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Medical Cannabis and Sleep

Topic: Sleep Quality and Insomnia

Sleep plays a crucial role in our overall well-being, impacting our physical health, mental clarity and emotional balance. Unfortunately, 1 in 4 adults in Canada experience sleep troubles. Sleep disturbances are associated with increased risk of depression and cardiovascular disease.

Current available pharmacological treatments for sleep disorders (i.e., benzodiazepines, hypnotics, antidepressants, antipsychotics) have many unwanted adverse effects, including dizziness, cognitive impairment, daytime sedation, weight gain, and possible dependency. As a result, alternative therapies have gained attention, and medicinal cannabis has emerged as a potential solution for sleep-related issues.

First, it is important to understand that there are many co-occurring conditions associated with sleep disorders that should be assessed and treated before considering cannabis as a treatment option, such as:

Medical conditions including pain, sleep apnea, GERD, metabolic issues, Parkinson’s/Alzheimer’s, restless legs, and gender-specific such as menopause/prostate.

Mental illness including mood and anxiety disorders, substance use disorders, and stress.

Contributing medications/substances such as steroids, bronchodilators, decongestions, cardiovascular meds, opioids, and stimulants.

Sleep-related issues are one of the most prevalent reasons people report taking medicinal cannabis.

THC and CBD are the most well-known cannabinoids, and they both play a role in the regulation of different physiological processes, including sleep. According to research, THC may have a dose-dependent effect on sleep: low doses show to reduce sleep onset latency and increase slow-wave sleep and total sleep time, whereas high doses appear to cause sleep disturbances. CBD, on the other hand, has been suggested to be stimulating at low doses, but when used to treat associated symptoms of evening anxiety or pain, CBD is thought to help in sleep.

A new randomized double-blind placebo-controlled crossover study finds medicinal cannabis improves sleep in adults. The cannabis oil with 10mg/mL THC and 15 mg/mL CBD was well tolerated and was effective in improving both time and quality of sleep.

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CBN is also gaining more recognition for its ‘sedative effect’ as a sleep aid. While the research on CBN and sleep remains inconclusive, CBN is believed to have significant fewer intoxication effects that THC.

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Medicinal cannabis holds promise as a potential therapeutic tool for individuals struggling with sleep disorders and associated conditions. Its ability to induce sleep, improve sleep quality, and alleviate pain makes it an attractive alternative for those seeking natural sleep aids. However, the effects of cannabis and sleep can vary depending on the route of administration (i.e., oral vs. inhaled), dose, and individual differences in tolerance and sensitivity.

• Always remember that good sleep hygiene could lead to better sleep:

• Avoid alcohol, caffeine, and nicotine before bed

• Maintain a regular bedtime/waketime

• Practice relaxation and mindfulness-based stress reduction techniques

• Reduce noise in the sleeping environment

• Restrict naps to 30 minutes

• Exercise regularly

• Review medications with your provider/pharmacist regularly

Need help getting a Medicinal Cannabis Treatment Plan for Sleep? Book an appointment here.

