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Published in: Current Pulmonology Reports 3/2020

01-09-2020 | Insomnia | Sleeping and Breathing (A Abreu, Section Editor)

Cannabinoids and Sleep: Helpful or Harmful?

Authors: Aleksandra Kwasnik, Alexandre Abreu, Alejandro Chediak

Published in: Current Pulmonology Reports | Issue 3/2020

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Abstract

Purpose of Review

Legalization and popular use of cannabis products have historically outpaced scientific literature. There is interest in the effects of cannabis and cannabinoids on human sleep and sleep disorders. This review summarizes research evaluating the relationship between cannabinoids and sleep published after 2016 and references background studies for clarification where no recent publications were available.

Recent Findings

Specific to sleep disorders, the most impactful research is arguably in the treatment of sleep disordered breathing though case reports are emerging to address several other conditions such as anxiety-mediated insomnia and restless legs syndrome.

Summary

Due to limitations including the Schedule I drug designation of cannabis and the heterogeneity of compounds in the cannabinoid family, current published works are likely insufficient to serve as a basis for clinical recommendations regarding the use of cannabinoids in sleep medicine.
Literature
2.••
go back to reference National Academies of Sciences, Engineering and Medicine; Health and Medicine Division’ Board on Population Health and Public Health Practice; Committee on the Health Effects of Marijuana: An Evidence Review and Research Agenda. The health effects of cannabis and cannabinoids: the current state of evidence and recommendations for research. Washington (DC): National Academies Press (US); 2017 Jan 12. 3. Available from https://www.ncbi.nlm.nih.gov/books/NBK425763/. This publication provides a detailed overview of the current status of cannabis research in the field of health. National Academies of Sciences, Engineering and Medicine; Health and Medicine Division’ Board on Population Health and Public Health Practice; Committee on the Health Effects of Marijuana: An Evidence Review and Research Agenda. The health effects of cannabis and cannabinoids: the current state of evidence and recommendations for research. Washington (DC): National Academies Press (US); 2017 Jan 12. 3. Available from https://​www.​ncbi.​nlm.​nih.​gov/​books/​NBK425763/​. This publication provides a detailed overview of the current status of cannabis research in the field of health.
3.
go back to reference Azofeifa A, Mattson ME, Schauer G, McAfee T, Grant A, Lyerla R. National estimates of marijuana use and related indicators-National Survey on Drug Use and Health, United States, 2002–2014. Morbidity and Mortality Weekly Report. 65(SS-11):1–25. Azofeifa A, Mattson ME, Schauer G, McAfee T, Grant A, Lyerla R. National estimates of marijuana use and related indicators-National Survey on Drug Use and Health, United States, 2002–2014. Morbidity and Mortality Weekly Report. 65(SS-11):1–25.
4.
go back to reference Corroon J, Phillips JA. A cross-sectional study of cannabidiol users. Cannabis Cannabinoid Res. 2018;3(1):152–61.CrossRef Corroon J, Phillips JA. A cross-sectional study of cannabidiol users. Cannabis Cannabinoid Res. 2018;3(1):152–61.CrossRef
5.
go back to reference Boehnke KF, Gangopadhyay S, Clauw DJ, Haffajee R. Qualifying conditions of medical cannabis license holders in the United States. Health Aff (Milwood). 2019;38(3):511. Boehnke KF, Gangopadhyay S, Clauw DJ, Haffajee R. Qualifying conditions of medical cannabis license holders in the United States. Health Aff (Milwood). 2019;38(3):511.
6.
