Monday, September 10, 2018

Obstructive Sleep Apnea becomes a qualifying condition in the New Mexico Medical Cannabis Program

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Santa Fe, NM - On Friday, September 7th 2018 at the New Mexico Medical Cannabis Advisory Board Hearing, the Chair of the Advisory Board, Dr. Laura Brown announced that while Secretary Gallagher declined to add Sleep Disorders into the medical cannabis program, the Secretary did ADD Obstructive Sleep Apnea as a New Qualifying Condition. Safe Access New Mexico, a Chapter of American For Safe Access successfully provided the Petition to add the new condition in November 2017. The New Mexico Medical Cannabis Program now has 22 Qualifying Health Conditions. 

Medical Cannabis and Sleep Apnea

Sleep apnea can wear you or your loved one out in no time. The breathing disruptions from the condition lower the quality of your sleep, making it hard for you and the 22 million other people in the U.S. with sleep apnea to get through the day and stay awake. Let’s learn more about cannabis and sleep apnea to help you determine if medical marijuana is the right treatment.

What is Sleep Apnea?

Sleep apnea is a sleeping disorder where you experience regular interruptions in breathing while sleeping, hence its name as apnea translates to “without breath” in Greek. You can experience as many as 30 disruptions in just one hour. These stoppages jolt you out of your deep sleep, reducing the amount of quality sleep you get.
Sleep apnea can reduce your late, non-REM and REM sleep stages. REM cycles repair and heal your body, as well as help you feel refreshed in the morning. That’s why many patients with sleep apnea struggle to stay awake during the day or feel fatigued.
Doctors often don’t detect sleep apnea because it only happens when you’re asleep. You can’t find it during an office visit or with a blood test. Many times, even the patient doesn’t know they have it — in fact, 80 percent of moderate to severe obstructive sleep apnea cases remain undiagnosed.
To diagnose sleep apnea, a doctor can use a variety of approaches. Sometimes, they’ll ask you to monitor your sleep quality and habits to see if they have a pattern. In other cases, they’ll conduct a physical exam or sleep study.
Two types of sleep apnea exist:
  • Obstructive sleep apnea — This is the most common form of the disorder and results from a blockage in your airway. Sometimes, the airway temporarily collapses, and other times, something else blocks it. The obstruction causes the air that gets past it to produce loud snorts and snoring.
  • Central sleep apnea — This type of apnea happens when the area of the brain that affects breathing doesn’t communicate with the muscles used for breathing right. It often occurs in patients with underlying conditions or prescription medicines that affect the brainstem.
Some patients can have both obstructive and central sleep apnea. This form of the disorder requires a multifaceted approach for successful treatment.
Certain people are more susceptible to sleep apnea than others. Men have a higher risk of having sleep apnea than women, and your risk gets higher as you age. Children and infants can also develop the condition, with one to four percent of children experiencing sleep apnea. Family history and health issues, like diabetes and heart problems, can increase your risks of sleep apnea.

Sleep Apnea Symptoms

In addition to interrupted breathing during sleep, sleep apnea patients can experience symptoms like:
  • Chronic fatigue
  • Sleepiness during the day
  • Headaches after waking up
  • Restless sleep patterns
  • Cognitive problems like memory loss, learning problems and lack of concentration
  • Mood issues like irritation, mood swings, personality changes or depression
  • Waking up often to use the bathroom
  • Sore throat or dry mouth when waking up
If you make frequent trips to the bathroom at night, consider talking to your doctor about sleep apnea. A recent study discovered that more than 84 percent of patients with sleep apnea make night time trips to the bathroom.
Patients with central sleep apnea can deal with additional symptoms, such as:
  • Problems swallowing
  • Changes in voice
  • Shortness of breath
  • Weakness or numbness
Knowing the symptoms of sleep apnea is the first step to treating the condition, which is crucial as it can increase your risk of a stroke.

