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Sleep disorders are a group of conditions that disrupt proper sleeping habits and thereby adversely affect health. Studies have shown cannabis improves the quality and duration of sleep and helps manage various sleep disorders.
Overview of Sleep Disorders
Sleep disorders are disruptions in normal sleeping patterns. Among the most common types of sleep disorders is insomnia, which is having difficulty of falling or staying asleep. Sleep apnea is characterized by breathing interruptions while sleeping. Restless legs syndrome is the tingling or prickly sensation in the legs while lying down. Narcolepsy is having sudden and irresistible bouts of sleep during the day. Parasomnias, which include nightmares, sleepwalking, sleep talking, wetting the bed, grinding the teeth, night terrors and head banging, can also disrupt proper sleep.
Sleep disorders can adversely affect one’s health and safety. Sleep deprivation decreases physical performance and alertness and impairs memory and cognitive abilities. This can increase the risk of occupational and automobile injuries and prevent participation in activities that require sustained attention. In addition, sleep deprivation and night disruptions can lead to relationship problems.
The method for treating sleeping disorders depends on the type. For some sleeping disorders, simply incorporating regular sleep habits can be effective. Making lifestyle changes, like adjusting one’s exposure to daylight, strategically scheduling naps, as well as sticking to a set sleeping schedule and routine, often help. For disorders that are caused by a disruption in circadian rhythm, a common treatment method is bright light therapy, which helps to synchronize the body’s clock by exposing the eyes to safe levels of intense light for brief durations throughout the day. Medications and melatonin treatments can help encourage quality sleep and assist in maintaining a proper sleep-wake cycle.
Findings: Effects of Cannabis on Sleep Disorders
Studies have shown that cannabis can improve the quality and duration of sleep and help treat various sleeping disorders. A major cannabinoid found in cannabis, tetrahydrocannabinol (THC), effectively reduces the amount of time it takes those with insomnia to fall asleep4. One study found that regular consumers of oral THC fell asleep faster and without difficulty compared to non-consumers9. Another study found that cannabis, when administered acutely, eased the falling asleep process and increased the duration of stage 4 sleep24.
THC has also been shown to decrease the number of awakenings throughout the night4. An animal trial found that a synthetic cannabinoid similar to THC was effective at attenuating seratonin-induced apnea by relaxing a muscle in the chin and tongue that has been implicated in the cause of the disorder2. Studies have also found that cannabinoids are effective for treating nightmares in military personnel with PTSD6,10.
A cannabis-based medication, containing both THC and an other major cannabinoid found in cannabis, cannabidiol (CBD), demonstrated in numerous studies to have positive effects on sleep22. One study found that acute CBD treatments were effective in increasing total sleep time3.
Most studies, however, have found that CBD possesses alerting properties13,15,17. One study found that CBD, when consumed while the lights were on, effectively increased wakefulness11. As a result, cannabis high in CBD could potentially help in the management of sleep deprivation and excessive daytime sleepiness.
Medical cannabis patients commonly use cannabis specifically for treating sleep disorders. One study found that nearly half of the adults purchasing medical cannabis at a cannabis dispensary were doing so to help manage insomnia. Most of those individuals reportedly preferred strains of cannabis with significantly higher concentrations of CBD1.
States That Have Approved Medical Marijuana for Sleep Disorders
Currently, no states have approved medical marijuana for the treatment of early morning disorder. However, in Washington D.C., any condition can be approved for medical marijuana as long as a DC-licensed physician recommends the treatment. In addition, a number of other states will consider allowing medical marijuana to be used for the treatment of early morning disorder with the recommendation from a physician. These states include: California (any debilitating illness where the medical use of marijuana has been recommended by a physician), Connecticut (other medical conditions may be approved by the Department of Consumer Protection), Massachusetts (other conditions as determined in writing by a qualifying patient’s physician), Nevada (other conditions subject to approval), Oregon (other conditions subject to approval), Rhode Island (other conditions subject to approval), and Washington (any “terminal or debilitating condition”).
Recent Studies on Cannabis’ Effect on Sleep Disorders
- Belendiuk, K.A., Babson, K.A., Vandrey, R., and Bonn-Miller, M.O. (2015, November). Cannabis species and cannabinoid concentration preference among sleep-disturbed medicinal cannabis users. Addictive Behaviors, 50, 178-81. Retrieved from http://www.sciencedirect.com/science/article/pii/S0306460315002269.
