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12-12-2018

Music, CBD and melatonin: the new go-to solutions for beating insomnia

The rising stars

There’s little doubt that within recent history, the quality of our sleep has never been as bad as it is today. The latest reports suggest that more than 40% of Europeans and North Americans regularly suffer from sleep problems (1), and that the time we spend asleep is getting shorter and shorter. Between 1999 and 2010, the number of prescriptions issued for sleep-related problems in the US rose by 293% … Chronic stress, ever-present artificial light (particularly from screens), mental over-stimulation and deteriorating diets are the primary factors behind this unprecedented global epidemic.


And the consequences are more serious than you might think. Memory problems, depression, mood disorders, increased risk of road accidents, cardiovascular problems and cancer, impaired cognitive efficiency, chronic diseases, diabetes, accelerated cognitive decline, oxidative stress (2-7) … The list of serious effects caused by too little sleep is as long as your arm. What’s worse, it’s insidious: we think we can get by on less sleep because we don’t feel any major impact in the short term, but over the longer term, the consequences are devastating.

As a society, we don’t think about sleep anymore and don’t even consider it to be anything important. But there’s nothing more important! We urgently need to focus on strategies that can help restore good quality sleep.” Mahesh Thakkar, PhD, Associate Professor and Director of Research at the University of Missouri School of Medicine's Department of Neurology.

How on earth am I going to start the day on the right foot when I’m plagued with insomnia? I can’t get to sleep, and when I do, I wake up at odd times during the night. How can I find a quick and lasting solution to this nightmare? Millions of people ask themselves these questions every night. And unfortunately, too many respond by turning to drugs (sleeping tablets or benzodiazepines) thereby plunging themselves into a fresh - and even worse - hell. Recent studies show that those who take these substances are at significantly increased risk of mortality and that their quality of life is impaired by the side-effects and dependency these medications induce.
But awareness of these negative effects is growing and people are increasingly seeking non-drug solutions to help their bodies regain control and gradually restore a natural balance. A number of plant extracts such as valerian, hawthorn, hop and passion flower are all effective options (8-9) but in the last few years, scientific research has identified three new candidates which appear to have unanimous support and which seem to have slightly stronger effects. Here we take a look at these three new paths to getting a good night’s sleep.

Relaxation music for the ‘mega-stressed’

Relaxation music has a growing fan base. Every night, millions of people across the world who struggle to get to sleep listen to hours-long audio tapes on the internet. Whether in the form of natural sounds (waterfalls, forests, waves), soft whispering (ASMR) or classical music, the principal is the same: the gentle, slow rhythmic sounds are designed to create an atmosphere conducive to relaxation. As the listener concentrates, a feeling of calm develops and the sensory stimulation to which we’re constantly exposed these days shuts down.


It’s proving very popular, but what does science have to say about it? With few exceptions, the results of studies conducted on the subject speak for themselves: not only is this approach able to reduce anxiety (10-11), but it can also relieve physical pain (12)! A meta-analysis by the famous Cochrane organisation concluded that listening to gentle music every night before bed improves all the criteria for good quality sleep (13). So what are the presumed mechanisms of action? It seems there are many: it modulates sympathetic nervous system activity (14), decreases circulating levels of cortisol (the ‘stress hormone’) (15-16), modifies hormone levels (particularly oxytocin), and reduces negative thoughts …
It’s clear then that, given how easy it is to access, you’d be mad not to try this powerful aid to resolving your sleep problems …


Note: if you’d like to try this technique for yourself, start by sampling a few different styles (Sleep Meditation Music, American native relaxing music, Rain Sounds, ASMR Sleepy Time) and set things up so that the device on which you’re listening stops after 30 minutes.


For more information: Trahan, T., Durrant, S. J., Müllensiefen, D., & Williamson, V. J. (2018). The music that helps people sleep and the reasons they believe it works: A mixed methods analysis of online survey reports. PLOS ONE, 13(11), e0206531.

