Sleep and the Pandemic

Can CBD help me with sleep problems ?

It’s one of the questions we get asked most of all and it’s always frustrating not to be able to give a definitive answer. We’re quite restricted with the advice we can provide when discussing CBD, but we wanted to look at the area of sleep in a little bit more detail to find out what advice we actually can provide.

In particular we wanted to look at the effects to which the pandemic and seemingly never-ending restrictions are having on the ability to perform one of our most basic urges; to simply  fall asleep !

Why is it important ?

We need to sleep. It enables our bodies to carry out some very important work, so let’s outline just a few which are most relevant to us; brain function, immunity and emotional well being.

Brain Function

Imagine your phone is your brain, now imagine all the inputs you receive on a daily basis through all of your 5 senses. We’re not just talking about the camera (eyes) but everything you touch, smell, hear and taste. We know how quickly the memory fills up and unless we start to delete some files, the phone doesn’t work very well. It’s pretty easy therefore, to imagine how quickly our brain’s “hard drive” fills up.

Brain plasticity theory states that sleep is necessary for brain functionality. It allows your nerve cells to organise themselves correctly via your glymphatic system which removes toxic by-products and allows your brain to function at it’s best when you wake up. The process of converting short term to long term memories and erasing the un-necessary information gathered up during the day also happens when you sleep. Our brain is giving itself a firmware upgrade, deleting un-necessary cache files and defragmenting overnight so hence we feel at our most productive after a full nights rest. 1

Immunity

We should always do our best to ensure a healthy immune system, this is more important than ever as we struggle to deal with this pandemic. The system is made up of two parts, the innate immune system with which we’re born, and an adaptive immune system which we constantly develop as the body is exposed to microbes.

When we sleep, our body makes cytokines. These are proteins which fight off infection and inflammation, they also produce antibodies and immune cells which aid the body and help destroy harmful germs and bacteria. During periods of sickness or stress, the body requires even more immune cells. The better we sleep, the more cytokines we produce and stronger our immune response becomes. All the vitamin supplements in the world aren’t going substitute for a healthy sleep pattern and adequate amount of recovery time for your body. 2

Emotional Well Being

You may have heard about the amygdala but if you aren’t familiar with the term, you’re intimately familiar with this part of the brain. Also known as our lizard brain, it’s the most primal part of our human experience and is responsible for our fight or flight response. It’s not the place you want to hang around if you’re looking for reasonable and rational debate nor if you want to design the next iPhone but it’s kept us alive as a species for hundreds of thousands of years so probably a good idea to keep it in good health.

Research into the amygdala, located in the temporal lobe, has shown that we are more likely to over-react when sleep deprived as opposed to when we get adequate sleep. Sleep leads to an increase in brain activity in the amygdala which supports the theory that stress, sleep and emotional stability are reliant on each other to maintain homeostatis. It is another factor which demonstrates the importance of adequate sleep to improve decision during our waking hours. 3

Sleep, Covid 19 and lockdowns

It’s clear that sleep is very important for maintaining balance within our system and that the lack of sleep causes difficulties with many different and diverse areas of our lives.

Would it therefore be surprising to learn that one European study has shown a staggering 74% of the population had complained about sleep problems after the first major lockdown (a 50% increase on the previous accepted figures) with the under 35 year old demographic being significantly more affected than the over 35’s ?

The effect on this demographic was noted as surprising and is a worrying trend linking anxiety, stress and sleep problems with younger people. The proliferation of unbridled access to smart phones 24/7 is a risk factor in almost all age groups now from as early as aged 7.

This was backed up by another study which echoed the findings and suggests that the results of imposed lockdowns are already and will continue to have a massive impact by disrupting sleep patterns due to stress and anxiety. It reaches the conclusion that this will have a significant negative impact on the mental health of the nation (in this case, France) 4.5

A similar study conducted in Brazil found that, of the adults surveyed, 40% of the population had experienced sleep problems where they had never experienced any problems before. More than 50% of the respondents now experience frequent sensations of anxiety and nervousness. 6

Whilst Covid-19 is a disease that will eventually be managed via treatment and vaccination, it’s not clear how this rise in sleep deprivation, anxiety and stress will have on a demonstrably large section of the population. The world has never seen such mass scale lockdown measures introduced on its citizens so it may be some years to come before we truly understand the lasting effects.

