Medical Cannabis for INSOMNIA? What does the research say?

Updated: Aug 22, 2021




Sleep disorders have been reported to affect around 35% of the general population. Sleep disorders have been associated with a wide range of detrimental health conditions including an increased risk of: hypertension, diabetes, obesity, depression, heart attack. Additionally the incidence of stroke and obstructive sleep apnea (OSA) are associated with an increased risk of depression, cardiovascular disease , and dementia [1].


The treatment of insomnia through current drug interventions include Eszopiclone, Lemborexant, Suvorexant, Zolpidem (Ambien, Edluar, Intermezzo) or over the counter sleep aids (Many sleeping pills are antihistamines) and all induce the risk of impairment the following day [2].


The use of plant-based treatments for insomnia such as medicinal cannabis, are increasingly being used as a safer alternative to prescription medications. Cannabinoids, including the two main phytocannabinoids Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD), are fast becoming the new go to pharmacological intervention, for sleep disorders [3].


How does Cannabis work to induce sleep?


There are two significant components in the cannabis plant that are known to interact with the human endocannabinoid and neurochemical systems in the body to have an effect on anxiety, mood and circadian sleep/wake cycle [4].


Sleep laboratory studies indicate the different cannabinoid responses in both stimulation and sedation. THC responses include residual sedation and CBD promotes wakefulness. CBD has also demonstrated efficacy in reducing generalised and specific anxiety which acts as an enabler for sleep [5].


Most recent studies include a randomized, crossover trial of the efficacy of a cannabinoid medicine compared with placebo, patients who had been experiencing insomnia for a period of greater than three months using sublingual cannabinoid extract found that not only was the medicine well tolerated, but significantly improved the symptoms of insomnia as well as the and sleep quality in individuals diagnosed with chronic insomnia [9].


What are the side effects of CBD and medical cannabis?


Research indicates that medical cannabis is generally well tolerated, while around 25% of patients may experience the occasional adverse side effect. Nervous disorders were the most commonly reported adverse side effect, followed by gastrointestinal disorders, tiredness, diarrhoea, and changes of appetite/weight in a small number of cases. The most common adverse effects occurred around 10% of patients including: mild dizziness, dry mouth, sedation, somnolence, nausea and fatigue. Most side effects occur during the first four weeks of treatment and can be reduced with an alteration in the titration (dose) and schedule [12].

Oftentimes the adverse effects may be simply eliminated by altering the CBD / THC ratios which can be easily remedied with your cannabis doctor in consultation.


What is the HISTORY of cannabis in treatment of sleep disorders?


Cannabis and its extracts have long been used to treat a number of sleep disorders including insomnia, sleep dispersion and sleep apnea, and more recent research has identified that endocannabinoid signaling can correlate to the modulation of sleep [7].


Ayurvedic medicine employs the use of the cannabis plant to induce sleep. A more recent study in 1991 determined that 90 percent of the participants found cannabis effective for sleep

and concluded that long-term use of the drug does not produce any harmful effect [6]. Historically, the use of cannabis to treat sleep disorders has been closely associated with its ability to reduce pain and rheumatism [8].


Various cultures around the world have used the Cannabis plant to treat a multitude of illnesses. Ancient China used Cannabis to treat malaria, menstrual pain, gout, and constipation [10]. It has even been reported that in medieval times, cannabis was used for pain, epilepsy, nausea, and emesis (vomiting), and in Western cultures cannabis has been used as an analgesic [11].


Physicians in the USA have prescribed Cannabis sativa for a multitude of illnesses until restrictions were put in place in the 1930s and then finally stopped using it in 1970 when the US federal government listed marijuana as a schedule I substance, reporting it as an illegal substance with no medical value. Research on the possible sleep effects of cannabis date back to the 1970s, but high-quality studies are scarce because of the drug’s legal status [10].


There is significant anecdotal evidence supporting the use of medical cannabis to treat sleep disorders from both medical professionals and patients. The use of cannabis to treat symptoms of pain, stress and sleep disorders, are three of the most common self reported reasons for its use in western society today [13].