go back to reference Carlini BH, Garrett SB, Carter GT. Medicinal cannabis: a survey among health care providers in Washington State. Am J Hosp Palliat Care. 2017;34(1):85–91.CrossRef Carlini BH, Garrett SB, Carter GT. Medicinal cannabis: a survey among health care providers in Washington State. Am J Hosp Palliat Care. 2017;34(1):85–91.CrossRef
7.
go back to reference Brand EJ, Zhao Z. Cannabis in Chinese medicine: are some traditional indications referenced in ancient literature related to cannabinoids? Front Pharmacol. 2017;8:108.CrossRef Brand EJ, Zhao Z. Cannabis in Chinese medicine: are some traditional indications referenced in ancient literature related to cannabinoids? Front Pharmacol. 2017;8:108.CrossRef
8.
go back to reference Schwabe AL, McGlaughlin ME. Genetic tools weed out misconceptions of strain reliability in Cannabis sativa: implications for a budding industry. Journal of Cannabis Research. bioRxiv 332320; dos: https://doi.org/10.1101/332320 Schwabe AL, McGlaughlin ME. Genetic tools weed out misconceptions of strain reliability in Cannabis sativa: implications for a budding industry. Journal of Cannabis Research. bioRxiv 332320; dos: https://​doi.​org/​10.​1101/​332320
9.
go back to reference Mackie K. Cannabinoid receptors as therapeutic targets. Annu Rev of Pharmacol Toxicol. 2006;46:101–22.CrossRef Mackie K. Cannabinoid receptors as therapeutic targets. Annu Rev of Pharmacol Toxicol. 2006;46:101–22.CrossRef
11.
go back to reference Baboon KA, Sottile J, Morabito D. Cannabis, cannabinoids, and sleep: a review of the literature. Curt Psychiatry Rep. 2017;19:23.CrossRef Baboon KA, Sottile J, Morabito D. Cannabis, cannabinoids, and sleep: a review of the literature. Curt Psychiatry Rep. 2017;19:23.CrossRef
12.
go back to reference Gorelick DA, Goodwin RS, Schwilke E, Schroeder JR, Schwope DM, Kelly DL, et al. Around-the-clock oral THC effects on sleep in male chronic daily cannabis smokers. Am J Addict. 2013;5:510–4.CrossRef Gorelick DA, Goodwin RS, Schwilke E, Schroeder JR, Schwope DM, Kelly DL, et al. Around-the-clock oral THC effects on sleep in male chronic daily cannabis smokers. Am J Addict. 2013;5:510–4.CrossRef
13.
go back to reference Linares IM, Guimaraes FS, Eckeli A, Cripps ACS, Zuardi AW, Souza JDS, et al. No acute effects of cannabidiol on the sleep-wake cycle of healthy subjects: a randomized double-blind, placebo-controlled, crossover study. Front Pharmacol. 2018;9:315.CrossRef Linares IM, Guimaraes FS, Eckeli A, Cripps ACS, Zuardi AW, Souza JDS, et al. No acute effects of cannabidiol on the sleep-wake cycle of healthy subjects: a randomized double-blind, placebo-controlled, crossover study. Front Pharmacol. 2018;9:315.CrossRef
14.
go back to reference Flores A, Maldonado R, Berrendero F. Cannabinoid-hypocretin crosstalk in the central nervous system: what we know so far. Front Neurosci. 2013;7:256.CrossRef Flores A, Maldonado R, Berrendero F. Cannabinoid-hypocretin crosstalk in the central nervous system: what we know so far. Front Neurosci. 2013;7:256.CrossRef
15.
go back to reference Flores A, Julia-Hernandez M, Maldonado R, Berrendero F. Involvement of the orexin/hypocretin system in the pharmacological effects induced by △9-tetrahydrocannabinol. Br J Pharmacol. 2016;173(8):1381–92.CrossRef Flores A, Julia-Hernandez M, Maldonado R, Berrendero F. Involvement of the orexin/hypocretin system in the pharmacological effects induced by △9-tetrahydrocannabinol. Br J Pharmacol. 2016;173(8):1381–92.CrossRef
16.
go back to reference American Academy of Sleep Medicine. International classification of sleep disorders. 3rd ed. Darien, IL: American Academy of Sleep Medicine; 2014. American Academy of Sleep Medicine. International classification of sleep disorders. 3rd ed. Darien, IL: American Academy of Sleep Medicine; 2014.
17.
go back to reference Vigil JM, Stith SS, Deviant JP, Brockelman F, Keeling K, Hall B. Effectiveness of raw, natural medical Cannabis flower for treating insomnia under naturalistic conditions. Medicines. 2018;11:5(3). Vigil JM, Stith SS, Deviant JP, Brockelman F, Keeling K, Hall B. Effectiveness of raw, natural medical Cannabis flower for treating insomnia under naturalistic conditions. Medicines. 2018;11:5(3).
