Friday, December 29, 2017

Medical Cannabis Benefits: Treating Sleep Disorders

Insomnia, a clinical sleep disorder, is characterized by the sufferer’s inability to fall asleep and or stay asleep. The disorder comes in two forms: Primary Insomnia where the individual’s sleep problems are not the result of another ailment or disorder, and Secondary Insomnia where the sleep problems are the result of another ailment, disease, or disability - examples include chronic pain conditions such as arthritis or fibromyalgia; anxiety and or depression; epilepsy; recovery from chemotherapy; HIV/AIDS; recovery from addiction; psychological issues; stress, and even some side effects from medication can result in Insomnia.

Insomnia can be very debilitating and can lead to drastically lowered energy levels and tiredness throughout the day, difficulties concentrating, problems with memory, irritability, and it can even cause and or exacerbate depression. At the worst, chronic lack of sleep or sleep deprivation can cause neurological problems in the brain.

There are a number of medications and treatments that help tackle insomnia, and it is relieving to know that some cases of insomnia may not even need medical intervention.

Using Cannabis to Treat Insomnia

Cannabis is a complex medicinal plant that may actually be used to treat a variety of debilitating symptoms caused by a surprisingly large number of ailments. Its usefulness as a non-lethal medicine cannot be overstated and its versatility in terms of how it can be consumed and as to how it can be useful for so many illnesses is something to be excited about. However, it is important to remember that consulting with your primary care physician should be your first priority when considering incorporating cannabis into one’s medical regiment and that cannabis is to be used as an adjunct therapy and not a replacement. It is also your responsibility to communicate with your doctor as to how your use of cannabis has affected your health and of your progress with utilizing medical cannabis.

Much of the recent research surrounding cannabis and its usefulness in treating insomnia is focused on the sedative effects of both Cannabidiol (CBD), Cannabinol (CBN), and even Tetrahydrocannabinol (THC). It is important to note, however, that the sedative effects often associated with THC are due to the synergistic terpenoids that work with it to provide a therapeutic effect useful for insomnia.

Overall, exciting studies have shown that cannabis may be quite useful for treating individuals suffering from Insomnia for the following reasons: assisting with falling asleep and overall quality of sleep; helping to manage possible anxiety and or depression; and with protecting the brain from possible damage and degeneration.

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 asleep. One study found that regular consumers of oral THC fell asleep faster and without difficulty compared to non-consumers. Another study found that cannabis, when administered acutely, eased the falling asleep process and increased the duration of stage 4 sleep.

THC has also been shown to decrease the number of awakenings throughout the night. 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 disorder. Studies have also found that cannabinoids are effective for treating nightmares in military personnel with PTSD.

A cannabis-based medication, containing both THC and another major cannabinoid found in cannabis, cannabidiol (CBD), demonstrated in numerous studies to have positive effects on sleep. One study found that acute CBD treatments were effective in increasing total sleep time.

Most studies, however, have found that CBD possesses alerting properties. One study found that CBD, when consumed while the lights were on, effectively increased wakefulness. 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 CBD.

Currently, no states have approved medical cannabis for the treatment of early morning disorder. However, in Washington D.C., any condition can be approved for medical cannabis as long as a DC-licensed physician recommends the treatment. In addition, a number of other states will consider allowing medical cannabis 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 cannabis 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”).

Cannabinoid significantly reduced nightmares in military personnel with PTSD.
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.

Synthetic cannabinoid similar to THC found to potentially treat obstructive sleep apnea.
Intranodose ganglion injections of dronabinol attenuate serotonin-induced apnea in Sprague-Dawley rat.

THC shown to have sedative properties. CBD found to have alerting properties and effective at counteracting sleepiness.
Effect of Delta-9-tetrahydrocannabinol and cannabidiol on nocturnal sleep and early-morning behavior in young adults.(

Cannabis effective at improving mood, pain, muscle spasms, and sleep.
A survey of cannabis (marijuana) use and self-reported benefit in men with chronic prostatitis/chronic pelvic pain syndrome.

Beneficial Cannabinoids and terpenoids Useful for Treating Insomnia

The cannabis plant offers a plethora of therapeutic benefits and contains numerous cannabinoids and terpenoid compounds that are useful for managing insomnia.

The following chart denotes which cannabinoids and terpenoids work synergistically with each other for possible therapeutic benefit. It may be beneficial to seek out strains that contain these cannabinoids and terpenoids.

Americans For Safe Access Condition-based Booklets
These booklets summarize the history of medical cannabis and the recent research used to treat a variety of conditions, including Cancer, Multiple Sclerosis, Chronic Pain, Arthritis, GastroIntestinal Disorders, Movement Disorders, HIV/AIDS, and conditions related to Aging. (About Americans For Safe Access)

A Patient's Guide to Medical Cannabis

This guide for patients who use medical marijuana (cannabis) covers everything you need to know. Created by Americans for Safe Access (ASA), a non-profit advocacy organization, this publication will help individuals who are using or considering cannabis treatments to better educate themselves, their families and their physicians. ASA has been developing information resources about medical marijuana (cannabis) for patients, their families, doctors, and elected officials for over a decade.

Article: "How to Qualify for Medical Cannabis in New Mexico"


Understanding medical cannabis.Elemental Wellness Center, 2014 Jul.

Cannabis and insomnia.Tringale, Rolando, et al.

O’Shaughnessy’s, 2011 Apr, 31-32.

The modulatory role of endocannabinoids and sleep.Murillo-Rodriguez, Eric.

Revisita de Neurologia, 2008, 46(3): 160-166.

The role of the CB1 receptor in the regulation of sleep.Murillo-Rodriguez, Eric.

Progress in Neuro-Psycopharmacology and Biological Psychiatry, 2008 Aug 1, 32(6): 1420-1427.

Cannabis, pain, and sleep: lessons from therapeutic clinical trials of Sativex, a cannabis-based medicine.Russo, Ethan B., et al.

Chemistry & Biodiversity, 2007 Aug 21, 4(8): 1729-1743.

Cannabidiol, a constituent of cannabis sativa, modulates sleep in rats.Murillo-Rodriguez, Eric, et al.

FEBS Letters, 2006 Aug 7, 581(18): 4337-4345.

Effects of ?-9 tetrahydrocannabinol and cannabidiol on nocturnal sleep and early-morning behavior in young adults.Nicholson, Anthony N., et al.

Journal of Clinical Psychopharmacology, 2004 Jun, 24(3): 305-313.

Pharmacology of cannabinoids.Grotenhermen, Franjo.

Neuroendocrinology Letters, 2004 Apr, 1-2: 15-23.

Anandamide enhances extracellular levels of adenosine and induces sleep: an in vivo microdialysis study.Murillo-Rodriguez, Eric, et al.

Sleep, 2003 Aug, 26(8): 943-947.

Established and potential therapeutic applications of cannabinoids in oncology.Walsh, Declan, et al.

Supportive Care in Cancer, 2003 Mar, 11(3): 137-143.

Functional role for cannabinoids in respiratory stability during sleep.Carley, DW, et al.

Sleep, 2002, 25(4): 391-398.