No Longer Sleepless in Seattle: Medical Marijuana Eases Insomnia

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](http://www.uic.edu/orgs/cnshr/clin-trials-res.html# pace2)
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.

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