Cannabidiol can improve sleep-related behaviors and rapid eye movement in parkinson’s disease patients
Nowadays, the medication used to treat REM sleep behavior disorder is limited, such as clonazepam, and benzodiazepines with a long half-life. The use of these drugs put the elderly individuals at risk of fall and side effects, namely confusion, daytime sleep, which restrict the use of them in Parkinson's patients with sleep behavior disorder.
Recent studies suggested that there was a significant improvement in sleep quality of patients with parkinson’s disease. A Brazilian research team collected information from some cases diagnosed with Parkinson's disease and sleep behavior disorder to assess clinical outcome in them. In this article, we provide details of these cases
What do the researchers say?
- Case 1: A 61-year-old man diagnosed with Parkinson's disease for 18 years has symptoms of agitation, complex behaviors during sleep characterized by talking, swearing, pushing, kicking, and gesturing. These features had already led to injury to the patient's wife. The wife reported that they took place from 2 to 4 times a week, lasting for 2 minutes and occurring mainly in the middle third of sleep.The clinical assessments were made before and after taking CBD at a dose of 75 mg per day for 6 weeks. The physician found that the patients had no agitation, nightmare or aggressive behaviors during sleep according to the patient and his wife reports.
- Case 2: A 59 year old man suffering from Parkinson's disease at 53 years of age was diagnosed with sleep behavior disorders one year ago. His wife described that the episode was brief, lasting for seconds, and characterized by laughing, yelling, and mainly kicking. The frequency is about 2 to 4 times per week in the final third of sleep. The patient almost forgot everything about the dream, but when he did, it seemed to be an argument with relatives, or an animal attack. After taking a CBD dose of 75 mg per day, no episodes of agitation, or nightmare were recognized by his wife during 6 weeks of treatment.
- Case 3: The last case described a man diagnosed with Parkinson's disease for 3 years and experienced sleep-related behaviors with 2 to 4 episodes per week, including laughing, pushing and kicking. Unlike the two mentioned-above cases, the symptoms last for a long - term before the onset of parkinson’s disease when he was 40 years of age. For 6 weeks, the patients took 300 mg CBD per day and showed reduction in the frequency of complex behavior during sleep to one episode a week.
In the case series, patients treated with CBD have rapid and stable reduction in the frequency of sleep behavior disorder. The dose ranges from 75 to 300 mg CBD per day and none of them had been previously treated for sleep behavior disorder. After CBD discontinuation, the symptoms returned to the same frequency and intensity as baseline. Although the case series collected information from only 3 Parkinson's patients with sleep - related behaviors, the study proved that CBD may be able to control the symptoms of REM sleep behavior disorder in Parkinson's patients.
Choosing the right dose of CBD
There is no one size fits all dosage for CBD. What’s optimal mainly depends on a range of factors, such as body weight, tolerance, symptoms, metabolism, and so on. These factors can yield unique effects for each CBD consumer. Keep in mind that you should pay close attention to how you feel after each dose. It might not occur immediately, and you should be patient to remember that you’re unlikely to get immediate results. As soon as you experience positive effects, lock in that dose and stick with it.
With oral route, start at a dose of 20 milligrams per day (using twice or three times a day) and increase the dose gradually to achieve desirable effects. Do not increase or decrease your dose more often or longer than recommended. Your condition may not improve faster, your risks of side effects will increase.
The recommended dosage forms are CBD capsule and CBD oil. As compared to capsule, CBD oil is extremely versatile because it can be taken under the tongue or smoked with vaping devices.
How to use
Taking capsules is the simplest and most convenient way to use CBD. You only need to swallow the capsule with at least 300 ml of water. The drawbacks of the oral route are low availability and delayed onset of effects.
There are some ways to take CBD oil, and we will provide two most common and effective methods to use CBD in this section.
Firstly, applying CBD sublingually is incredibly easy. CBD oil needs to be put under the tongue and held from 60 to 120 seconds without swallowing to allow adequate time for CBD to diffuse completely across the epithelial cells. The method remains the same when you use CBD oils or tinctures. You must hold the CBD under the tongue since different areas of the mouth might not be permeable enough for diffusion into the bloodstream. Taking CBD sublingually provides fast onset of action and high bioavailability.
Vaping CBD seems to be slightly more difficult than taking CBD sublingually. The first step to vaping properly is to determine how much CBD you consume each time. If you feel unconfident at first, you should start with the easiest option. Disposable cartridges and pods are the simplest tools for new users. Refillable vape pens are a little bit more advanced but more cost-effective in the long term. It is important to read the instructions carefully before using them.
Notice about using CBD
Overall, it is vital that your doctor check your improvements, disease progression, side effects, and interaction with food or drugs at regular visits to make sure CBD is working properly.
- Notice any side effects and tell your doctor right away.
- Don’t take other medicine (including ETC, OTC medicines, herbal, or vitamin supplements) unless they have been discussed with your doctor.
As regards CBD products, they are made by a company that provides
- Third-party test
- Business certification
- Certificate of analysis (COA), no contain more than 0.3% THC and pass tests for heavy metals, pesticides, etc.
- Source of their hemp
- Product information (Brand, CBD content, ingredients, potency, route of administration, indication, instruction)
- Customers’ review
- No subject of FDA warning letter or make any unsupported health claim
Drug interaction
People considering or taking CBD products should always mention their use to their doctor, especially if you are taking other medications or have underlying ailments, such as kidney disease, liver disease, heart failure, or immunocompromised condition. Pharmacists are also a reliable source to help you learn about potential drug interaction with supplements, over-the-counter drugs or prescribed drugs.
Reference
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7115444/