Cannabis and Sleep Apnea
Can cannabis help sleep apnea? So far, the research points to yes. The main psychoactive chemical in marijuana has shown promising results for patients who suffer from sleep apnea.
Sleep apnea is a condition in which tissues in your throat malform to obstruct your breathing as you sleep. This results in periods throughout the night during which you stop breathing and wake up, even if you aren’t fully aware of it.
The American Sleep Apnea Association estimates more than 22 million Americans suffer from this condition, and some 80 percent of cases go undiagnosed. This is a big problem because sleep apnea disturbs the normal sleep cycle, and it has been linked to all sorts of cardiovascular problems like heart disease and stroke. It also causes grogginess and compromised function during the day.
How to treat sleep apnea: current methods
The mainstay of treatment for sleep apnea so far has been a bulky electrical device called a CPAP machine. CPAP stands for “continuous positive airway pressure.” Basically, you wear a mask that forces air into your lungs as you sleep, pushing away the tissue obstruction that causes you to stop breathing during the night.
A CPAP machine forces air into the lungs of an individual with sleep apnea.
The CPAP machine is effective, but because it’s bulky and expensive, many patients don’t comply with the prescription.
In extreme cases of sleep apnea, people undergo surgery. Sometimes, it doesn’t cure the problem, and recovery can be grueling.
What causes sleep apnea?
Many of the causes of sleep apnea are mechanical. People who are overweight experience it more because of the extra bulk, and people who smoke tobacco may experience it because of throat inflammation, among other causes.
But the latest research shows a component of many cases of sleep apnea stems from the central nervous system, and that’s where cannabis can help.
You have a flap of flesh in the back of your throat that blocks the stuff you eat and drink from going up into your nasal cavity. In sleep apnea, this flap descends to block your airway when you sleep.
The vagus nerve helps control your throat and gut — including your pharynx. This is the anatomical part of your throat that causes sleep apnea.
It’s a thick bulb of the vagus nerve called the nodose ganglion that controls the muscles in the pharynx and the fleshy flap implicated in sleep apnea. The nodose ganglion is what tells your throat muscles what to do and when.
In many cases of sleep apnea, an excess of the neurochemical serotonin stimulates the nodose ganglion, causing it to malform the throat muscles to block the airway.
Can cannabis help sleep apnea?
Taking Delta-9 tetrahydrocannabinol (THC), which is the main psychoactive cannabinoid in marijuana, helps block serotonin from affecting the nodose ganglion. The result? No sleep apnea, in many cases.
Dronabinol, sold under the brand name Marinol, is a pharmaceutical distillate of THC. The U.S. Food and Drug Administration (FDA) currently approves dronabinol to counteract the side effects of cancer treatment and some other uses.
Lately, researchers from the University of Illinois have completed the third and most rigorous phase of clinical trials to get the FDA to approve the drug for treatment of sleep apnea. As of January 2017, the trials testing dronabinol for sleep apnea have proven successful, according to the medical journal Sleep Review.
It’s never a good idea to use any drug outside the supervision of a doctor, and this article is not providing individual medical advice. However, one thing is clear for people who self medicate with marijuana for sleep apnea: Choosing edible marijuana is preferable.
One of the major causes of sleep apnea is inflammation of the airways by the smoke particles from tobacco. If you extrapolate those findings, smoking marijuana could make your sleep apnea worse.
How can cannabis help sleep apnea most effectively? Aside from using edibles, be sure to check out the top strains of cannabis for sleep.
References For “Can Cannabis Help Sleep Apnea?”
“What Is Sleep Apnea?”
National Heart, Lung, and Blood Institute
National Institutes of Health
Functional role for cannabinoids in respiratory stability during sleep.
Carley DW, Paviovic S, Janelidze M, Radulovacki M.
Nodose Ganglion Definition
Farlex Partner Medical Dictionary
Especially among veterans with PTSD, a large body of anecdotal evidence exists showing that cannabis helps you sleep. Exactly how it helps you sleep and whether that sleep is of helpful quality is still debated in medical circles. As with many aspects of the pharmacology of marijuana, the social stigma and legal hurdles around experimenting with pot have left us with a dearth of scientific literature on the matter.
Scientists conducted a lot of research on marijuana in the 1960s and 70s, but legal restrictions choked off many avenues for that research. But since different states now allow the sale of medical and recreational marijuana, scientific investigation in the therapeutic effects of cannabis has experienced a renaissance. The effect of marijuana on sleep is one aspect of that renewed interest.
