Sleep, Melatonin and CBD

Sleep, Melatonin and CBD

CBD and melatonin products for various indications are popping up everywhere- the internet, your grocery store, the gas station, and your local massage spa. There is good research that these products can help with sleep. Yet, it is important for you to understand more about these products so you are knowledgeable on how they can be used, drug interactions and side effects.

Let’s Start With Melatonin

Melatonin is made in our brain and the amount we produce does decrease with age, usually after age 30 and onwards. Melatonin is also released in smaller amounts in bone marrow, platelets, gastrointestinal tract, eyes, skin, and lymphocytes, it is primarily regulated by the pineal gland (just behind your forehead), a place called the “third eye”. Melatonin has an essential role in regulating the body’s daily and annual biological rhythms, including the sleep/wake cycle. Newborns have tons of melatonin, which explains why they sleep so much. It stays high for most people through their teens, even into the college years. It’s interesting that the actual range of natural melatonin production in people is very varied Genetics play a major factor which likely explains why you may see insomnia dominant in certain families.

Melatonin is not JUST a sleep hormone. It is also an ‘indolamine’, a family of neurotransmitters – or neuro chemicals – which also includes serotonin. Thus, melatonin and serotonin are intimately related, with evidence that a serotonin deficiency may also result in decreased levels of melatonin. 

Melatonin helps us by falling asleep, sleep efficiency (percent of time asleep to total time in bed), and awakening. In addition to supporting sleep, research suggests that melatonin supports antioxidant activity, cardiovascular health, and immune function.

Melatonin and Sleep

Melatonin has a very vital function in what is known as the CIRCADIAN RHYTHM. It regulates our sleep wake cycle in its entirety. Our circadian rhythm is intricately tied to things like our hormonal balances, optimization of our neurological, cardiovascular, and immune systems. A balanced and consistent circadian cycle has massive implications on wellness and longevity. There are a few main things that can disrupt this cycle. One of these factors is light exposure. We evolved to respond to sunrise and sunset, with the big burst of melatonin coming on roughly 2-3 hours after sunset, making us feel sleepy. For example, if the sun sets at 7:00 PM, then our bodies would want us to go to bed by 10:00 PM. Living far north of the equator, however, the sun may set before 5 PM in winter and after 9 PM in summer. That’s usually not a problem in the summer. However, in winter, that early sunset may encourage sleep at around 7 or 8 PM. Most people don’t go to bed that early and since melatonin’s effect wears off after 2-3 hours, it’s common to get a second wind right at bedtime.

Artificial light presents an even bigger problem Even a brief exposure to light at around 9 or 10 PM may push back our natural melatonin release by a couple of hours, meaning that we might miss nature’s cue to go to sleep.

CBD and Sleep

Most research on cannabidiol (CBD) has looked at its possible benefits for anxiety disorders, perceived stress, and more general feelings of anxiousness. This research is helpful for sleep concerns, considering stress and anxiety-related sleep disruption is quite common. Some of the more recent research for use of CBD for sleep is growing and looks quite promising. 

At this point, research most solidly points to CBD as a support for stress and anxiety-related sleep concerns. This application is also supported by current evidence indicating CBD’s us for anxiety-related concerns.

CBD and Melatonin Together

There is growing evidence that dosing with CBD may support sleep disruption through the night, and melatonin can support sleep onset. This combination may work to support overall sleep (head to this article for more on sleep and CBD). Interestingly, some individuals may find CBD makes them more alert, but without increased anxiousness. In these individuals, using CBD at night may negatively impact sleep, whereas use earlier in the day may support sleep. This phenomenon is why melatonin in combination with CBD used at night and over a short-term period may address more substantial sleep concerns as melatonin may offset the wake-inducing effects of CBD. There are more products in the market with various ratio formulations of CBD and melatonin.

Melatonin Is Not a Long-Term Solution

Melatonin should generally only be used for short term sleep “resets” over a few nights or a few weeks. We often see people who come to us with the understanding that they need to take daily and long-term dosing with melatonin. They also think that higher dosing is better than lower dosing… incorrect as you shall see. 

Melatonin can be used in the short term to reset a healthy sleep cycle. After that, it can be used more sporadically, as needed, or again after a period of time to reestablish a sleep schedule. That’s the case when it’s combined with CBD as well. Occasionally, melatonin can be used more consistently for longer periods of time when under the guidance of a qualified healthcare practitioner (of course, it’s important to check with your doctor/pediatrician before starting any supplement, including short-term use of melatonin).

Why Can’t It Be Used Long-term? 

For most of us and most of the time, melatonin is produced by the body and doesn’t need our assistance. Short term supplementation can be fine; however, you want your body to produce its own levels of melatonin and not suppress it with taking melatonin. If you suppress melatonin production, it will put you into a cycle of chronic sleep disruption and decreasing response to increased doses of melatonin. Our chaotic schedules, late-night device use, time changes, and other scenarios may cause melatonin disruption. Melatonin supplementation can then serve as a cue for the body to recalibrate. That’s why melatonin supplements should only be used occasionally, and while working on the other reasons for being unable to fall asleep (e.g., handling stress in more healthy ways).

