Whether you have a sleep disorder or you're having troubles with sleep, cannabis could be an option for you. Read on to find out how cannabis can affect sleep and whether it's useful in treating insomnia.
We note that the subject contained in this article represents illegal activity in certain jurisdictions. Whilst we do not condone any acts which are contrary to any such laws, we understand that readers in those jurisdictions which have decriminalised cannabis may find this article of interest.
Getting a good night's sleep is essential for how we function and perform. Sleep, in general, is important in maintaining our mental and physical health, yet it remains elusive for a large population of people.
The research estimates that 35-40% of the world's adult population experience insomnia symptoms every year, with 10-30% of this same group suffering from an insomnia disorder. An estimated 40-70% of this population have chronic insomnia disorders.
With so many people experiencing sleep disorders worldwide, an unconventional cure is starting to gain some interest. Cannabis is being touted as a novel yet effective treatment, with fewer side effects than its alternatives. But can medical cannabis treat insomnia or its symptoms, and in doing so, provide a good night's sleep?
What is insomnia?
First, let's start by looking at what insomnia is and what its symptoms might present as. Essentially, insomnia is a difficulty in falling or staying asleep, when you have the right circumstances in which to fall asleep.
Insomnia can be defined as a set of symptoms as well as a clinical disorder. Even people who aren't diagnosed with this sleep disorder can still suffer from its symptoms. The duration, intensity and frequency of these symptoms are what distinguishes the two. Frequent, long and severe symptoms are often indicative of having the insomnia sleep disorder.
These symptoms include: trouble falling asleep, difficulty staying asleep, waking early and feeling unrefreshed upon waking. The last one is especially detrimental, as people who suffer from an insomnia disorder experience some form of daytime impairment as well. Some examples of this include fatigue, irritability, problems with memory, inability to concentrate and an overall decrease in energy.
Acute insomnia is a bunch of these symptoms which present for a night or two. This affects nearly all of us at some stage and is normally triggered by a stressful event. Chronic insomnia is when these symptoms present three or more nights a week over the course of at least a month. It is estimated that chronic insomnia affects a billion people worldwide.
Outside of these symptoms, chronic insomnia has also been associated with serious long-term health issues such as cardiovascular disease, diabetes and obesity. The elderly are the most affected demographic, with an estimated 50% of senior citizens regularly affected by insomnia.
As insomnia affects so many of us, it is imperative that more research is conducted on effective treatments. For those who haven't find the right one, cannabis could be an intriguing option.
Cannabis as a treatment
Although prescription medications such as zolpidem (Stillnox) and temazepam (Temaze) are gaining popularity, they may not be the ideal treatment. Benzodiazepines, which are commonly prescribed for sleep disorders, are highly addictive and potentially dangerous. In 2016, benzodiazepines were the most common substance found in overdose deaths in Australia, beating opioids such as oxycodone and codeine, and potent narcotics like fentanyl.
Even cannabis may not be the ideal treatment, but it is shaping as a safer alternative. Studies show that cannabis is a popular choice for people managing sleep issues worldwide. As cannabis has a long history of medicinal use, there is anecdotal evidence to suggest that this plant was used to induce and improve sleep throughout the centuries.
Studies also show that insomnia is actually one of the main reasons people use cannabis medically, along with other health issues such as pain, anxiety and depression. Physical pain, anxiety and depression are all conditions that can affect sleep and are major sources of insomnia.
As cannabis can help to manage these conditions, there is a growing body of research to suggest that cannabis can also be effective in treating comorbid insomnia indirectly (i.e. insomnia caused by these conditions).
How does cannabis affect sleep?
THC (or tetrahydrocannabinol) is the cannabinoid responsible for facilitating sleep, due to its sedative qualities. Cannabis strains for insomnia treatment are typically high in THC.
Consumption of high THC cannabis reduces the amount of REM sleep you get. A reduction in REM means a reduction in the amount of time spent dreaming. This can be handy for people who suffer from PTSD, as it means they could have a reduction in nightmares.
By reducing the amount of REM sleep, more time is spent in a 'deep sleep' state. This state of deep sleep is theorised to be the most restorative and restful part of the sleep cycle. Although this is the case, REM sleep is still important in homeostasis and healthy cognition. A reduction of REM sleep could impair daily functioning.
CBD (or cannabidiol) has a myriad of medical applications, but it is unclear whether this cannabinoid aids sleep. Some studies report CBD as a 'wake-inducing agent', while others state that its relaxing effects facilitate a better sleep. While it may not influence sleep directly, CBD has proved useful in treating factors that contribute to insomnia, such as anxiety and pain.
Outside of just cannabinoids, several terpenes have been identified for producing sedative effects. Certain terpenes also have other therapeutic benefits, such as anti-inflammation, pain relief and anxiety reduction. This indicates that they are also useful in managing insomnia symptoms. Myrcene, limonene, terpineol and terpinolene are all terpenes with sedative effects, while pinene and phytol are terpenes which increase overall sleep time.
Cannabis doesn't just make falling asleep easier. Improving the length and quality of sleep is another of its benefits. A study on how THC affects sleep found that subjects experienced fewer interruptions in their sleep and a decrease in premature awakenings. Cannabis may also promote better breathing while sleeping and help to manage sleep apnoea, however further research needs to be conducted for this condition.
Another consideration is that different strains of cannabis do different things. While some can be relaxing and sedating, others can be energising and stimulating. Knowing which strain produces which effect is important in making the right choice for you.
A strain with less than 20% THC is recommended for insomnia treatment as anything higher will result in grogginess the next morning. Different strains produce their effects due to their cannabinoid and terpene compositions, but typically indica strains are better at inducing sleep. For more information on strains, be sure to check out some of our strain profiles.
The jury's still out on whether cannabis can provide a better night's sleep, but there is promise in its ability to treat insomnia. While there is a strong body of evidence to support using cannabis, more research needs to be conducted on cannabis and its effects on sleep as a whole, including any adverse effects.
In Australia, some of this research has been conducted by Zelira Therapeutics Ltd (ASX:ZLD). This company is a global leader in medicinal cannabis that is beginning to build a portfolio of clinical assets to treat insomnia.
Recently their insomnia drug ZTL-101 achieved a significant improvement in Insomnia Severity Index scores for patients with chronic insomnia. They also reported little to no adverse effects. For more information on the clinical trials, click here.
While cannabis has proven to be an effective sleep aid, it is still a short-term fix. Cannabis is mainly recommended for cases where medication is the only option in treating insomnia.
Before trying medication, making lifestyle changes that promote a regular sleep schedule should be considered. Some of these changes include exercising more and eating healthier. Practising good sleep hygiene and incorporating behaviours that support this lifestyle will help to promote good sleep.
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