Conclusion and Recommendations

There is certainly evidence emerging that CBD is a useful tool for those suffering from Sleep deprivation and anxiety. However, clinical trials on humans are still few and far between and with an understandably large proportion of research effort being pumped into Covid-19, it’s not yet clear when a scientific consensus will emerge on its efficacy. 7

If you’re considering supplementing with CBD we always recommend the “start low and go slow” philosophy. Ensure you have a good quality product and follow the recommended guidelines but try  half the recommended dose to begin with and gradually build this up over time if necessary. Some people will find they need less than the recommended dose to achieve the desired effect.

We would also recommend you follow some of the sleep hygiene principals which are recommended by the task force of the European CBT-I Academy which are outlined below. 8

They have issued a comprehensive report which looks at sleep problems specifically linked to home confinement related to Covid 19 but the actions should act as a good guide to everyday sleep hygiene.

• Try to keep a regular night-time and wake-up time schedule
• Always get up at more or less the same time, bring some structure to the day, in particular for children.
• Schedule brief (e.g. 15 min) times during the day to stress and reflect upon the situation: write thoughts down, talk about stress, etc. Try to restrict your thinking about these things to specific times to reduce the chance that this stress interferes with night-time sleep.
• If possible, use your bed only for sleep and sex, and for no other activity; this is best achieved by only going to bed when you normally feel sleepy Limit the amount of time you are exposed to news about COVID-19. If more time is available and means allow it: make your home and in particular your bedroom a more comfortable, quiet, dark and cool environment.
• Exercise regularly, preferably in daylight.
• Try to get natural daylight during the day, particularly in the morning, and if not possible, have your home brightly lit in the daytime by opening curtains and blinds, or having lights on; try to have dim light during the evening, with it even darker at night.
• Choose familiar and relaxing activities before bedtime: e.g. reading a book, yoga, etc.
• If you are less active during the day than normal, also eat less at set times, and at the latest 2 hr before desired sleep onset, to prevent sleep disruption.

 References

1. Kolb, B. and Whishaw, I.Q., 1998. Brain plasticity and behavior. Annual review of psychology, 49(1), pp.43-64.
2. Asif, N., Iqbal, R., Fahad, C. 2017 Am J Clin Exp Immunol. 6(6): 92–96.
3. Scott AJ, Webb TL, Rowse G. 2017 Does improving sleep lead to better mental health? A protocol for a meta-analytic review of randomised controlled trials.BMJ Open
4. Beck, F., Léger, D., Fressard, L., Peretti‐Watel, P., Verger, P. and Coconel Group, 2020. Covid‐19 health crisis and lockdown associated with high level of sleep complaints and hypnotic uptake at the population level. Journal of sleep research, p.e13119.
5. Peretti-Watel, P., Alleaume, C., Léger, D., Beck, F., Verger, P. and COCONEL Group, 2020. Anxiety, depression and sleep problems: a second wave of COVID-19. General Psychiatry, 33(5).
6. Barros, M.B.D.A., Lima, M.G., Malta, D.C., Szwarcwald, C.L., Azevedo, R.C.S.D., Romero, D., Souza Júnior, P.R.B.D., Azevedo, L.O., Machado, Í.E., Damacena, G.N. and Gomes, C.S., 2020. Report on sadness/depression, nervousness/anxiety and sleep problems in the Brazilian adult population during the COVID-19 pandemic. Epidemiologia e Serviços de Saúde, 29, p.e2020427.
7. Shannon, S., Lewis, N., Lee, H. and Hughes, S., 2019. Cannabidiol in anxiety and sleep: a large case series. The Permanente Journal, 23.
8. 8 Altena, E., Baglioni, C., Espie, C.A., Ellis, J., Gavriloff, D., Holzinger, B., Schlarb, A., Frase, L., Jernelöv, S. and Riemann, D., 2020. Dealing with sleep problems during home confinement due to the COVID‐19 outbreak: Practical recommendations from a task force of the European CBT‐I Academy. Journal of Sleep Research, p.e13052.