An important impetus for the study of how cannabis helps you sleep is the widespread use of cannabis among veterans of the wars in Iraq and Afghanistan – many of whom reported having post-traumatic stress disorder. The chief reason these traumatized vets reported using pot to cope, according to a 2014 study, is that it helped them sleep.
How does marijuana affect sleep?
Sleep is an active process that has four distinct neurological stages through the night, labeled stages I through IV and, collectively, Non-Rapid-Eye-Movement sleep. This progression is followed by a period of Rapid Eye Movement (REM) sleep, during which brain wave signals are similar to those of the waking mind.
What scant literature there is comes to the general conclusion that marijuana use tends to deepen and lengthen the periods of Non-Rapid-Eye-Movement (N-REM) sleep and shorten the REM cycle.
If this holds true in future studies, it has pros and cons. Pro: N-REM sleep is restorative and necessary, and cannabinoids in marijuana can help users reach that state and stay in that state longer. Con: REM sleep is vital. Researchers still aren’t sure of its precise physiological purpose, but losing REM sleep tends to make you groggy and less alert during the day.
What do we know about how cannabis helps you sleep?
There are a couple of points of consensus borne out by more robust cannabis research.
One is that habitual cannabis users have trouble sleeping as a withdrawal symptom from stopping cannabis use. The other is that cannabis, specifically the cannabinoid component cannibidiol (CBD), has a marked anxiety-reducing and analgesic effect. It’s useful in conjunction with the other most potent cannabinoid in marijuana, Delta-9 Tetrahydrocannabinol (THC). Studies show these active ingredients improve the sleep of people with all kinds of pain-induced and anxiety-induced insomnia.
This was described in a study using a pharmaceutical distillation called Sativex, made of CBD and THC in a one-to-one ratio:
“No tolerance to the benefit of Sativex on pain or sleep, nor need for dosage increases have been noted in safety extension studies of up to four years, wherein 40–50% of subjects attained good or very good sleep quality”.
Though this study was done using a pharmaceutical distillation of the active chemicals, CBD and THC are often found in similar ratios in different strains of whole marijuana. However, these pharmaceutical distills do not include the other 100+ cannabinoids found in cannabis nor the vast array of terpenes. Thus, studies that use distillates like Sativex are not considering the medical benefits of cannabis for sleep when consumed naturally– a process that allows for all the cannabinoids and terpenes to be consumed in parallel, allowing for what is known as the entourage effect.
Future research into cannabis and sleep should be cautious to take into account the medicinal benefits that arise from the entourage effect. Keep in mind that certain strains of cannabis are more appropriate for sleep than others. Be sure to check out our list of sleep strains to find which is best helping you get the rest you need.
REFERENCES FOR HOW CANNABIS HELPS YOU SLEEP
Cannabis, Pain, and Sleep: Lessons from Therapeutic Clinical Trials of Sativex®, a Cannabis-Based Medicine
Ethan B. Russo, Geoffrey W. Guy, Philip J. Robson
Chemistry and Biodiversity
The effects of cannabinoid administration on sleep: a systematic review of human studies
Peter J. Gates, Lucy Albertella, Jan Copeland of the National Cannabis Prevention and Information Centre, UNSW Medicine, Australia
Sleep Medicine Reviews
Cannabidiol, a constituent of Cannabis sativa, modulates sleep in rats
Eric Murillo-Rodríguez, Diana Millán-Aldaco, Marcela Palomero-Rivero, Raphael Mechoulam, René Drucker-Colín
Effect of cannabidiol on sleep disruption induced by the repeated combination tests consisting of open field and elevated plus-maze in rats.
Hsiao YT, Yi PL, Li CL, Chang FC.
Sleep Disturbance in Heavy Marijuana Users
Karen I. Bolla, PhD, et al
The Journal Sleep
Effectiveness of Cannabidiol Oil for Pediatric Anxiety and Insomnia as Part of Posttraumatic Stress Disorder: A Case Report
Scott Shannon, MD, ABIHM
Using cannabis to help you sleep: Heightened frequency of medical cannabis use among those with PTSD
Marcel O. Bonn-Millera, Kimberly A. Babsonc, Ryan Vandreyd
Drug and Alcohol Dependence