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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 helps us store memories, build immunity, repair tissue, regulate metabolism and blood pressure level, control appetite and blood glucose, and process learning, plus a myriad of other physiological processes – all of these are regulated by the endocannabinoid system (ECS).
In accordance with the National Institute of Neurological Disorders and Stroke at 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 top reported medical complaint within the Unites States along with 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 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 – possess a 75-95 percent increased probability 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 marketplace for such products are experiencing regarding a 4.5 percent growth rate between now and 2021.
The pursuit of good night’s sleep can 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 aids in his paper “Hypnotic drug hazards of mortality, infection, depression, and cancer: but lack of 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, and other barbiturates utilized for sleep. Of these 40 studies, thirty-nine learned that usage of hypnotics is “associated with excess mortality” towards the tune of the 4.6 times greater risk of death for hypnotic users.
Grim statistics: ten thousand deaths annually are directly brought on by and attributed to hypnotic drugs, based on medical examiner data. However, large epidemiological studies suggest the number of fatalities might actually be nearer to 300,000-500,000 annually. The real difference can be associated with underreported usage of hypnotics during death and the fact that prescription hypnotics are rarely listed as the reason for death.
Dr. Kripke concludes that even limited use of sleeping pills causes “next day functional impairment,” increases probability of “on-the-road driver-at-fault crashes,” increases falls and accidental injuries especially among seniors, is associated to “2.1 times” as many new depression incidents compared to randomized placebo recipients, and increases the potential risk of suicide. Furthermore, the use of opioids combined with hypnotics – two known dose-dependent respiratory suppressants – can be extremely dangerous, especially when blended with alcohol along with other drugs.1
Because of the problems with conventional soporifics, medical scientists happen to be exploring different ways to boost sleep by targeting the endocannabinoid system (ECS). Because the primary homeostatic regulator of human physiology, the ECS plays an important role inside the sleep-wake cycle as well as other circadian processes.
Italian scientist Vicenzo DiMarzo summarized the broad regulatory function of the endocannabinoid system within the phrase “Eat, sleep, relax, protect and then forget.”
The two main kinds of sleep: non-rapid eye movement sleep (NREM), which has three stages, and rapid eye-movement (REM) sleep, which is its very own stage of sleep. A complete sleep cycle occurs 5 to 6 times per night. The initial full cycle of 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 as follows:
Stage 1 NREM sleep is the changeover from wakefulness to sleep. During 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 brain waves begin to slow from their daytime wakefulness patterns.
Stage 2 NREM sleep is a period of light sleep prior to deciding to enter deeper sleep. Your heartbeat and breathing slow, and muscles relax even further. Your system temperature drops and eye movements stop. Brain wave activity slows but is marked by brief bursts of electrical activity. You may spend more of your repeated sleep cycles in stage 2 sleep compared to other sleep stages.
Stage 3 NREM sleep is the period of deep sleep (slow-wave sleep) that you should feel refreshed each morning. It takes place in longer periods during the first 50 % of the evening. Your heartbeat and breathing slow for their lowest levels while asleep. Your muscle mass are relaxed, the human brain waves become even slower, it is not easy to waken in this cycle. This is when the body is stimulating development and growth, repairing muscle tissue, boosting the defense mechanisms, and building energy for the upcoming day.
Stage 4 REM sleep initially occurs about 90 minutes after drifting off to sleep. The eyes move rapidly from side to side behind closed eyelids. Mixed frequency brain wave activity becomes nearer to that noticed in wakefulness. Your breathing becomes faster and irregular, and your heartrate and blood pressure levels increase to near waking levels. The majority of your dreaming occurs during REM sleep (although dreams could also occur 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 learned your day before and consolidate memories. When you age, you sleep less of your time and energy in REM sleep.
The way we fall asleep, stay asleep, awaken, and remain awake is part of your internal biological process regulated by our circadian rhythms and our endocannabinoid system. Circadian rhythms govern a wide variety of actions in your body, including hormone production, heart rate, metabolism, and once to attend sleep and get up.
It’s as though we have an internal biochemical timer or clock that keeps track of our need for sleep, guides the body to sleep and then influences the intensity of sleep. This biological mechanism is affected by external forces including travel, medication, food, drink, environment, stress and more. Key question: Does the endocannabinoid system regulate our experience of circadian rhythms or the other way around?
Proof a powerful relationship between the two is observed in the sleep-wake cycle fluctuations of anandamide and 2-AG (the brain’s own marijuana-like molecules), combined with the metabolic enzymes that create and break down these endogenous cannabinoid compounds.
Anandamide is present within the brain at higher levels at nighttime plus it works with the endogenous neurotransmitters oleamide and adenosine to produce sleep. Conversely, 2AG is higher throughout the day, suggesting that it is involved with 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 that are concentrated inside the central nervous system, including areas of the mind related to 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 vital aspect in modulating sleep homeostasis.
This may not be the situation, 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 task of studying and treating sleep disturbances is complicated by the fact that sleep disorders are symptomatic of many chronic illnesses. In many cases, poor sleep results in chronic illness, and chronic illness always involves an actual imbalance or dysregulation of the endocannabinoid system. Although we continue to have much to discover the relationship between the ECS and circadian rhythms, it’s clear that adequate quality sleep is a critical part of restoring and looking after one’s health.
Cannabinoids have been utilized for centuries to market sleepiness and to help individuals stay asleep. In the acclaimed medical reference Materia Medica, published inside 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 definitely the one that produced a narcotism most closely resembling natural sleep without causing any extraordinary excitement of the vessels, or any particular suspension of secretions, or without fear of a hazardous 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 continue to drive a large proportion of individuals to seek relief with cannabis. Poor sleep and insufficient sleep cause physiological changes in the body after only one night, causing slower reaction times, deceased cognitive performance, less energy, aggravated pain and vtkvnz inflammation, and in some cases overeating or cravings for top-fat, high-carbohydrate “comfort” foods. A 2014 study by Babson et al notes that approximately 50 percent of long term cannabis consumers (over a decade) report using cannabis as a sleep aid. Among medical marijuana patients, 48 percent report using cannabis to aid with insomnia.
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