- Calik, M.W., Radulovacki, M., and Carley, D.W. (2014, January 1). Intranodose ganglion injections of dronabinol attenuate serotonin-induced apnea in Sprague-Dawley rat. Respiratory Physiology & Neurobiology, 190, 20-24. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3880550/.
- Chagras, M.H., Crippa, J.A., Zuardi, A.W., Hallak, J.E., Machado-de-Sousa, J.P., Hirotsu, C., Maia, L., Tufik, S., and Andersen, M.L. (2013, March). Effects of acute systemic administration of cannabidiol on sleep-wake cycle in rats. Journal of Psychopharmacology, 27(3), 312-6. Retrieved from http://journals.sagepub.com/doi/pdf/10.1177/0269881112474524.
- Cousens, K., and DiMascio, A. (1973). (−)δ9 THC as an hypnotic. Psychopharmacologia, 33, 355-364. Retrieved from http://link.springer.com/article/10.1007/BF00437513.
- Dahl, R.E., Scher, M.S., Williamson, D.E., Robles, N., and Day, N. (1995). A longitudinal study of prenatal marijuana use: Effects on sleep and arousal at age 3 years. Archives of Pediatrics & Adolescent Medicine, 149(2), 145-50. Retrieved from http://store.jamanetwork.com/productDetails.aspx?articleId=517460.
- Fraser, G.A. (2009). The use of a synthetic cannabinoid in the management of treatment-resistant nightmares in posttraumatic stress disorder (PTSD). CNS Neuroscience & Therapeutics, 15, 84-88. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/j.1755-5949.2008.00071.x/pdf.
- Gates, P.J., Albertella, L., and Copeland, J. (2014, December). The effects of cannabinoid administration on sleep: a systematic review of human studies. Sleep Medicine Reviews, 18(6), 477-87. Retrieved from http://www.sciencedirect.com/science/article/pii/S1087079214000215.
- Goonawardena, A.V., Plano, A., Robinson, L., Platt, B., Hampson, R.E., and Riedel, G. (2011). A pilot study into the effects of the CB1 cannabinoid receptor agonist WIN55,212-2 or the antagonist/inverse agonist AM251 on sleep in rats. Sleep Disorders, vol. 2011, Article ID 178469, 7 pages. Retrieved from https://www.hindawi.com/journals/sd/2011/178469/.
- Gorelick, D.A., Goodwin, R.S., Schwilke, E., Schroeder, J.R., Schwope, D.M., Kelly, D.L., Ortemann-Renon, C., Bonnett, D., and Huestis, M.A. (2013, September-October). Around-the-clock oral THC effects on sleep in male chronic daily cannabis smokers. The American Journal on Addictions, 22(5), 510-514. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4537525/.
- Jetley, R., Heber, A., Fraser, G., and Boisvert, D. (2015, January). The efficacy of nabilone, a synthetic cannabinoid, in the treatment of PTSD-associated nightmares: A preliminary randomized, double-blind, placebo-controlled cross-over design study. Psychoneuroendocrinology, 51, 585-8. Retrieved from http://www.psyneuen-journal.com/article/S0306-4530(14)00413-2/fulltext.
- Murillo-Rodriguez, E., Millan-Aldaco, D., Palomero-Rivero, M., Mechoulam, R., and Drucker-Colin, R. (2006, August 7). Cannabidiol, a constituent of Cannabis sativa, modulates sleep in rats. FEBS Letters, 580(18), 4337-45. Retrieved from http://onlinelibrary.wiley.com/doi/10.1016/j.febslet.2006.04.102/full.
- Murillo-Rodriguez, E., Millan-Aldaco, D., Palomero-Rivero, M., Mechoulam, R., and Drucker-Colin, R. (2008, December). The nonpsychoactive Cannabis constituent cannabidiol is a wake-inducing agent. Behavioural Neuroscience, 122(6), 1378-82. Retrieved from http://psycnet.apa.org/index.cfm?fa=buy.optionToBuy&id=2008-17011-019.
- Murillo-Rodriguez, E., Palomero-Rivero, M., Millan-Aldaco, D., Mechoulam, R., and Drucker-Colin, R. (2011, March 14). Effects on sleep and dopamine levels of microdialysis perfusion of cannabidiol into the lateral hypothalamus of rats. Life Sciences, 88(11-12), 504-11. Retrieved from http://www.sciencedirect.com/science/article/pii/S0024320511000336.
