A Good Night’s Sleep—Essential for Full Body Restoration

When looking at the word restoration, REST is the first four letters of this essential pursuit. As clinicians treating patients with sleep disorders, we invariably look to restore homeostasis, whether it be hormone therapy, metabolic health, brain health, cardiovascular performance, musculoskeletal function, or stress/adrenal dysfunction. Research shows poor sleep is involved in many of these aspects of health, including increased risk of Alzheimer’s,¹ high blood pressure,² and diabetes.³

One of the most common reasons many of my patients are plagued by sleep disturbances is pain. In this article, we’ll look at how pain affects sleep and a protocol I use to decrease pain and inflammation and promote a good night’s rest.

How Pain Affects Sleep

Patients who suffer from pain experience sleep problems. Pain often flares up at night, and certain sleeping positions can exacerbate the pain. Being uncomfortable while sleeping leads to waking up frequently. Additionally, many patients dealing with pain are on medications that cause side effects that interfere with sleep.

The ironic thing is that getting enough shuteye can improve pain. Sleep loss, on the other hand, causes inflammation. People in pain who don’t sleep well have more intense pain and greater levels of disability.⁴

Usefulness of CBD, Beta-Caryophyllene, Melatonin, and Curcumin

In my clinical practice, I’ve found that four ingredients offer synergistic support for sleep. These ingredients are CBD, Beta-Carophyllene, Melatonin, and Curcumin.

Cannabidiol (CBD), Pain Relief and Sleep

Research has shown that CBD supports a good night’s rest by:

• Improving sleep quality,
• Reducing occasional stress to promote healthy sleep, and
• Supporting a healthy pain response.

In one study, people who received 160 mg CBD slept more and awakened less during the night compared with the placebo.⁵ Another study found similar results when investigating the effects of CBD in 103 patients.⁶ CBD enhanced sleep quality in 66.7% of participants.

CBD works through the endocannabinoid system, which promotes restful sleep by regulating your body’s internal clock.⁷ It also calms the central nervous system.⁶

CBD also can soothe stress. In a double-blind study, 57 healthy males were given oral CBD at doses of 150 mg, 300 mg, or 600 mg or a placebo before a public speaking test.⁸ Compared with the placebo, 300 mg of CBD caused a significant decline in stress during the speech. In another study, 600 mg of CBD before a public speaking test significantly reduced stress, cognitive impairment, and discomfort in speech performance.⁹

One of the most interesting aspects of CBD is that it may support a healthy and normal pain response. In one study, 53% of 97 patients reduced or eliminated opioid use within eight weeks after beginning supplementation with a CBD-rich hemp extract.¹⁰ Nearly all the patients who used CBD had improved quality of life, including improved sleep quality.

Beta-caryophyllene

Beta-caryophyllene (BCP) is a terpene that governs the activation of one of the two primary receptors in the endocannabinoid system. It is found in many herbs, including lavender, and is thought to play a role in lavender’s ability to help people sleep longer.

BCP promotes a healthy inflammatory and pain response.^11,12 This antioxidant is also calming and can promote relaxation and sleep.¹³

Melatonin

Melatonin is one of the most well-known supplements for supporting a healthy circadian rhythm. It also plays a role in the way we perceive pain.¹⁴

Melatonin levels often drop for the following reasons:

• Age
• Disease
• Exposure to light
• Problems with melatonin receptors

In older adults, 5 mg of melatonin significantly enhanced sleep efficiency during the day and night.¹⁵ Melatonin accomplished this by lengthening the duration of stage 2 non-rapid eye movement sleep and slightly reducing the amount of wakefulness during the night.

Melatonin may be beneficial for:¹⁶

• Circadian rhythm sleep disorders in the blind
• Delayed sleep phase (delayed sleep-wake phase sleep disorder)
• Reducing the time it takes to fall asleep, especially in older adults
• Jet lag, including improved alertness and daytime sleepiness
• Shift work disorder

Non-sleep-related benefits of melatonin include:¹⁷

• Antioxidant protection
• Healthy aging
• Immune support
• Defending against metabolic disorders

Curcumin Protects Against Lack of Sleep

When used together with CBD, BCP, and melatonin, curcumin is an excellent choice to support a healthy inflammatory response, reduce pain, and defend against the negative consequences of sleep loss. In several studies, curcumin prevented brain changes caused by chronic sleep deprivation in rats.^{18 19-21} In a study of mice given curcuminoids, the animals fell asleep faster and slept more deeply.

In a human study, curcumin improved sleep quality and had antioxidant actions in people with type 2 diabetes and coronary heart disease.²²

Enhanced Absorption

All the ingredients mentioned in this article need to be absorbed well to work effectively. For example, CBD has limited oral bioavailability because it’s fat-soluble and has extensive first-pass metabolism. CBD absorption also can vary among different individuals. I recommend a type of technology known as VESIsorb®, which improves absorption and bioavailability. A human study found CBD using VESIsorb® technology was 4.4 times more bioavailable than CBD not using the technology.²³

 

Sleeping Well for Better Health

Proper sleep is essential to every aspect of health. How well a patient is sleeping is an important foundational topic to bring up during an initial examination. In my clinical practice, I use a synergistic combination of CBD, beta-caryophyllene, melatonin, and curcumin to support restful sleep in patients and to reduce any pain that’s interfering with their rest. This combination effectively gives patients restful slumber and restores their well-being.