Melatonin for those whose sleep patterns are out of synch

We’ll be honest: melatonin is not really new to the sleep aid market. This hormone is already appreciated by thousands of people for its ability to help them get to sleep more quickly or more easily. But until very recently, there had been no real explanation of how it worked. Now, as a result of several studies, especially one carried out by a team at the University of Missouri, we know that melatonin specifically deactivates brain cells which allow us to stay awake and alert (17). On the surface of these brain cells are specific receptors to which melatonin molecules adhere. If these receptors are blocked, the melatonin doesn’t work and the subject will remain awake.


Melatonin is a hormone that’s naturally secreted by the body as natural light fades. It signals to the brain that night is falling and that it’s time to activate the physiological processes that lead to sleep. The problem is that significant exposure to artificial light inhibits this secretion and disrupts the sleep cycle. This is precisely what happens when we spend the evening in front of the television or looking at our mobile phones … Such behaviour serves to postpone the period of melatonin secretion, thus reducing our chances of getting to sleep quickly and increasing the risk of feeling sleepy in the morning! If we maintain these habits over time, the quality of our sleep can be seriously affected and various health problems can develop.


To re-establish normal sleep cycles and make it easier to fall asleep, the idea is therefore to take supplementary melatonin to replace that which the body is failing to produce at the right time. For obvious reasons, this strategy is particularly effective for night shift workers, but it also works for those with delayed sleep phase syndrome. Increasingly common, this is the result of going to bed late and getting up late. It generally affects teenagers and young adults, but the over-50s are increasingly affected too, particularly those who live alone, are unemployed or who have retired. Many older people also suffer the reverse problem, advanced sleep phase syndrome. This is where a person has trouble staying awake past early evening and then wakes up in the early hours of the morning and can’t get back to sleep. Several studies have shown that melatonin is highly effective at improving all these problematic shifts in sleep patterns - much more effective, for example, than the use of aids like eye masks or ear plugs (18).

“Melatonin enabled study participants to obtain an extra half hour of sleep when they attempted to do so at a time when they were not producing melatonin themselves”. Professor Czeisler, author or a study showing the benefits of melatonin for several sleep problems (19).

On the other hand, melatonin is not very effective at inducing sleep in people who are stressed or anxious, or who dwell on the day’s problems, or are suffering pain of various sorts. Evidence suggests that such individuals are better off opting for the third ‘rising star’: CBD.


Note: if you have problems getting to sleep or with feeling drowsy in the morning, melatonin can be a valuable aid provided you don’t exceed the recommended dose (1.5g) and you only use it occasionally or for short periods. For a return to restorative sleep over the long term, you need to make changes to your daytime habits.

CBD for those with serious anxiety or pain

What has made CBD so sought-after by victims of insomnia and those suffering from chronic pain? It’s undoubtedly the recent advances in science. Over the past few years, a number of studies have demonstrated the short-term benefits of CBD on sleep, particularly in helping people to fall asleep (20). In one study on individuals prone to regular insomnia, administration of CBD increased participants’ total sleep duration and reduced the frequency of night-time waking (21). Another study showed that CBD improved sleep quality, although this effect is reversed if the CBD is combined with THC as in the case of cannabis (22). Like CBD, THC is a cannabinoid but it has unwelcome psychotropic effects which make its use unacceptable for many people.


Several mechanisms have been identified to explain how CBD works, including first and foremost its anxiolytic and sedative action (23). It may also promote relaxation, vasodilation and pain relief as a result of its cannabinoid nature. Cannabinoids are able to adhere to certain neuron receptors – endocannabinoid receptors – triggering a multiplicity of chain reactions, some of which are involved in regulating the sleep-wake cycle (24-25). This is particularly the case for the reduction in intensity and impact of symptoms related to anxiety and chronic stress (26) and the triggering of sleep itself.

Our study has clarified CBD’s mechanism of action and has shown it can be used as a treatment without the dangerous side-effects of THC”, said Professor Gobbi who demonstrated that CBD modulates serotonin transmission.

Note: if you wish to evaluate the effects of CBD on your body and you think stress or pain might be affecting your sleep, you can start with a mild supplement such as CBD Oil 6%, before potentially moving on to a stronger product like CBD 25mg.


And if you’re tempted to try all three at once, there’s now a new Supersmart formulation: CBD + Melatonin. In cases of serious insomnia or to prevent it from developing, take one capsule 30 minutes before bed (preferably around 8pm, the time when melatonin receptors are at their most sensitive (27)) and put on some relaxation music for a period of 30 minutes.