Typical Treatments for Sleep Apnea

Most doctors will recommend breathing devices, surgery or lifestyle changes for treating sleep apnea. If an underlying condition causes your apnea, your doctor will also try to address its symptoms.
The most common treatment for sleep apnea is a continuous positive airway pressure (CPAP) machine. To use a CPAP machine, you fit a mask over your mouth that you wear while you sleep. It blows air into your throat, which puts pressure on your airway to keep it open.
A CPAP machine can cause mild to moderate side effects, including:
  • Dry or stuffy nose
  • Irritated skin
  • Dry mouth
  • Headaches
  • Physical discomfort
  • Stomach bloating
Some patients may only need to make lifestyle changes to experience relief. Smoking and alcohol increase the severity of sleep apnea symptoms, so quitting those substances can help. They can also change their sleep habits, sleeping on their sides or using a treatment to keep their nasal passages open.
Patients experiencing mild sleep apnea symptoms might use a mouthpiece when they sleep. An orthodontist will make you a custom-fit device, just like they do with braces and retainers. The mouthpiece corrects your jaw and tongue to facilitate open airways.
In certain cases, surgery to remove or shrink excess tissue can clear your respiratory system to make it easier to breathe at night. When your physician just needs to shrink or stiffen your throat tissue, you can get the procedure done right at the doctor’s office. Procedures involving incisions and tissue removal must be done at a hospital and require a longer recovery period.

Medical Cannabis for Sleep Apnea Treatment

Often, an airway obstruction causes sleep apnea. The airway may temporarily collapse while sleeping. Alternatively, there may be something such as enlarged tonsils blocking the airway. In these cases, the obstruction is the problem. Treatment with medical marijuana may not be able to stabilize breathing without lifestyle changes or medical treatment for the blockage.
Overweight individuals are most likely to have this problem. Losing weight may help with the sleep apnea, though it can be a combination of obstructed airways and the issues mentioned earlier with serotonin causing abnormal breathing patterns. In these cases, weight loss can help the former while medical cannabis can help the latter, leading to sleep that is more restful.

As mentioned above, sleep apnea can have a mild to severe impact on quality of sleep. Medical cannabis can help some individuals with sleep disruption, difficulty falling asleep and difficulty falling back to sleep, get sleep and stay asleep for as long as their bodies need it. In this way, medical marijuana can improve the quality of life for sleep apnea sufferers.
Those who respond well are likely to find that they are suffering less fatigue during the day because their sleep quality has improved. Because medical cannabis has these added benefits, it’s usable for all three types of sleep apnea — that caused by obstruction, that caused by brain function and that caused by both.
Daytime fatigue is one of the most common sleep apnea symptoms. While we often associate medical cannabis with sleepiness and relaxation, some cannabis strains can energize patients dealing with chronic fatigue. A patient can use an energizing medical cannabis strain to relieve any lingering sleepiness they feel during traditional treatment.
Other medical cannabis strains can relax the user and help them sleep deeper. In the situation that the patient needs an alternative to sleeping pills, they can use medical cannabis instead. While sleeping pills often stop working, medical cannabis is reliable in delivering its effects.
When a sleep apnea patient deals with mood problems caused by sleep apnea, they can use uplifting strains to improve their mood and reduce depression and irritation. Medical cannabis serves as a potent antidepressant and calms you down, which can make a difference in your day-to-day life if you experience anxiety or depression.
With the knowledge we have about medical cannabis and sleep apnea, we can safely say that medical cannabis serves as an excellent supplement to typical sleep apnea treatment. While we’re still learning about the direct effects of cannabinoids on sleep apnea, we can use medical cannabis to reduce symptoms and address underlying causes of the condition.

Picking the Right Medical Cannabis Treatment Method for Sleep Apnea

Customizing your medical cannabis treatment plan continues after you choose a strain. Now, you must decide how to consume it. Fortunately, you have tons of options, most of which work well for sleep apnea:
  • Smoking  This may be the most popular way to use medical cannabis, but it’s also the least healthy. When you smoke medical cannabis, it releases toxic chemicals that damage your respiratory system. Plus, smoking can exacerbate your sleep apnea problems.
  • Vaping — This form could work for you if you want a similar experience to smoking without the harmful byproducts. Make sure to use a vape accessory that minimizes charring to reduce the toxins as much as possible.
  • Edibles — The effects of edibles can vary depending on how your body reacts to them, but they can provide an extended release instead of the quick and fast effects of inhalation. If you’re trying to lose weight to reduce your symptoms, you should choose a healthier supplement option and avoid a high-sugar edible item, like a brownie.
  • Topicals — This treatment works best for patients with disorders that cause concentrated pain, but you can use a patch to circulate the medicine throughout your entire body. Plus, since the chemicals in a patch enter your bloodstream, they don’t have to bypass your digestive or respiratory systems. That means that you absorb the entire dose.

References
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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.
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