- Murillo-Rodríguez, E., Palomero-Rivero, M., Millán-Aldaco, D., Arias-Carrión, O., and Drucker-Colín, R. (2011). Administration of URB597, Oleoylethanolamide or Palmitoylethanolamide Increases Waking and Dopamine in Rats. PLoS ONE, 6(7), e20766. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136458/.
- Murillo-Rodriguez, E., Poot-Ake, A., Arias-Carrion, O., Pancheco-Pantoja, E., Fuente-Ortegon Ade, L., Arankowsky-Sandoval, G. (2011, September 1). The Emerging Role of the Endocannabinoid System in the Sleep-Wake Cycle Modulation. Central Nervous System Agents in Medicinal Chemistry, 11(3), 189-96. Retrieved from http://www.eurekaselect.com/89056/article.
- Murillo-Rodríguez, E., Sarro-Ramírez, A., Sánchez, D., Mijangos-Moreno, S., Tejeda-Padrón, A., Poot-Aké, A., Guzman, K., Pacheco-Pantoja, E., and Arias-Carrión, O. (2014). Potential Effects of Cannabidiol as a Wake-Promoting Agent. Current Neuropharmacology, 12(3), 269–272. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4023456/.
- Nicholson, A.N., Turner, C., Stone, B.M., and Robson, P.J. (2004, June). Effect of Delta-9-tetrahydrocannabinol and cannabidiol on nocturnal sleep and early-morning behavior in young adults. Journal of Clinical Psychopharmacology, 24(3), 305-13. Retrieved from http://journals.lww.com/psychopharmacology/pages/articleviewer.aspx?year=2004&issue=06000&article=00011&type=abstract.
- Paton, W.D.M., and Pertwee, R.G. (1972, February). Effect of cannabis and certain of its constituents on pentobarbitone sleeping time and phenazone metabolism. British Journal of Pharmacology, 44(2), 250-61. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1666020/.
- Pava, M.J., Makriyannis, A., and Lovinger, D.M. (2016). Endocannabinoid Signaling Regulates Sleep Stability. PLoS ONE, 11(3), e0152473. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4816426/.
- Prasad, B., Radulovacki, M.G., and Carley, D.W. (2013). Proof of Concept Trial of Dronabinol in Obstructive Sleep Apnea. Frontiers in Psychiatry, 4, 1. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3550518/.
- Rueda-Orozco, P.E., Soria-Gomez, E., Montes-Rodriguez, C.J., Perez-Morales, M., and Prospero-Garcia, O. (2010, April 5). Intrahippocampal administration of anandamide increases REM sleep. Neuroscience Letters, 473(2), 158-162. Retrieved from http://www.sciencedirect.com/science/article/pii/S0304394010002284.
- Russo, E.B., Guy, G.W., and Robson, P.J. (2007, August). Cannabis, pain, and sleep: lessons from therapeutic clinical trials of Sativex, a cannabis-based medicine. Chemistry & Biodiversity, 4(8), 1729-43. Retrieved from http://onlinelibrary.wiley.com/doi/10.1002/cbdv.200790150/pdf.
- Santucci, V., Storme, J.J., Soubrie, P., and Le Fur, G. (1996, January). Arousal-enhancing properties of the CB1 cannabinoid receptor antagonist SR 141716A in rats as assessed by electroencephalographic spectral and sleep-waking cycle analysis. Life Sciences, 58(6), PL103-10. Retrieved from http://www.sciencedirect.com/science/article/pii/0024320595023194?via%3Dihub.
- Schierenbeck, T., Riemann, D., Berger, M., Hornyak, M. (2008, October). Effect of illicit recreational drugs upon sleep: cocaine, ecstasy and marijuana. Sleep Medicine Reviews, 12(5), 381-9. Retrieved from http://www.smrv-journal.com/article/S1087-0792(07)00167-0/fulltext.
- Sleep Disorders. (2015, December 16). MedlinePlus. Retrieved from https://www.nlm.nih.gov/medlineplus/sleepdisorders.html.
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- Tripp, D.A., Nickel, J.C., Katz, L., Krsmanovic, A., Ware, M.A., and Santor, D. (2014). A survey of cannabis (marijuana) use and self-reported benefit in men with chronic prostatitis/chronic pelvic pain syndrome. Canadian Urological Association Journal, 8(11-12), E901–E905. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4277530/.