References

  1. CDC. Insufficient Sleep Is a Public Health Epidemic [Internet]. CDCFeatures: Data & Statistics. 2014. http://www.cdc.gov/features/dssleep/
  2. Chee MW, Chuah YM. Functional neuroimaging and behavioral correlates of capacity decline in visual short-term memory after sleep deprivation. Proc Natl Acad Sci U S A [Internet]. 2007/05/21. 2007; 104(22):9487–92. https://www.ncbi.nlm.nih.gov/pubmed/17517619 https://doi.org/10.1073/pnas. 0610712104 PMID: 17517619
  3. Paterson JL, Dorrian J, Ferguson SA, Jay SM, Lamond N, Murphy PJ, et al. Changes in structural aspects of mood during 39–66 h of sleep loss using matched controls. Appl Erg [Internet]. 2010/07/24. 2011; 42(2):196–201. https://www.ncbi.nlm.nih.gov/pubmed/20659729
  4. Durmer JS, Dinges DF. Neurocognitive consequences of sleep deprivation. Semin Neurol [Internet]. 2005; 25(1):117–29. https://www.ncbi.nlm.nih.gov/pubmed/15798944 https://doi.org/10.1055/s-2005- 867080 PMID: 15798944
  5. Knutson KL, Van Cauter E. Associations between sleep loss and increased risk of obesity and diabetes. Ann N Y Acad Sci [Internet]. 2008; 1129:287–304. https://www.ncbi.nlm.nih.gov/pubmed/18591489 https://doi.org/10.1196/annals.1417.033 PMID: 18591489
  6. Spira AP, Chen-Edinboro LP, Wu MN, Yaffe K. Impact of sleep on the risk of cognitive decline and dementia. Curr Opin Psychiatry [Internet]. 2014; 27(6):478–83. https://www.ncbi.nlm.nih.gov/pubmed/ 25188896 https://doi.org/10.1097/YCO.0000000000000106 PMID: 25188896
  7. Parthasarathy S, Vasquez MM, Halonen M, Bootzin R, Quan SF, Martinez FD, et al. Persistent insomnia is associated with mortality risk. Am J Med [Internet]. 2014/10/16. 2015; 128(3):268–75.e2. https:// www.ncbi.nlm.nih.gov/pubmed/25447616 https://doi.org/10.1016/j.amjmed.2014.10.015 PMID: 25447616
  8. Bent S, Padula A, Moore D, et al. Valerian for sleep: a systematic review and meta-analysis. Am J Med. 2006 Dec;119(12):1005-12.
  9. Akhondzadeh S, Naghavi HR, et al. Passionflower in the treatment of generalized anxiety: a pilot double-blind randomized controlled trial with oxazepam. J Clin Pharm Ther 2001 Oct;26(5):363-7.
  10. Fancourt D, Williamon A, Carvalho LA, Steptoe A, Dow R, Lewis I. Singing modulates mood, stress, cortisol, cytokine and neuropeptide activity in cancer patients and carers. Ecancermedicalscience [Internet]. 2016/04/05. 2016; 10:631. https://www.ncbi.nlm.nih.gov/pubmed/27170831 https://doi.org/10. 3332/ecancer.2016.631 PMID: 27170831
  11. Koelsch S, Boehlig A, Hohenadel M, Nitsche I, Bauer K, Sack U. The impact of acute stress on hormones and cytokines, and how their recovery is affected by music-evoked positive mood. Sci Rep [Internet]. 2016/03/29. 2016; 6:23008. https://www.ncbi.nlm.nih.gov/pubmed/27020850 https://doi.org/ 10.1038/srep23008 PMID: 27020850
  12. Nilsson U. The anxiety- and pain-reducing effects of music interventions: a systematic review. AORN J [Internet]. 2008; 87(4):780–807. https://www.ncbi.nlm.nih.gov/pubmed/18395022 https://doi.org/10. 1016/j.aorn.2007.09.013 PMID: 18395022
  13. Jespersen K V, Koenig J, Jennum P, Vuust P. Music for insomnia in adults. Cochrane Database Syst Rev [Internet]. 2015/08/13. 2015;(8):CD010459. https://www.ncbi.nlm.nih.gov/pubmed/26270746 https://doi.org/10.1002/14651858.CD010459.pub2 PMID: 26270746
