Sleep Apnea

Sleep apnea is a medical disorder characterized by frequent interruptions in breathing of up to ten seconds or more during sleep. The condition is associated with numerous physiological disorders, including fatigue, headaches, high blood pressure, irregular heartbeat, heart attack and stroke. Though sleep apnea often goes undiagnosed, it is estimated that approximately four percent of men and two percent of women ages 30 to 60 years old suffer from the disease.

Limited data shows that cannabinoids may hold promise in addressing sleep apnea. Writing in the June 2002 issue of the journal of the American Academy of Sleep Medicine, researchers at the University of Illinois (at Chicago) Department of Medicine reported “potent suppression” of sleep-related apnea in rats administered either exogenous or endogenous cannabinoids. Another animal trial reported that injected doses of synthetic THC mitigates apnea and augments upper airway muscles in rats.

In a clinical settings, the administration of dronabinol mitigates apnea in adults. Writing in the journal Frontiers in Psychiatry in 2013, investigators concluded that THC administration significantly mitigated symptoms of the disorder in patients with Obstructive Sleep Apnea over a three-week period. “Dronabinol treatment may be a viable alternative or adjunctive therapy in selected patients with OSA,” authors concluded.

A 2017 clinical trial of 73 subjects with moderate to severe obstructive sleep apnea reported that the administration of dronabinol prior to bedtime reduced symptom severity and improved subjective sleepiness.

A 2017 review of the literature concludes: “Novel studies investigating cannabinoids and obstructive sleep apnea suggest that synthetic cannabinoids such as nabilone and dronabinol may have short-term benefit for sleep apnea due to their modulatory effects on serotonin-mediated apneas. CBD may hold promise for REM sleep behavior disorder and excessive daytime sleepiness, while nabilone may reduce nightmares associated with PTSD and may improve sleep among patients with chronic pain. Research on cannabis and sleep is in its infancy and has yielded mixed results. Additional controlled and longitudinal research is critical to advance our understanding of research and clinical implications.”

REFERENCES

[1] Carley et al. 2002. Functional role for cannabinoids in respiratory stability during sleep. Sleep 25: 399-400.

[2] Calik et al. 2014. Intranodose ganglion injections of dronabinol attenuate serotonin-induced apnea in Sprague-Dawley rat. Respiratory, Physiology & Neurobiology 190: 20-24.

[3] Prasad et al. 2013. Proof of concept trial of dronabinol in obstructive sleep apnea. Frontiers in Psychiatry [open access journal].

[4] Carley et al. 2017. Pharmacotherapy of apnea by cannabimimetric enhancement, the PACE clinical trial: effects of dronabinol on obstructive sleep apnea. Sleep [online ahead of print].

[5] Babson et al. 2017. Cannabis, cannabinoids, and sleep: A review of the literature. Current Psychiatry Reports 19: 23.

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