If you are having trouble going to sleep or staying asleep and have unsuccessfully tried prescription medications that have side effects you cannot tolerate, it's time to investigate a plant-based alternative sleep aid that has great reported results.



Takeaways


  • Sleep disorders are associated with increased risk of hypertension, diabetes, obesity, depression, heart attack, and stroke and obstructive sleep apnea (OSA) are associated with an increased risk of depression, cardiovascular disease , and dementia.

  • Most current drug interventions or over the counter sleep aids induce the risk of impairment the following day.

  • The use of medicinal cannabis is fast becoming the new go to pharmacological intervention for sleep disorders.

  • A most recent 2021 randomised trial: Treating insomnia symptoms with medicinal cannabis; recorded positive results with minimal and tolerable side effects.

  • Cultures around the world have used the Cannabis plant to treat a multitude of medical illnesses, including Ayurvedic medicine which employs the use of the cannabis plant to induce sleep.

  • Research on the possible sleep effects of cannabis date back to the 1970s, but high-quality studies are scarce because of the drug’s legal status.

  • There is significant anecdotal evidence supporting the use of Medical cannabis to treat sleep disorders from both medical professionals and patients



For more information on your eligibility for Medicinal Cannabis in Australia, or to book a telehealth or in person appointment with a specialised Cannabis Doctor, Click Here.





References


1. Sleep disorders and sleep deprivation: an unmet public health problem. (2007). Choice Reviews Online, 44(10), 44–5682. https://doi.org/10.5860/choice.44-5682


2. Webmd - Drugs to Treat Insomnia Medically Reviewed by Michael W. Smith, MD on July 26, 202; https://www.webmd.com/sleep-disorders/insomnia-medications


3. Maroon, J., & Bost, J. (2018). Review of the neurological benefits of phytocannabinoids. Surgical neurology international, 9, 91. https://doi.org/10.4103/sni.sni_45_18


4. Zou, S., & Kumar, U. (2018). Cannabinoid Receptors and the Endocannabinoid System: Signaling and Function in the Central Nervous System. International journal of molecular sciences, 19(3), 833. https://doi.org/10.3390/ijms19030833


5. Shannon, S., Lewis, N., Lee, H., & Hughes, S. (2019). Cannabidiol in Anxiety and Sleep: A Large Case Series. The Permanente journal, 23, 18–041. https://doi.org/10.7812/TPP/18-041


6. Chaturvedi, G. N., Rai, N. P., Pandey, U. S., Singh, K. P., & Tiwari, S. K. (1991). Clinical survey of cannabis users in varanasi. Ancient science of life, 10(3), 194–198. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3331287/


7. Prospéro-García, O., Amancio-Belmont, O., Becerril Meléndez, A. L., Ruiz-Contreras, A. E., & Méndez-Díaz, M. (2016). Endocannabinoids and sleep. Neuroscience & Biobehavioral Reviews, 71, 671–679. https://doi.org/10.1016/j.neubiorev.2016.10.005


9. Walsh, J. H., Maddison, K. J., Rankin, T., Murray, K., McArdle, N., Ree, M. J., Hillman, D. R., & Eastwood, P. R. (2021). Treating insomnia symptoms with medicinal cannabis: a randomized, crossover trial of the efficacy of a cannabinoid medicine compared with placebo. Sleep. Published. https://doi.org/10.1093/sleep/zsab149


10. Zuardi, A. W. (2006b). History of cannabis as a medicine: a review. Revista Brasileira de Psiquiatria, 28(2), 153–157. https://doi.org/10.1590/s1516-44462006000200015


11. Shannon S, Lewis N, Lee H, Hughes S. Cannabidiol in anxiety and sleep: A large case series. Perm J 2019;23:18-041. DOI: https://doi.org/10.7812/TPP/18-041


12. Iffland, K., & Grotenhermen, F. (2017). An Update on Safety and Side Effects of Cannabidiol: A Review of Clinical Data and Relevant Animal Studies. Cannabis and cannabinoid research, 2(1), 139–154. https://doi.org/10.1089/can.2016.0034







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