cbd oil for parkinson’s and rls

Can CBD Help With Sleep?

Arno Kroner, DAOM, LAc, is a board-certified acupuncturist, herbalist, and integrative medicine doctor practicing in Santa Monica, California.

Getting better sleep is a challenge for many people, and researchers are exploring whether cannabidiol (CBD) can help. Over 80 different chemicals, called cannabinoids, can be found in the Cannabis sativa plant. The most abundant cannabinoid found is tetrahydrocannabinol (THC), while the second most abundant is CBD.

Unlike THC, CBD is non-psychoactive, so it does not give you the high or buzz you feel when using cannabis products that contain THC. Instead, CBD is well known for its soothing, relaxing properties. This is why CBD is being actively investigated for its use in improving sleep difficulties.

The research, while emerging and evolving, is promising, suggesting that CBD may improve both sleep quality and quantity.

What the CBD Research Says

While it's true there is scientific evidence that CBD can help with sleep, many of the human studies examining this association are small, and/or they lack a control group.

In addition, some studies have examined the combined role of THC and CBD for sleep, which we are not addressing here.

That said, here are examples of research studies supporting the use of CBD for improving sleep:

  • In a study of 72 adults with primary symptoms of anxiety and poor sleep, over 65% of the patients improved their sleep quality scores after taking daily CBD (average dose of 25 milligrams) for one month. This improvement was sustained over the duration of the study (a total of three months).
  • In a study of 21 patients with Parkinson’s disease without dementia or other psychiatric conditions, participants experienced improved quality of life (including sleep) when taking 300 milligrams of CBD per day.
  • In a case series of four patients with Parkinson’s disease and REM sleep behavior disorder, CBD (75 to 300 milligrams per day for 6 weeks) reduced the frequency of rapid eye movement (REM) sleep behavior events.
  • In a pediatric case study of a 10-year-old patient with posttraumatic stress disorder (PTSD), the patient had an increase in sleep quality and quantity and decrease in anxiety after taking 25 milligrams of CBD at bedtime and 6 to 12 milligrams of CBD sublingual spray during the day (as needed for anxiety).

Taking a Step Back

The idea of finding a natural therapy for sleeping problems is certainly appealing. However, sleep is a complex phenomenon. In fact, there is an array of reasons why a person may suffer from sleeping difficulties.

While not an exhaustive list, some potential reasons include:

  • Having a psychiatric condition like anxiety or depression
  • Having a primary sleep disorder like restless leg syndrome or sleep apnea
  • Experiencing chronic pain (which wakes a person from sleep)
  • Having a medical condition like hyperthyroidism, Parkinson’s disease, or acid reflux
  • Experiencing trauma or chronic stress

Genetics, environmental factors (such as travel, a crying baby, a loud bedroom), medications, or substance abuse may also contribute to poor sleep.

If you or a loved one is dealing with sleep problems, it's important to see your healthcare provider or a sleep specialist. In some instances, treatment of the underlying problem (e.g., an overactive thyroid or changing a medication) will resolve the problem. Other diagnoses may require a more comprehensive approach.

Other Considerations

Besides addressing the cause behind you or your loved one's sleep issues, there are other problems to consider regarding the use of CBD.

Formulations

CBD oil is extracted from the marijuana or hemp plant, which are both strains derived from the Cannabis sativa plant.

Once extracted, CBD oil can be taken by itself or infused into other forms, including:

  • Edibles (for example, gummies or chocolates)
  • Tinctures (add drops to drinks or food)
  • Capsules
  • Vapors (inhaled)
  • Ointments and lotions
  • Sprays
  • Bath salt

The concern here is that the concentration and absorption of CBD will vary among these different formulations—and this will ultimately affect CBD's therapeutic effect.

Dosing

Dosing is another consideration. Unfortunately, it's not yet clear exactly what dose of CBD is needed to give a person a restful night's sleep.

For instance, in one of the studies mentioned above, the average adult dose used was 25 milligrams per day, whereas in another study, the participants used 300 milligrams per day.

It's likely that the dose required needs to be individualized and perhaps, titrated, based on its effect.

Factors that may affect dosing include:

  • The severity of the person's sleep disorder
  • Medications the person is taking (both sleep-related and drugs that may interact with CBD)
  • Side effects experienced (such as whether the person is feeling drowsy or fatigued the next day)
  • The formulation used

Another factor in dosing is that there is only one CBD medication available by prescription—Epidolex—which is FDA-approved for some forms of epilepsy. Its CBD concentration and purity are standardized. CBD products bought without prescription lack standardization.

A 2017 study found that only 31% of 84 CBD products bought online were labeled accurately for concentration, with 43% having less CBD than stated and 26% having more. In addition, over 21% had detectable THC.  