References

1. Winer JR, Deters KD, Kennedy G, et al. Association of Short and Long Sleep Duration With Amyloid-β Burden and Cognition in Aging. JAMA Neurol. 2021;78(10):1187-1196.
2. Bathgate CJ, Fernandez-Mendoza J. Insomnia, Short Sleep Duration, and High Blood Pressure: Recent Evidence and Future Directions for the Prevention and Management of Hypertension. Curr Hypertens Rep. 2018;20(6):52.
3. Antza C, Kostopoulos G, Mostafa S, Nirantharakumar K, Tahrani A. The links between sleep duration, obesity and type 2 diabetes mellitus. J Endocrinol. 2021;252(2):125-141.
4. Evans S, Djilas V, Seidman LC, Zeltzer LK, Tsao JCI. Sleep Quality, Affect, Pain, and Disability in Children With Chronic Pain: Is Affect a Mediator or Moderator? J Pain. 2017;18(9):1087-1095.
5. Carlini EA, Cunha JM. Hypnotic and antiepileptic effects of cannabidiol. J Clin Pharmacol. 1981;21(S1):417s-427s.
6. Shannon S, Lewis N, Lee H, Hughes S. Cannabidiol in Anxiety and Sleep: A Large Case Series. Perm J. 2019;23:18-041.
7. Sanford AE, Castillo E, Gannon RL. Cannabinoids and hamster circadian activity rhythms. Brain Res. 2008;1222:141-148.
8. Linares IM, Zuardi AW, Pereira LC, et al. Cannabidiol presents an inverted U-shaped dose-response curve in a simulated public speaking test. Braz J Psychiatry. 2019;41(1):9-14.
9. Bergamaschi MM, Queiroz RH, Chagas MH, et al. Cannabidiol reduces the anxiety induced by simulated public speaking in treatment-naïve social phobia patients. Neuropsychopharmacology. 2011;36(6):1219-1226.
10. Capano A, Weaver R, Burkman E. Evaluation of the effects of CBD hemp extract on opioid use and quality of life indicators in chronic pain patients: a prospective cohort study. Postgrad Med. 2020;132(1):56-61.
11. Scandiffio R, Geddo F, Cottone E, et al. Protective Effects of (E)-β-Caryophyllene (BCP) in Chronic Inflammation. Nutrients. 2020;12(11).
12. Paula-Freire LI, Andersen ML, Gama VS, Molska GR, Carlini EL. The oral administration of trans-caryophyllene attenuates acute and chronic pain in mice. Phytomedicine. 2014;21(3):356-362.
13. Galdino PM, Nascimento MV, Florentino IF, et al. The anxiolytic-like effect of an essential oil derived from Spiranthera odoratissima A. St. Hil. leaves and its major component, β-caryophyllene, in male mice. Prog Neuropsychopharmacol Biol Psychiatry. 2012;38(2):276-284.
14. Palmer ACS, Souza A, Dos Santos VS, et al. The Effects of Melatonin on the Descending Pain Inhibitory System and Neural Plasticity Markers in Breast Cancer Patients Receiving Chemotherapy: Randomized, Double-Blinded, Placebo-Controlled Trial. Front Pharmacol. 2019;10:1382.
15. Duffy JF, Wang W, Ronda JM, Czeisler CA. High dose melatonin increases sleep duration during nighttime and daytime sleep episodes in older adults. J Pineal Res. 2022;73(1):e12801.
16. Staff MC. Melatonin. Mayo Clinic. https://www.mayoclinic.org/drugs-supplements-melatonin/art-20363071. Published 2023. Accessed2024.
17. Hardeland R. Neurobiology, pathophysiology, and treatment of melatonin deficiency and dysfunction. ScientificWorldJournal. 2012;2012:640389.
18. Erfanizadeh M, Noorafshan A, Namavar MR, Karbalay-Doust S, Talaei-Khozani T. Curcumin prevents neuronal loss and structural changes in the superior cervical (sympathetic) ganglion induced by chronic sleep deprivation, in the rat model. Biol Res. 2020;53(1):31.
19. Noorafshan A, Karimi F, Karbalay-Doust S, Kamali AM. Using curcumin to prevent structural and behavioral changes of medial prefrontal cortex induced by sleep deprivation in rats. Excli j. 2017;16:510-520.
20. Noorafshan A, Karimi F, Kamali AM, Karbalay-Doust S, Nami M. Restorative effects of curcumin on sleep-deprivation induced memory impairments and structural changes of the hippocampus in a rat model. Life Sci. 2017;189:63-70.
21. Um MY, Yoon M, Kim M, et al. Curcuminoids, a major turmeric component, have a sleep-enhancing effect by targeting the histamine H1 receptor. Food Funct. 2022;13(24):12697-12706.
22. Shafabakhsh R, Mobini M, Raygan F, et al. Curcumin administration and the effects on psychological status and markers of inflammation and oxidative damage in patients with type 2 diabetes and coronary heart disease. Clin Nutr ESPEN. 2020;40:77-82.
23. Knaub K, Sartorius T, Dharsono T, Wacker R, Wilhelm M, Schön C. A Novel Self-Emulsifying Drug Delivery System (SEDDS) Based on VESIsorb(®) Formulation Technology Improving the Oral Bioavailability of Cannabidiol in Healthy Subjects. Molecules. 2019;24(16).