The Benefits of Using Cannabis for Sleep Disorders

Cannabinoids are being considered for the treatment of individuals with many different types of sleep disorders. Recently, cannabis has been found helpful to patients living with obstructive sleep apnea who now use continuous positive airway pressure. Preclinical studies have demonstrated that combining the agent oleamide with THC aids in the stabilization of respiration in all stages of sleep. Oleamide is a derivative of oleic acid that is derived from olive oil. Oleamide accumulates in the cerebrospinal fluid during sleep deprivation and induces sleep when injected into animals. Oleamide produces this effect because it resembles anandamide, the endogenous marijuana-like compound in the brain, and activates the same receptors.

Dronabinol, a synthetic version of Δ9-tetrahydrocannabinol (THC), lowered the apnea-hypopnea index, a diagnostic tool for determining the presence and severity of obstructive sleep apnea, in a clinical study. Due to these promising results in clinical trials, dronabinol is now considered safe for the short-term treatment of obstructive sleep apnea. Nabilone, a synthetic endocannabinoid receptor agonist, was given to patients with posttraumatic stress disorder who reported having nightmares. When compared with a placebo treatment, nabilone proved helpful in reducing the frequency of nightmares.

A single study investigated the effects of cannabidiol (CBD) on REM behavior disorder. This is a sleep disorder in which people, usually males, physically act out vivid dreams that are often unpleasant. Often the sleeper will make violent arm and leg movements that can injure their bed partners. CBD treatment reduced the incidence of these symptoms.

Cannabis may also reduce the symptoms of Restless Leg Syndrome. The brains of patients with Restless Leg Syndrome may be in what is called a “hyperdopaminergic state” – too much dopamine is being released inside the basal ganglia. Recent studies have shown that cannabis reduces the synthesis of dopamine. Thus, the efficacy of cannabis in patients with Restless Leg Syndrome may be due to its ability to prevent the excessive release of dopamine and restore normal neural activity in the basal ganglia.

An analysis of the literature on the use of cannabis products as an aid for better sleep quality discovered that sleep improvements were seen in 7 out of 19 randomized studies and in 7 out of 12 uncontrolled trials. Surprisingly, there were no significant differences between the effects of CBD and THC. Cannabis was most often effective in patients with pain-related disorders. Most of the subjects tested reported subjective improvements in sleep quality, however, close diagnostic examinations showed no improvements in sleep architecture.

One important caveat is that cannabis has its greatest sleep-promoting effects for those who are occasional users. In contrast, chronic cannabis use can disrupt circadian rhythms and reduce the duration of the deepest phases of slow-wave sleep when the brain does not usually produce dreams. The reduction in the deeper sleep phases may reduce the amount of growth hormones and wound-healing hormones produced by the body.

Based on the available evidence, cannabinoids can be used as an alternate treatment for various sleep disorders. Obviously, more clinical trials are required in order to determine the optimal dose and duration of treatment.