  14. Fancourt D, Ockelford A, Belai A. The psychoneuroimmunological effects of music: a systematic review and a new model. Brain Behav Immun [Internet]. 2013/10/21. 2014; 36:15–26. https://www.ncbi.nlm. nih.gov/pubmed/24157429 https://doi.org/10.1016/j.bbi.2013.10.014 PMID: 24157429
  15. Linnemann A, Ditzen B, Strahler J, Doerr JM, Nater UM. Music listening as a means of stress reduction in daily life. Psychoneuroendocrinology [Internet]. 2015/06/21. 2015; 60:82–90. https://www.ncbi.nlm. nih.gov/pubmed/26142566 https://doi.org/10.1016/j.psyneuen.2015.06.008 PMID: 26142566
  16. Thoma M V, La Marca R, Bro¨nnimann R, Finkel L, Ehlert U, Nater UM. The effect of music on the human stress response. PLoS One [Internet]. 2013/08/05. 2013; 8(8):e70156. https://www.ncbi.nlm. nih.gov/pubmed/23940541 https://doi.org/10.1371/journal.pone.0070156 PMID: 23940541
  17. Rishi Sharma, Pradeep Sahota, Mahesh M. Thakkar. Melatonin promotes sleep in mice by inhibiting orexin neurons in the perifornical lateral hypothalamus. Journal of Pineal Research, 2018; e12498 DOI: 10.1111/jpi.12498
  18. Hua-Wei Huang, Bo-Lu Zheng, Li Jiang, Zong-Tong Lin, Guo-Bin Zhang, Ling Shen, Xiu-Ming Xi. Effect of oral melatonin and wearing earplugs and eye masks on nocturnal sleep in healthy subjects in a simulated intensive care unit environment: which might be a more promising strategy for ICU sleep deprivation? Critical Care, 2015; 19 (1) DOI: 10.1186/s13054-015-0842-8
  19. Rush University Medical Center. "Melatonin Most Effective For Sleep When Taken For Off-hour Sleeping." ScienceDaily. ScienceDaily, 1 May 2006.
  20. Chait LD. Subjective and behavioral effects of marijuana the morning after smoking. Psychopharmacology. 1990;100(3):328–33.
  21. Carlini EA, Cunha JM. Hypnotic and antiepileptic effects of cannabidiol. J Clin Pharmacol. 1981;21(8–9 Suppl):417S–27S.
  22. Nicholson AN, Turner C, Stone BM, Robson PJ. Effect of Delta-9- tetrahydrocannabinol and cannabidiol on nocturnal sleep and earlymorning behavior in young adults. J Clin Psychopharmacol. 2004;24(3):305–13.
  23. Zuardi AW. Cannabidiol: from an inactive cannabinoid to a drug with wide spectrum of action. Rev Bras Psiquiatr. 2008;30(3):271– 80.
  24. Sanford AE. Cannabinoids and hamster circadian activity rhythms. Brain Res. 2008;1222:141–8.
  25. Vaughn LK, Denning G, Stuhr KL, de Wit H, Hill MN, Hillard CJ. Endocannabinoid signalling: has it got rhythm? Br J Pharmacol. 2010;160(3):530–43.
  26. Campos AC, Moreira FA, Gomes FV, Del Bel EA, Guimarães FS. Multiple mechanisms involved in the large-spectrum therapeutic potential of cannabidiol in psychiatric disorders. Philos Trans R Soc Lond B Biol Sci. 2012;367:3364–78.
  27. Van den Heuvel CJ, Ferguson SA, Macchi MM, Dawson D. Melatonin as a hypnotic: con. Sleep Med Rev. févr 2005;9(1):71 80.
Order the nutrients mentioned in this article
CBD Oil 6 %

CBD hemp oil standardised to 6.4% cannabidiol (CBD)

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CBD + Melatonin

Powerful synergy for deep, natural sleep

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