Medical Cannabis as a treatment option
What is insomnia?
According to the Mayo Clinic “Insomnia is a common sleep disorder that can make it hard to fall asleep, hard to stay asleep, or cause you to wake up too early and not be able to get back to sleep. You may still feel tired when you wake up”.
The amount of sleep each person needs does vary and may vary for the same person at different points in time. Most adults will need a minimum of between seven and eight hours each night.
Many adults experience insomnia, which lasts for days or weeks at some stage in life. This is usually the result of stress or a traumatic event. However, some have long-term , or chronic, insomnia which persists for longer than a month.
Insomnia is more common above the age of 60 and more common in females than males. Stress or trauma can contribute to insomnia. Travel and busy work schedules may be a factor as can caffeine, alcohol and eating late at night.
A number of medical conditions may cause or contribute to insomnia. These include an overactive thyroid, gastro-oesophageal reflux, chronic pain, some forms of cancer and heart disease. Sleep apnoea is a separate defined entity.
Some medications can affect sleep as a side effect. Mental health conditions such as anxiety and depression can also cause insomnia.
The symptoms include, difficulty falling asleep, waking up during the night, waking up too early, not feeling well-rested after sleep and daytime tiredness or sleepiness.
During the day people may experience irritability, difficulty with focussing on tasks, paying attention and memory. There can be higher rates of errors and accidents.
Insomnia can become a cycle where one worries about sleep and this in turn can worsen the insomnia.
Insomnia has been linked to higher rates of type two diabetes, high blood pressure and heart disease although no mechanism has been found. There are higher rates of mental health conditions such as depression and anxiety in those who have insomnia. Poor sleep can impact on performance at work or sport and also on relationships.
Where an underlying cause is present, treatment should be directed at that in the first instance.
Preventative measures include managing stress, regular exercise, reducing caffeine and not eating later in the evening.
Having a regular night time routine, a comfortable bed and pillow, switching off screens at least half an hour before bed can help. Some people find herbal teas, guided relaxations or deep breathing exercises before bed beneficial.
Sleeping tablets can be helpful short term but are not advised long term as the effectiveness wears off and they can be addictive. Melatonin, the body’s sleep hormone can be helpful and can be prescribed as a sustained release formulation.
Treatment with medicinal cannabis
Treatment for insomnia with medicinal cannabis
Medicinal cannabis has been shown to assist with insomnia. Many people using medicinal cannabis for other purposes report sleeping better. It can be prescribed by a doctor when other treatments have failed or have caused unacceptable side effects. Studies suggest that a formulation of pure CBD or high in CBD may be the most useful although individual response varies, and some may do better with a formulation equal in THC and CBD. Read more at the Mayo Clinic
There are several organizations in Australia which provide information and support to people with Insomnia and their families. Below are links to their websites:
Cannabis, Cannabinoids, and Sleep
a Review of the Literature
Current Psychiatry Reports,
VariousLink to publication
An Open‐Label Comparison of Nabilone and Gabapentin as Adjuvant Therapy or Monotherapy in the Management of Neuropathic Pain in Patients with Peripheral Neuropathy
Medical cannabis may be a well tolerated alternative management strategy in sleep disorders associated with peripheral neuropathy
Cannabinoid ratioLink to publication
Effectiveness of Cannabidiol Oil for Pediatric Anxiety and Insomnia as Part of Posttraumatic Stress Disorder
This case study provides clinical data that support the use of cannabidiol oil as a safe treatment for reducing anxiety and improving sleep in a young girl with post traumatic stress disorder.
The Permanente Journal,
25mg CBDLink to publication