Folks who may feel it necessary to take melatonin more frequently are genuine night owls or those who work rotating or night shifts that don’t allow them to sleep until their natural waking time. 

So, once a more normal sleep schedule is established, then it’s likely wise to reduce the melatonin amount over a period of a week until the melatonin/CBD product is completely removed. A CBD product could then be moved earlier in the day and as needed to address stress and general anxiousness, in effect likely supporting sleep as well.

CBD Dosage and Use

It’s important to know there is no established dosage for CBD and individuals may respond quite differently to different dosages. Currently, we believe that common dose range for CBD in adults is 15-30 mg daily. With some conditions, such as those involving pain or inflammation, the recommended dose can be higher, but it seems to be best-tolerated and most effective for anxiety, sleep, and mood in this moderate range. 

After discussing with a doctor, look for a high quality, broad-spectrum, all natural, non-GMO hemp product that is THC-free (i.e., measures less than 0.3% THC). Avoiding THC is particularly important for some individuals looking to support anxiousness or for sleep concerns as THC may increase anxiety for some individuals and long-term THC use is associated with sleep disruption CBD is commonly take in doses of 10-15 mg twice times daily, with or without meals, or in a single dose of 20-30 mg daily.

Melatonin Dosage and Use

As noted, melatonin is primarily used to help reset the onset of sleep for those who’ve gotten off schedule, or if the normal sleep cues are not working for some reason. Daily doses between 0.5 mg to 5 mg taken at bedtime have been studied and found to be supportive; Increasing dose can be helpful but should never exceed 5 mg. 

Melatonin is usually recommended in a sublingual form, which are forms meant to dissolve under the tongue rather than swallow it (e.g., Lights Out Quick, which is a 2.5 mg dose). Those forms work much faster and are better absorbed because they don’t have to be digested and make their way through the liver—it goes directly into the bloodstream. These forms are ideal as well because they can be used shortly before bed and only when it’s evident that falling asleep may be a struggle.

Combination melatonin/cbd products are generally in gummy form and are often taken 30-60 minutes before desired bedtime.

CBD Side Effects

As noted, CBD is generally considered well-tolerated. However, CBD can cause side effects. These side effects can be more confusing given the unreliability of the purity and dosage of CBD in products (which is why purchasing a high-quality product is essential). 

Side effects of CBD may include:

  • Drowsiness
  • Dizziness and lightheadedness
  • Dry Mouth
  • Diarrhea
  • Increased appetite 
  • Lowered blood pressure

The most common side effect is very mild sedation, though that is usually not a problem for those with high anxiety and may be a welcome effect for those with sleep troubles. Like most things that are calming, adding CBD to other sedating medications, or combining CBD with alcohol, may cause excess sedation. 

There is too little information about the safety of CBD during pregnancy or while breastfeeding, so it is not recommended.

CBD Interactions

Research suggests many side effects that occur with CBD use are likely the result of drug-to-drug interactions between CBD and other medications an individual may be taking. That’s why it’s so important to speak with your doctor before starting any supplement, and this is particularly true with CBD.

Here’s how these interactions occur: CBD is broken down by the body via the same pathway as many prescription drugs. If multiple compounds are competing in this pathway (e.g., CBD and a prescription drug), then something called “altered concentration” can occur. This means that too little or too much of the drug is left in the body. When too little remains, a drug may no longer work as intended. When too much remains, side effects may increase. Penn State College of Medicine has a really handy list of medications that may be impacted by altered concentration due to a combination with cannabinoids. Unfortunately, this list does not make any distinctions between CBD or THC, but it provides some guidance. Bring this list to your doctor before starting any CBD product.  

Penn State also found potentially serious interactions between prescription CBD and THC products and the following products:

  • Warfarin and other blood thinners
  • Amiodarone (heart medication)
  • Levothyroxine (thyroid medication)
  • Seizure medications (clobazam, lamotrigine, valproate)

Melatonin Side Effects

Melatonin is generally considered very safe. Melatonin is also non-habit forming. However, anything that is routinely taken for sleep can become a habit that is hard to break, even if it is technically not addicting.

Some folks who take melatonin frequently may find that they begin to wake up after 3-4 hours. This might be a rebound of wakefulness as the effects of melatonin wear off. As noted above, that’s why melatonin supplements should only be used occasionally, and while working on the other reasons for being unable to fall asleep (e.g., handling stress in more healthy ways).

As with any supplement, melatonin supplements can interact with various medications, including Anticoagulants and anti-platelet drugs, anticonvulsants, contraceptive, diabetes medications, and immunosuppressants. As we always say around here, be sure to check with your doctor before adding any supplement.

If you are interested in learning more and which products to select, speak with a ShaMynds clinical team member to learn more.

By Dr Tasnim Khan of ShaMynds Healing Center.

 

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