DEAR DR. ROACH: What is your opinion on taking gummies that contain 8 mg each of CBD, CBN and THC before bedtime for sleeping assistance? I am an 81-year-old male and have been taking them for several months, and they seem to help me. Could you comment on gummies for elderly people to assist with sleeping issues and any downsides of taking them? — D.R.

ANSWER: Based on limited published data, there seems to be some benefit to a combined cannabinoid preparation to help people sleep. However, the studies show several interesting other points. One is that a placebo preparation, such as a gummy with no medication, was also effective.

Although I could not find a direct head-to-head comparison, CBD (cannabidiol, which does not have euphoric psychoactive properties — meaning it doesn’t get you “high”) alone appears to be as effective as CBD with THC (tetracannibinol, which is the most important psychoactive chemical in cannabis). CBN (cannabinol) is less psychoactive than THC. (CBN is not made by the plant; it’s a breakdown product of THC.)

The doses of THC and CBN you are taking are not considered high doses for people who use cannabis recreationally, but they are enough for many people to feel the effects, especially if they aren’t used to them. If any feeling of intoxication you get doesn’t bother you, you can keep taking the current preparation you are using. If you don’t like how you feel, you could switch to an all-CBD preparation, which is likely to be as effective for sleep without intoxicating properties.

I have received several letters recommending melatonin for sleep. It does work well for some people, and although it doesn’t work for everybody, it is pretty safe. I recommend a lower dosage, about 1-3 mg.

A nurse practitioner colleague recommended 200- to 400-mg magnesium supplements, which is also effective for sleep for many. It may also help with constipation, which is common in older people. (Of course, if a person already has loose stools or diarrhea, magnesium will make things worse.)

DEAR DR. ROACH: I am on verapamil, Losartan and hydralazine. My friend told me that if I started eating grapefruit, I could give up my high blood pressure medicine. Is this advisable? — C.S.

ANSWER: The combination of medication you are taking is highly effective — enough to reduce blood pressure very significantly. Depending on the doses used, I would not be surprised to see a systolic blood pressure drop up to 20 or 30 points in a person with moderately high blood pressure.

By contrast, eating grapefruit regularly drops blood pressure by an average of 3 to 5 points. Stopping your prescription medications in favor of grapefruit juice could cause a dramatic and dangerous blood pressure surge, so I urge you strongly not to do so.

There are ways to help control blood pressure without medication. Salt restriction is helpful for some, especially when sodium is replaced with potassium. (Grapefruits are high in potassium.) Cutting down on alcohol helps many, especially those who drink moderate amounts or more. Proper sleep and regular exercise, as with so many conditions, can be helpful. Stress management with meditation, mindful breathing and other techniques has a modest benefit for those who practice.

Unfortunately when the blood pressure is very high, medication is sometimes the only way to get the blood pressure down into the ideal range to prevent heart disease and stroke.