Side Effects

Research suggests that, in the short-term, CBD is largely safe and well-tolerated. Some people, however, do experience side effects, such as:  

  • A change in appetite (either reduced or increased)
  • Weight gain or loss
  • Tiredness
  • Diarrhea
  • Increase in liver enzymes

In addition, some people may experience a worsening of their sleep quality after taking CBD.   This paradoxical effect warrants further investigation.

Legality

Lastly, there is the legal issue of CBD to consider. Here is a brief summary of the laws encompassing CBD:  

Federal Law

CBD oil extracted from industrial hemp, which must contain less than 0.3% THC, is federally legal. Marijuana, however, remains illegal under federal law in the United States.

State Law

Hemp-derived CBD is legal in all 50 states. However, state laws vary with regard to the legality of marijuana. CBD oil that still contains THC or other cannabinoids may only be sold in states that have legalized marijuana use.

A Word From Verywell

While an encouraging prospect, there is still much to learn about CBD and its role in sleep. To ensure your safety, please only move forward with taking CBD under the guidance of your healthcare provider.

Dosage of CBD for restless leg syndrome

Restless leg syndrome is a disorder not known to many and even commonly missed by a doctor.

Restless Leg Syndrome (RLS) in-depth

Also known by the name Willis-Ekbom Disease’, can be categorised under neurological disorders or movement disorders or even chronic sleep disorders.

What defines RLS are its characteristic features:

  1. An irresistible urge to move legs especially while resting during evening or night time.
  2. Unpleasantsensations over your legs.
  3. Disturbed sleep.
  4. Temporary relief while walking or moving around.
  5. Distinct symptom-free period in the morning .

Restless Leg Syndrome is not a primary sleep disorder with discomfort as an after effect. Instead at its core lies a sensorimotor neurological disorder with secondary involvement of sleep. Thus, sleeping pills cannot be a solution for this condition.

Chronology of symptoms:

It begins with an unpleasant, somewhat annoying sensation which can be described as aching throbbing, pulling, itching, crawling, or creeping almost anything which comes up especially when you lie down for some rest. This compels you to move your legs for temporary relief. Symptoms recur once the movement stops demanding a continuous action which disturbs sleep.

Restless leg syndrome prefers

  • Women over men though can affect both.
  • Middle-aged or elderly people over young and kids. It may begin at any age and its symptoms keep intensifying and evolving with age.
  • The Lower part of body (legs) more than the arms, chest and head where the weird sensations are quite less.
  • Can be unilateral or bilateral or alternate between sides.

Can you imagine?

Around 7-10% of U.S population is struggling with Restless Leg Syndrome, but most of them do not even recognise it as a problem in itself. They focus on their disturbed sleep and even consume sleep medications attributing all the discomfort to lack of sleep. But my dear friends, this attitude could be perilous. RLS needs prompt attention right from the beginning otherwise this said-to-be insignificant regular urge holds potential to land you up in a pathetic situation.

How? Here goes the cascade,

Irritating sensation or pain –> continuous leg movement –> disturbed sleep
–> Mental fatigue –> depression, dementia, confusion, altered cognition, loss of concentration, daytime sleepiness, decline in performance and productivity, etc
–> Physical exhaustion –> diseases like hypertension, heart attack, stroke, diabetes, obesity and much more –> poor quality of life.

Though, RLS won’t threaten actual life, the way it declines your quality of life is really worrisome. So, it is better to start the management process with the very first hint of RLS.

For prompt Management, let’s dig out the root cause first.

Mostly multifactorial, search for the exact aetiology is still going on. Some possible causes include

Iron deficiency-

As per studies, iron deficiency (in the brain) stands out as a key player to make you kicking. So, iron supplements are the most popular treating modality for RLS. RLS can be seen in presence of normal blood but deficient brain iron levels.

Other potential causes include:

  • Lower dopamine levels
  • Folate deficiency
  • Underlying vein issues
  • Peripheral neuropathy
  • Pregnancy
  • Medications such as antidepressants and anti-nausea medications
  • Chronic illnesses including iron deficiency anaemia, kidney diseases, fibromyalgia, Parkinson’s disease etc.
  • Genetics condition -studies show RLS can be passed down the generations via genes wherein it can express at an earlier age.

RLS types based on etiology:

  • Primary Restless Legs Syndrome (idiopathic form): No known cause or precipitating factor.
  • Secondary restless legs syndrome: secondary to above mentioned precipitating causes.

Purely on the basis of classical symptoms and history of the patient.

Ways to kick-off Resting Leg Syndrome

  • Treat the basic aetiology.
  • Medications like opiates, anticonvulsants and dopamine agonists show some relief but not in all patients.
  • Pill-free techniques like calf massage, daily exercises, warm and cold compresses, ice packs, warm baths , etc also do their share.