18.
go back to reference Shannon S, Lewis N, Lee H, Hughes S. Cannabidiol in anxiety and sleep: a large case series. Perm J. 2019 Jan;23:18–041.PubMedPubMedCentral Shannon S, Lewis N, Lee H, Hughes S. Cannabidiol in anxiety and sleep: a large case series. Perm J. 2019 Jan;23:18–041.PubMedPubMedCentral
19.••
go back to reference Zinchuk A, Gentry M, Concato J, Yaggi K. Phenotypes in obstructive sleep apnea: a definition, examples and evolution of approaches. Sleep Med Rev. 2017;35:113–23 This publication describes the differences between phenotypic presentations of sleep apnea and provides the basis for a pharmaceutical approach in select groups of patients. Zinchuk A, Gentry M, Concato J, Yaggi K. Phenotypes in obstructive sleep apnea: a definition, examples and evolution of approaches. Sleep Med Rev. 2017;35:113–23 This publication describes the differences between phenotypic presentations of sleep apnea and provides the basis for a pharmaceutical approach in select groups of patients.
20.••
go back to reference Carley DW, Prasad B, Reid KJ, Malkani R, Attarian H, Abbott SM, et al. Pharmacotherapy of apnea by cannabimimetic enhancement, the PACE clinical trial: effects of dronabinol in obstructive sleep apnea. Sleep. 2018;41(1):zsx184. https://doi.org/10.1093/sleep/zsx184This study represents one of the first clinical trials using pharmaceuticals to control obstructive sleep apnea. Carley DW, Prasad B, Reid KJ, Malkani R, Attarian H, Abbott SM, et al. Pharmacotherapy of apnea by cannabimimetic enhancement, the PACE clinical trial: effects of dronabinol in obstructive sleep apnea. Sleep. 2018;41(1):zsx184. https://​doi.​org/​10.​1093/​sleep/​zsx184This study represents one of the first clinical trials using pharmaceuticals to control obstructive sleep apnea.
21.
go back to reference Prasad B, Radulovacki MG, Carley DW. Proof of concept trial of dronabinol in obstructive sleep apnea. Front Psychiatry. 2013;4:1.PubMedPubMedCentral Prasad B, Radulovacki MG, Carley DW. Proof of concept trial of dronabinol in obstructive sleep apnea. Front Psychiatry. 2013;4:1.PubMedPubMedCentral
22.
go back to reference Ramar K, Rosen IM, Kirsch DB, Chervin RD, Carden KA, Aurora RN, et al. American Academy of Sleep Medicine Board of Directors. Medical cannabis and the treatment of obstructive sleep apnea: an American Academy of Sleep Medicine position statement. J Clin Sleep Med. 2018;14(4):679–81.CrossRef Ramar K, Rosen IM, Kirsch DB, Chervin RD, Carden KA, Aurora RN, et al. American Academy of Sleep Medicine Board of Directors. Medical cannabis and the treatment of obstructive sleep apnea: an American Academy of Sleep Medicine position statement. J Clin Sleep Med. 2018;14(4):679–81.CrossRef
23.
go back to reference Megelin T, Ghorayeb I. Cannabis for restless legs syndrome: a report of six patients. Sleep Med. 2017;36:182–3.CrossRef Megelin T, Ghorayeb I. Cannabis for restless legs syndrome: a report of six patients. Sleep Med. 2017;36:182–3.CrossRef
24.
go back to reference Keith DR, Gunderson EW, Haney M, Foltin RW, Hart CL. Smoked marijuana attenuates performance and mood disruptions during simulated night shift work. Drug Alcohol Depend. 2017;178:534–43.CrossRef Keith DR, Gunderson EW, Haney M, Foltin RW, Hart CL. Smoked marijuana attenuates performance and mood disruptions during simulated night shift work. Drug Alcohol Depend. 2017;178:534–43.CrossRef
Metadata
Title
Cannabinoids and Sleep: Helpful or Harmful?
Authors
Aleksandra Kwasnik
Alexandre Abreu
Alejandro Chediak
Publication date
01-09-2020
Publisher
Springer US
Published in
Current Pulmonology Reports / Issue 3/2020
Electronic ISSN: 2199-2428
DOI
https://doi.org/10.1007/s13665-020-00254-y

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