No Longer Sleepless in Seattle: Medical Marijuana Eases Insomnia

byhellomd3 minutes

Insomnia, the inability to fall or stay asleep, affects approximately 30% of adults in the U.S. Ninety-five percent of insomnia sufferers take a pharmacologic sleep aid, such as hypnotics and antidepressants, which can produce various side effects, from dizziness to irregular heartbeats, addiction and potential overdose.

As an alternative, medical marijuana eases the symptoms of insomnia through its compound delta-9-tetrahydrocannabinol (THC). THC acts on the central nervous system, and at the right dosage, it produces a sedating effect. Cannabidiol (CBD), another major component, triggers vascular or smooth muscle relaxation and reduces anxiety at the same time.

Cannabis has also demonstrated promising results in sleep apnea, one of the common causes of sleep disturbance. Sleep apnea, a disorder characterized by repeated pauses in breathing or shallow breaths during sleep, is often due to a collapsed airway. Classified as obstructive sleep apnea (OSA), it leads to an insufficient supply of oxygen to the brain. A 2013 study conducted by the University of Illinois in Chicago found that dronabinol, the synthetic form of cannabinoid, significantly reduced Apnea Hypopnea Index (AHI) by 32% in adults with moderate to severe OSA. AHI refers to the number of apnea episodes per hour, with 15 to 30 episodes considered moderate, and more than 30 as severe. The 17 subjects, aged 21 to 65, exhibited no serious adverse effects throughout the dose escalation intervention that lasted 21 days.

Dronabinol is FDA-approved for the treatment of chemotherapy side effects, such as nausea and vomiting. Its muscle-toning action on the upper airway is similar to that induced by the Continuous Positive Airway Pressure (CPAP) machine used in the treatment of OSA. Dronabinol is a viable option for patients who cannot tolerate long-term usage of the mask. The PACE Clinical Trial, a larger study funded by the National Institutes of Health, is also underway to determine dronabinol's efficacy and safety in OSA, and the biomechanisms involved.

Insomnia and other sleep disorders are prevalent in cases of fibromyalgia, a syndrome that presents chronic muscle and soft tissue pain, tenderness, and fatigue, affecting 5 million adults in America. A randomized, controlled trial demonstrated that nabilone, another FDA-approved cannabinoid for cancer-related nausea, is effective in enhancing sleep in patients with fibromyalgia. As researchers at McGill University Health Centre in Canada noted, although nabilone and the antidepressant amitriptyline improved sleep, nabilone had a greater effect on the Insomnia Severity Index. Since it was well tolerated by the 32 subjects, the authors recommended that low-dose nabilone be considered as a treatment alternative.

Between 54% to 63% of Americans who experience chronic and acute pain report experiencing sleep disturbances, the National Sleep Foundation revealed in the 2015 Sleep in America Poll. Pain management is therefore crucial to restoring better quality sleep. Several studies have already confirmed the analgesic effect of marijuana in chronic pain associated with neuropathy (peripheral nerve dysfunction) and spasticity (muscle control disorder), conditions that manifest in a host of diseases, like cardiovascular, diabetes, and HIV. As science reveals, medical marijuana does have a role in pain and sleep management.