But still, there was no full-proof solution to RLS. Search continued and the latest addition came in the form of

  • Cannabidiol (CBD) – most promising.

Though CBD again is not a cure to the condition, it promises utmost relief from RLS symptoms.

Research and patient reviews strongly backed this claim of CBD.

So, what is this CBD?

CBD (short for cannabidiol) available in the market is an industrial cannabinoid extract of hemp variety of the cannabis plant. Hemp is nothing but a variant of the cannabis plant containing a lesser concentration of THC (<0.3%), the psychoactive component, rendering it safe and legal. A cannabis plant is known to possess more than 100 cannabinoids of which CBD and THC are predominant.

THC is responsible for the world-famous HIGH (psycho-activity) and also the reason for the illegal status of marijuana (THC > 0.3%), other variant of the cannabis plant. Apart from the cannabinoids, the cannabis plant also contains aromatic compounds called ‘terpenes’ and some flavonoids too.

Based on the content, CBD products are divided into 3 subtypes

  • CBD isolate: 99% pure CBD with no other cannabinoids.
  • Broad-spectrum CBD: Contains CBD with most other cannabinoids plus terpenes and flavonoids, but no THC.
  • Full-spectrum CBD: CBD with all other cannabinoids wherein THC concentration is < 0.3%. Terpenes and flavonoids are also present.

Cannabidiol – a saviour for Restless Leg Syndrome patients

Cannabidiol is well known as a mood relaxant, anxiety reliever, stress buster, pain killer and even a sleep promoter . All these assets of CBD act as a boon for a RLS patient. By using CBD, they are relieved of their symptoms though temporarily and can enjoy a sound, peaceful, undisturbed sleep and fresh morning, the next day.

Moreover, as hemp-derived CBD is free from any major side effects such as psycho-activity and addiction, kudos to meagre THC content, it can easily enter your night time routine without causing any harm.

How does Cannabidiol manage all this?

CBD positively targets one of the most efficient and complicated cell-signalling receptor system of the body – The Endocannabinoid System (ECS)- which itself regulates our perception of certain physiological sensations, such as mood, cognition, stress, hunger, energy level, pain, and sleep, among many others.

Any deviation from normal such as anxiety, pain, etc are the after-effects of endocannabinoid system deficiency. Exogenous CBD restores this deficiency either by replacing endogenous cannabinoids or by preventing their breakdown. By this, CBD relieves the symptoms and restores the balance.

By virtue of its analgesic effects, relaxant properties, CBD relaxes the restless legs, calms down the nerves and thus, eases the pain, discomfort and the subsequent movements of the legs.

Similarly, by relieving stress and anxiety, it generates a serene mental environment facilitating a nice stretched sleep.

Anti-inflammatory action of CBD products can be beneficial for varicose veins, which itself is a triggering factor for Restless Leg Syndrome.

Guidelines to use Cannabidiol for Restless Leg Syndrome

  1. Dosage of CBD for restless leg syndrome is a crucial determinant of its effectivity.

– Response to a particular CBD product varies as per individual experience, body weight, and desired effect. Similarly, dosage also differs.

– As a thumb rule, it is advised to start with a minimal dosage followed by gradual increase till you get the desired effect.

– Effects can be seen even with doses as low as 5mg or some individuals may require 30- 50 mg of CBD for a similar effect.

– Consult a doctor to evaluate apt dosage schedule for you.

– Using CBD oil is one of the age-old, popular, reliable and affording way.

– Tinctures offer rapid results.

– Topical CBD oil deliver targeted results which sounds quite reasonable in RLS management.

We conclude:

CBD on account of its multiple actions can soothe RLS patients, rip off their symptoms and urge, and eventually the grave after-effects too, but it certainly is not a cure for RLS.

FAQs

What aggravates restless leg syndrome?

certain medications such as

  • anti-nausea drugs (e.g. prochlorperazine or metoclopramide).
  • antipsychotic drugs (e.g., haloperidol or phenothiazine derivatives).
  • antidepressants that increase serotonin (e.g., fluoxetine or sertraline).
  • some cold and allergy medications are known to aggravate RLS.

Do vitamins help restless leg syndrome?

  • Supplementation with iron showed promising results.
  • Vitamin Cand E supplements reduced RLS symptoms in patients on haemodialysis.
  • Vitamin D supplements relieved RLS symptoms in vitamin D deficient patients.

Do elevating legs help restless leg syndrome?

  • Yes, as this position soothes the nerves in the legs and prevents compression, reducing the probability of RLS.

Can drinking water help restless legs?

Dehydration can aggravate any condition and RLS is not an exception.

  • Stay hydrated.
  • Avoiding diuretics such as caffeine, night-time alcohol intake.
  • Drink liberal amounts of sparkling water, filtered water, or decaffeinated teas throughout the day.

Are there any food restrictions for restless leg syndrome patients?