Consuming medical cannabis reduces sleep disorders caused by PTSD

Consuming medical cannabis reduces sleep disorders caused by PTSD

A new one Anxiety Disorders Journal Study examines the association between medical cannabis (MC) use and sleep in Israel using an electronic diary method between April 2020 and April 2021.

Study: Posttraumatic stress disorder, sleep, and medical cannabis treatment: A daily diary study.Image source: 24K Production / Shutterstock.com

PTSD and sleep

Both sleep disturbances and nightmares are standard features of posttraumatic stress disorder (PTSD), included in the Diagnostic and Statistical Manual of Mental (DSM-5) diagnostic criteria for this disorder.

Previous studies have shown that 80-90% of patients with PTSD experience sleep disturbances, with nightmares and insomnia among the most commonly reported symptoms. PTSD patients who experience more severe sleep disturbances are more likely to have severe PTSD, suicidal ideation, self-harm, and disability.

Treating PTSD Sleep Disorders

Various medication interventions can be used to treat PTSD-related sleep disorders. Although several medications appear to be effective in reducing the incidence of sleep disorders associated with PTSD, their treatment remains challenging.

In addition to medications like prazosin and olanzapine being used successfully to treat PTSD-related sleep disorders, cannabis has also been shown to improve sleep in patients with severe PTSD.

Chemical composition of cannabis

Cannabidiol (CBD) and tetrahydrocannabinol (THC) are the two most studied chemical compounds in cannabis. Early clinical research studies have shown that THC can reduce the occurrence of nightmares and improve sleep quality in PTSD patients; However, most studies on CBD are limited to preclinical animal models.

Despite these observations, these studies were often conducted for short periods of time and used low-dose single-molecule extracts or synthetic pharmaceutical cannabinoids. These THC/CBD formulations differ significantly from the concentrations of most cannabis products. Additionally, most people smoke herbal cannabis, while these studies involved sublingual administration of THC or CBD.

About the study

The current study invited participants via email to individuals in the Israel Institute of Technology Cancer Biology and Cannabinoid Research Laboratory database through Facebook groups related to PTSD and CD, as well as through Reuth Rehabilitation Hospital in Tel Aviv. Participants selected for the study completed a baseline survey, followed by daily surveys sent at 7:30 a.m. and 7:30 p.m. for a total period of 14 days.

Daily sleep outcomes were measured, including the number of times participants woke up the previous night, the frequency of nightmares, and whether they woke up too early without being able to go back to sleep. In addition, the time of last MC consumption the previous night, the time the patient fell asleep, and the CBD and THC concentrations of the primary MC products were also reported.

Sleep problems were measured using the Pittsburgh Sleep Quality Index (PSQI) with scores ranging from zero to 21. PTSD symptom severity was measured using the PTSD Checklist (PCL-5) with scores ranging from zero to four. Scores were summed to obtain a total score, with higher scores indicating more severe PTSD.

Study results

About 56% of the study participants were male and were on average 40 years old. All study participants were previously diagnosed with PTSD; However, 82% received license to use MC to treat their PTSD.

The mean PTSD severity score was 47.57, while the mean PSQI score was 10.19. A total of 22% of participants reported using non-MC sleeping pills during the study. The average CBD and THC concentrations in the MC products were 4.35% and 18%, respectively.

An interim gap of 73.93 minutes was reported by patients between taking MC and falling asleep, while an average of 1.83 nighttime awakenings were reported. Additionally, study participants reported waking up too early 40% of study nights and having nightmares 37% of the time.

People who fell asleep later reported fewer nighttime awakenings and nightmares and a greater likelihood of waking up too early. People with higher levels of PTSD severity were more likely to have more nightmares and wake up earlier. Additionally, people who reported using MC products with higher concentrations of CBD were less likely to wake up early.

Conclusions

Using MC products appears to improve sleep problems associated with PTSD. However, further research, such as clinical trials, is needed to accurately understand the effects of MC, particularly CBD, on overall PTSD symptoms and sleep disorders.

restrictions

The actual dose of CBD or THC consumed among study participants may have been under- or over-represented because the reported cannabinoid concentrations of the MC products may be unreliable or misreported by participants, and the researchers did not measure cannabis dosage themselves.

Another limitation was that the period before and the initial period of MC consumption were not analyzed. Additionally, sleep measurement was limited and based solely on self-reports.

The current study also did not include a clinical assessment of PTSD. Finally, participants' expectations regarding the use of MC as a sleep aid and their extent were not described.

Reference:

• Sznitman, SR, Meiri, D., Amit, BH, et al. (2022). Posttraumatische Belastungsstörung, Schlaf und medizinische Cannabisbehandlung: Eine tägliche Tagebuchstudie. Zeitschrift für Angststörungen. doi:10.1016/j.janxdis.2022.102632. https://www.sciencedirect.com/science/article/abs/pii/S0887618522001050.