Medical Cannabis has legally expanded to 41 states as an effective medical intervention in select conditions with the most robust medical evidence limited to PTSD, chronic pain, arthralgias, epilepsy, and to possibly counter the side effects associated with cancer therapies. However, most of us know of at least anecdotal reports of medical marijuana’s application in insomnia.
Insomnia is defined as subjectively impaired sleep duration or quality usually associated with difficulty falling asleep or difficulty maintaining sleep throughout the night. Individuals with insomnia may also experience early morning awakening, although this specific characteristic may be superimposed over an underlying depressive disorder. General prevalence rates of insomnia have increased in recent years and now include approximately 30% of the population.
Current pharmacological therapies for insomnia include the use of sedatives, hypnotics, and in some cases the off-label use of anti-depressants like Trazadone. Although medication is warranted in some select cases of insomnia, it can also lead to dependence and significant side effects in individuals which warrants the further exploration of novel, non-habit forming therapies.
A recent medical review in the Current Psychiatry Reports assessed the current literature surrounding cannabis and insomnia. The review found that the current evidence surrounding cannabis and sleep is conflicting and is highly dependent on the dosage, mode of administration, timing, and ratio of cannabinoids. For instance, higher dosages of isolated THC preparations were associated with decreased REM and poorer overall quality of sleep. However, low dose THC in conjunction with high dose CBD seemed to improve both sleep quality and latency.
Cannabis research is still in its infancy and larger randomized placebo-controlled studies are needed to clearly determine the clinical utility of cannabis on sleep.
Dr. Tanner Wilson, DC, IFMCP is a Functional Medicine Doctor in Kansas that specializes in the treatment of chronic disease conditions.