References
• Health Canada. For health care professionals: cannabis and cannabinoids. 2018. Available: https://www.canada.ca/en/health-canada/services/drugsmedication/cannabis/information-medical-practitioners/information-healthcare-professionals-cannabis-cannabinoids.html.
• Hirshkowitz M, Whiton K, Albert SM, et al. National Sleep Foundation’s updated sleep duration recommendations: Final report. Sleep Health 2015; 1:233–43.
• Irish LA, Kline CE, Gunn HE, Buysse DJ, Hall MH. The role of sleep hygiene in promoting public health: A review of empirical evidence. Sleep Medicine Reviews 2015; 22:23–36.
• Ried, K., Tamanna, T., Matthews, S., & Sali, A. (2023). Medicinal cannabis improves sleep in adults with insomnia: a randomised double-blind placebo-controlled crossover study. Journal of Sleep Research, 32 (3), 1-12.
• Suzuki K, Miyamoto M, Hirata K. Sleep Disorders in the elderly: Diagnosis and management. Journal of General and Family Medicine 2017 Apr; 18(2):61–71.
• Vaillancourt, R., Gallagher, S., Cameron, J.D., & Dhalla, R. (2022). Cannabis use in patients with insomnia and sleep disorders: retrospective chart review. Retrieved from https://hybridpharm.com/wp-content/uploads/2022/04/Cannabis-use-in-insomnia-patients.pdf.  
Previous Article
Overcoming Challenges with Medical Cannabis in Canada
The history of cannabis use, current regulations, and emerging evidence of medicinal cannabis's effectiveness are all complex, and we must come together and fight for what we know is best for patients!  Medicinal cannabis may be a valuable tool in the management of certain conditions like chronic pain, and more research and education are needed to ensure safe and effective use. Most important of all, medical patients must be assessed and monitored by a trained healthcare practitioner, just like any other medication. When people with serious health conditions—and sometimes life-threatening ones—are pushed to self-medicate using recreational cannabis products and without medical supervision, there is a serious risk of ineffective symptom management, problematic cannabis use, incorrect dosing and product selection, and side effects. The legal framework for medicinal cannabis in Canada has evolved significantly in recent years, but there are still challenges when it comes to access and affordability. The source and price of medicinal cannabis continue to be areas of concern for patients and healthcare providers alike. As the landscape continues to evolve, it will be important to ensure that patients have access to safe, effective, and affordable medicinal cannabis products. How is Starseed overcoming these challenges? 1) Starseed Medicinal is the leading medicinal cannabis producer, partnering with unions, employers, insurers, and patients in need to deliver affordable and responsible cannabis coverage. Starseed is now the preferred provider for over 300,000 Canadians suffering from medical conditions and seeking to learn more about cannabis therapy. 2) Starseed offers a compassionate care program to patients who need financial assistance to obtain their medicinal cannabis. 3) With cannabis now well-established in Canadian healthcare, Starseed provides evidence-based education to physicians and healthcare professionals working in long-term care and retirement homes, primary care clinics, and specialized pain clinics. 4) To support clinical decisions, Starseed created a high-quality database of patient-reported real-world evidence. While there is some evidence that cannabis can help with conditions including chronic pain and nausea, Starseed acknowledges that additional research is needed for specific conditions and cannabis product standardization. 5) Starseed released a first-of-its-kind digital Patient Treatment Plan for patients who need tailored products and practical dosing instructions based on their healthcare provider's recommendations. As a team of healthcare professionals, we are committed to providing medical pathways and patient-centered services through technology, innovation, and education in order ensure safe and effective cannabis use. 6) It is critical to overcome misconceptions and stigma to move the Canadian medicinal cannabis program forward. While cannabis contains psychoactive components that can cause euphoria (or a "high"), medicinal cannabis products are carefully formulated to minimize unwanted side effects while maximizing therapeutic benefits. Patients can choose from a variety of products with varied levels of cannabinoids (CBD, THC, CBG, CBN), such as oils, capsules, and topicals. Starseed sees medicinal cannabis as an essential part of a broader shift towards a more patient-centered approach to healthcare. Healthcare providers are increasingly incorporating cannabis into their treatment plans and collaborating with Starseed to ensure that patients receive safe, effective treatments as cannabis becomes more accepted as a potential therapeutic option. References: Clarke, H. & Fitzcharles, M. (2023). The evolving culture of medical cannabis in Canada for the management of chronic pain. Frontiers in Pharmacology, 14, 1-11.
Next Article
What is CBG?
CBG (cannabigerol) is a type of cannabinoid derived from the cannabis plant. CBG, like CBD, is non-intoxicating (it does not get you high) and can be used as an alternative or supplement to CBD and THC-based cannabis products. It is known as the "mother of all cannabinoids" and is a remarkably versatile compound with significant therapeutic promise. Here are several areas where CBG has shown potential therapeutic effects in preclinical animal studies: -        Neurological illnesses such as Huntington’s disease (HD), amyotrophic lateral sclerosis (ALS), Parkinson’s disease (PD) and multiple sclerosis (MS) -        Gastrointestinal diseases such as inflammatory bowel disease (IBD) -        Chemotherapy-induced nausea and cachexia -        Antibacterial agent Although this research into CBG has shown promise, there is still much to understand and more research on its efficacy and long-term effects is required. How is CBG used today? A team of American scientists recently examined the perceived therapeutic effects of consuming CBG-dominant products in humans (see Figure 1 below). Anxiety (51.2%), chronic pain (40.9%), depression (33.1%), and insomnia (30.7%) were the most frequent medical conditions reported to show efficacy. In addition, a significant proportion of people reported stopping taking the top three drug classes—antidepressants, non-opioid analgesics, and proton pump inhibitors. The most frequent side effects were dry eyes, dry mouth, sleepiness, and increased appetite. Why is CBG so exciting? Anxiety appears to be one of the most common indications for CBG, with patients reporting benefit. And anxiety can be difficult to treat because some anti-anxiety medications, such as benzodiazepines, are not widely accepted and might have negative health consequences such as addiction, memory loss, etc. Can CBG be an alternative for anxiety? It is certainly a desirable alternative. While preclinical and clinical studies indicate its efficacy in various conditions, further research is necessary to fully understand CBGs therapeutic potential and optimize its use as a medicinal agent. Please contact our client care team at 1-844-756-7333 or speak to your healthcare practitioner if you have any questions about Starseed’s CBG products. [1] Russo, E. (2019). The case for the entourage effect and conventional breeding of clinical cannabis: no “strain,” no gain. Frontiers in Plant Science, 9 (1969), 1-8. [2] Russo, E. (2021, November 4). CBG: The Up & Coming Cannabinoid [Webinar]. CReDO Science. https://credo-science.com/cbg-the-up-coming-cannabinoid/ [3] (Gaoni & Mechoulam, 1964) [4] Russo, E.B., Cuttler C., Cooper, Z.D., Stueber, A., Whiteley, V.L., & Sexton, M. (2022). Survey of patients employing cannabigerol-predominant cannabis preparations: perceived medical effects, adverse events, and withdrawal symptoms. Cannabis and Cannabinoid Research, 7 (5), 706-716. Nachnani, R., Raup-Konsavage, W.M., & Vrana, K.E. (2021). The pharmacological case for cannabigerol (CBG). The journal of pharmacology and experimental therapeutics., 376(2), 204-212. Retrieved from https://jpet.aspetjournals.org/content/jpet/376/2/204.full.pdf

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