Up to 10% of the U.S are affected by restless legs syndrome (RLS). Studies have shown that CBD can have calming effects among anxious and sleep-deprived individuals, but can it help with RLS?
Read on to learn about what the research available, though limited, has to say about the treatment of RLS with CBD oil and our recommendations.
What is CBD?
Cannabidiol (CBD) is a natural, popular remedy used for many common ailments. It is just one component of many chemical compounds found in the cannabis plant. CBD has close ties with our endocannabinoid system (or ECS for short), which describes the complex network of neurotransmitters in our bodies that can modulate stress, pain, and inflammation in our bodies. The ECS has a number of cannabinoid and endocannabinoid receptors, most notably the CB1 and CB2 receptors.
CB1 receptors are found in high amounts in our central nervous system (CNS), while CB2 receptors are commonly found in our bodies’ immune cells and are thought to play a role in our bodies’ modulation of inflammation. CBD is often mistaken for its counterpart THC, which is responsible for many of the psychoactive effects of cannabis. Not only is this false, but CBD is also thought to have a protective effect against the negative psychological effects we see in the regular use of cannabis.
What is Restless Legs Syndrome?
Restless legs syndrome (RLS) is a neurological condition. Also referred to as Willis-Ekbom disease, RLS causes an uncomfortable urge to move your legs. This is usually due to an unpleasant sensation felt in them.
When left untreated, RLS can affect your overall quality of life. For most people afflicted, the urge becomes more unbearable when relaxed or trying to sleep. It also puts you at risk of developing mental health issues like anxiety and depression.
The exact causes of RLS are still yet to be known, though there has been some research suggesting that kidney disease, genetics and an imbalance of dopamine levels in the brain may be responsible. Peripheral nerve damage, iron deficiency, and spinal cord problems may also increase one’s risk of developing RLS.
The most common treatment of RLS available today is through medications that increase the dopamine in the brain. Short-term effects are usually mild; however, they can cause impulse control disorders and daytime sleepiness.
Diagnostic criteria for RLS
While the symptoms may be obvious, there are many layers to understanding and diagnosing RLS. The International Restless Legs Syndrome Study Group have established the following criteria:
You have an uncontrollable urge to move your legs
Those afflicted with the condition often feel a strange sensation – pulling, tingling, or itching sensations that make the urge to move legs unbearable.
Worsening of symptoms with inactivity
If in situations where legs should be stationary or resting (for example sitting or sleeping) the strange senses intensify, this may be an indication of a link to RLS.
Improvement of symptoms with activity
Movements in the legs such as stretching or walking may temporarily or partially stave off uncomfortable sensations
Worsening of symptoms in evening or night
During resting hours, the urge to move legs and the strange sensations in them drastically increases
What does the research say?
Currently, the research surrounding the topic of CBD and restless legs are limited, however here is what we know.
New emerging research has been looking at the link between RLS and dopamine in the brain. It is said to be possible that RLS is caused by a disruption in pathways responsible for the synthesis of dopamine.
In such cases, the brains of patients with RLS may be in a “hyper-dopaminergic state,” whereby too much dopamine is released inside the basal ganglia. A recent study showed that chronic cannabis use was associated with reduced dopamine synthesis capacity. Therefore, the recent successes of cannabis in patients with RLS may be due to its “dopaminergic blunting” effect.
There may be, therefore, a benefit to the use of CBD for the alleviation of RLS, but more research is needed to verify these claims.
One cross-sectional study looking into the reasons for CBD use found that about 5% of users had been using CBD for RLS.
Though purely anecdotal, some patients report that the use of CBD relieved their symptoms of RLS, and interest in this method of treatment continues to grow.
There is not much supporting evidence as to the efficacy of CBD and its interactions with RLS, but the use of CBD in hopes to alleviate uncomfortable symptoms is common and safe under professional supervision.
Some studies have found that there may be a connection between RLS and an increased risk of anxiety disorders than the general population.
While it is not clear how the two interact, CBD may be able to help alleviate symptoms of anxiety second to RLS. CBD has been well-tolerated and effective in studies regarding the treatment of social anxiety and PTSD, so it might also help with anxiety associated with RLS.
Insomnia is one of the more worrisome symptoms of RLS as it affects one’s day-to-day function. Disturbances in sleep are extremely common in RLS. Due to an increase in the sensory symptoms of RLS around bedtime, sleep is impacted significantly.
Studies have long investigated the impact of CBD on the sleep cycle. One study in particular which looked at four individuals with Parkinson’s disease found that CBD improved symptoms of REM sleep behavior disorder, synonymous with poor sleep and nightmares. CBD therefore may be a useful therapeutic tool for sleep disorders in the future, with more research and close observation.
How to use CBD for RLS
The use of CBD is fairly straightforward, though it may come in various forms.
In this form, CBD oil is usually mixed with alcohol and in the form of a spray. One systematic review found that when taken sublingually (under the tongue), it had the fastest absorption compared to other methods (pharmacokinetics).
CBD often comes in dropper form or with a spray nozzle. A drop of CBD can similarly be taken sublingually.
Capsule or edibles
Edibles and capsules are different in that the half-life of CBD is generally longer, meaning it may take longer to feel its effects. This, however, in comparison to a sublingual application is dose-dependent.
Finding the right dose for Restless Legs Syndrome
As the effectiveness of CBD is dose-dependent, it will take some trial and error before you reach the ideal dose. Depending on the total concentration of CBD in the body, one “dropper” can either be too high or too low.
It is best to start slowly, consult your doctor about a recommendation, and look at the product’s recommended dose. The key thing here is that you can always increase your dose until you’ve reached the results you’re after, but it is best to consult your doctor first.
As a general rule of thumb, doses can be taken between 4-6 hours apart at any time of the day. If you are looking to ease symptoms of bedtime worsened RLS, it is best to take an hour before sleeping.
Selecting quality CBD oil
It is important to carefully research before buying any products, as low-quality CBD oil may do more harm than good.
Some things to think about before making a selection:
High-quality CBD will come with a Certificate of Analysis (COA), which will indicate that it has no more than 0.3% THC. Another important aspect of the COA is lab results, as higher-quality CBD is more likely to be from companies with third-party lab analysis as opposed to “in-house.”
Free of contaminants
Cannabis is a highly effective bio-accumulator, meaning it is extremely good at absorbing chemicals and elements like heavy metals in its environment. The presence of pesticides, molds, and heavy metals can be very harmful. Standard and trusted quality checks such as a COA from a third party are the best way to go.
Research the company you are buying from, looking out for key themes such as any lawsuits or FDA warning letters, etc. A quality company will also be transparent about where and how their hemp is grown.
Safety and side effects
According to the World Health Organization, CBD is generally “well tolerated with a good safety profile,” but some may experience the following side effects.
- Changes in weight
- Changes in appetite
Many of the side effects mentioned may be due to interactions between CBD and various medications. If you are currently taking any prescription medication, it is always recommended to speak to your doctor before trying CBD.
The bottom line
Always consult your doctor before you try CBD, especially if you have a health condition or are taking medications. Your doctor may be able to recommend quality CBD products by trusted suppliers.
Much of the research available, while limited, points toward CBD being beneficial for the treatment of RLS, however, further investigation is needed to be sure.
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