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Cannabis use in patients with insomnia and sleep disorders: Retrospective chart review

Insomnia is a sleep disorder characterized by a difficulty to fall and stay asleep. Common causes are stress, mental health disorders such as depression and anxiety, chronic pain, and poor sleeping habits.

 

Current treatments for insomnia include H1-antagonists, benzodiazepines and hypnotics, while other medications are used off-label for sleep, including antidepressants and second-generation antipsychotics. Unfortunately, many of these medications have unwanted adverse effects, including dizziness, cognitive impairment, daytime sedation, weight gain, metabolic syndromes and the potential for addiction and dependency.

 

Cannabis, both medicinal and non-medicinal, has become increasingly used for insomnia in recent years. There have been conflicting accounts on the potential impact of cannabis for insomnia, but a recent meta-analysis   shows that while there is data demonstrating a positive effect of cannabis on outcomes in patients living with insomnia, the data is low quality due to small sample sizes and short treatment periods. Despite this, sleep disorders tend to be one of the most common reasons individuals report using medicinal cannabis, along with chronic pain and mental health related disorders.

 

Recently, a retrospective chart review conducted  in Ottawa, Ontario, was conducted to cover and include patients who were interested in or already using medicinal cannabis for sleep disorders. A qualitative, exploratory approach was taken to evaluate the descriptive efficacy and safety of medical cannabis when prescribed for insomnia or comorbid conditions. The comprehensive data collection also involved investigating the impact of cannabis on other medication used for insomnia.

 

A total of 38 patients were identified as having adequate follow-up documentation to assess the impact of medical cannabis. At time of data collection, 15 patients (39%) were able to reduce or completely discontinue a prescription medication indicated for sleep. On follow-up, 27 patients (71%) reported a subjective improvement in their sleep or related condition. Only 8 patients (21%) reported any adverse effects from medical cannabis use, and these were manageable and did not require discontinuation of cannabis.

 

This review suggests the benefits of cannabis for use in sleep-related disorders. However, due to the small samples size and nature of the study, further clinical trials are required to substantiate this data.

 

Reference:

  1. Vaillancourt, Régis et al. “Cannabis use in patients with insomnia and sleep disorders: Retrospective chart review.” Canadian pharmacists journal : CPJ = Revue des pharmaciens du Canada : RPC vol. 155,3 175-180. 15 Apr. 2022, doi:10.1177/17151635221089617

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