam, along with other barbiturates employed for sleep. Of those 40 studies, thirty-nine learned that intake of hypnotics is “associated with excess mortality” towards the tune of a 4.6 times higher risk of death for hypnotic users.
Grim statistics: 10,000 deaths each year are directly caused by and attributed to hypnotic drugs, according to medical examiner data. However, large epidemiological studies suggest the number of fatalities could possibly be nearer to 300,000-500,000 annually. The real difference could be attributed to underreported usage of hypnotics during death and the fact that prescription hypnotics are rarely listed as the cause of death.
Dr. Kripke concludes that even limited usage of sleeping pills causes “next day functional impairment,” increases risk of “on-the-road driver-at-fault crashes,” increases falls and accidental injuries especially among seniors, is associated to “2.1 times” as much new depression incidents in comparison to randomized placebo recipients, and increases the chance of suicide. Furthermore, the usage of opioids coupled with hypnotics – two known dose-dependent respiratory suppressants – can be very dangerous, specially when mixed with alcohol and other drugs.1
Given the issues with conventional soporifics, medical scientists happen to be exploring other ways to boost sleep by targeting the endocannabinoid system (ECS). As the primary homeostatic regulator of human physiology, the ECS plays a significant role in the sleep-wake cycle and other circadian processes.
Italian scientist Vicenzo DiMarzo summarized the broad regulatory function of the endocannabinoid system within the phrase “Eat, sleep, relax, protect and forget.”
There are two types of sleep: non-rapid eye movement sleep (NREM), which has three stages, and rapid eye-movement (REM) sleep, that is their own stage of sleep. A complete sleep cycle occurs 5 to 6 times per night. The very first full cycle from the night is 70-100 minutes with remaining cycles lasting 90-120 minutes each. The stages of sleep based on the National Institute of Neurological Disorders & Stroke are the following:
Stage 1 NREM sleep is definitely the changeover from wakefulness to sleep. Throughout 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 begin 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 further. The body temperature drops and eye movements stop. Brain wave activity slows but is marked by brief bursts of electrical activity. You may spend much more of your repeated sleep cycles in stage 2 sleep compared to other sleep stages.
Stage 3 NREM sleep will be the duration of deep sleep (slow-wave sleep) that you should feel refreshed in the morning. It occurs in longer periods through the first half of the night. Your heartbeat and breathing slow to their lowest levels while sleeping. Your muscle mass are relaxed, your mind waves become even slower, it is difficult to waken throughout this cycle. This is where your body is stimulating growth and development, repairing muscles, boosting the immunity mechanism, and building energy for the upcoming day.
Stage 4 REM sleep initially occurs about 90 minutes after drifting off to sleep. Your vision move rapidly back and forth behind closed eyelids. Mixed frequency brain wave activity becomes even closer to that seen in wakefulness. Your breathing becomes faster and irregular, along with your heartrate and blood pressure levels increase to near waking levels. Much of your dreaming occurs during REM sleep (although dreams can also occur in non-REM sleep). Your arm and leg muscles become temporarily paralyzed, which prevents you against acting from the dreams. This stage is when you process everything you learned the morning before and consolidate memories. When you age, you sleep less of your time and energy in REM sleep.
How we fall asleep, stay asleep, get up, and remain awake is an element of the internal biological process regulated by our circadian rhythms and our endocannabinoid system. Circadian rhythms govern an assorted selection of actions in your body, including hormone production, heartrate, metabolism, and once to visit sleep and wake up.
It’s as if we now have an internal biochemical timer or clock that keeps a record of our requirement for sleep, guides the body to sleep then influences the intensity of sleep. This biological mechanism is impacted by external forces such as travel, medication, food, drink, environment, stress and more. Key question: Does the endocannabinoid system regulate our experience with circadian rhythms or the other way round?
Evidence of a powerful relationship involving the two is observed in 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 up these endogenous cannabinoid compounds.
Anandamide is present inside the brain at higher levels at night and it works jointly with the endogenous neurotransmitters oleamide and adenosine to produce sleep. Conversely, 2AG is higher in the daytime, 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 can be concentrated within the nervous system, including parts of your 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 an important aspect in modulating sleep homeostasis.
This is not the case, however, with regards 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 challenge of studying and treating sleep disturbances is complicated by the fact that sleep disorders are symptomatic of many chronic illnesses. Oftentimes, poor sleep brings about chronic illness, and chronic illness always involves an actual imbalance or dysregulation of the endocannabinoid system. Although we have much to learn about the relationship in between the ECS and circadian rhythms, it’s clear that adequate quality sleep is a critical component of restoring and looking after one’s health.
Cannabinoids have already been used for centuries to advertise sleepiness and to help people stay asleep. Inside the acclaimed medical reference Materia Medica, published within the 18th century, cannabis was listed as a ‘narcotica’ and ‘anodyna’ (pain reliever). Its reintroduction to Western medicine by Sir William B. O’Shaughnessy in 1843 led to studies that underscored the remedial properties of “Indian hemp” for sleep disorders.
“Of all anaesthetics ever proposed, Indian hemp is the one which produced a narcotism most closely resembling natural sleep without causing any extraordinary excitement from the vessels, or any particular suspension of secretions, or without fear of an unsafe 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 little or no effects in 25.5 percent.
Sleep-related problems carry on and drive a large percentage of individuals to seek relief with cannabis. Poor sleep and sleep deficiency cause physiological changes within the body after just one single night, leading to 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 % of long-term cannabis consumers (over 10 years) report using cannabis as a sleep aid. Among medical marijuana patients, 48 percent report using cannabis to help with insomnia.