Medicinal cannabis loses efficacy against insomnia with frequent use
Click Here to Manage Email Alerts
Patients with chronic pain and insomnia who frequently used medicinal cannabis to relieve those symptoms said the substance helped them maintain their sleep in the short term, researchers reported in BMJ Supportive & Palliative Care. However, over longer periods of time, these same patients appeared to develop a tolerance to the drug’s sleep-inducing properties.
“Given the large scale of sleep problems in the general population and among chronic pain patients in particular, along with rapid developments in the field of [medicinal cannabis], it is surprising how few studies have focused on the sleep-inducing effects of medicinal cannabis treatment in chronic pain patients,” Sharon R. Sznitman, PhD, MA, of the University of Haifa Faculty of Social Welfare and Health Sciences in Israel, and colleagues wrote.
They evaluated sleep problems in 129 patients (mean age, 61.29 years; 49% men) with chronic pain. Approximately half used whole plant cannabis for medicinal purposes. Collectively, the medicinal cannabis cohort used the substance for an average of 4 years and used an average of 31 g monthly.
Researchers found that among all patients, 27.2% reported always waking up during the night; 24.1% of the patients reported always waking up early and not falling back asleep; and 20.2% reported always having difficulties falling asleep. The medicinal cannabis users were less likely than the noncannabis users to wake up at night (4.59 vs. 5.54; P = .018). There were no differences between the two groups in terms of the other sleep measures.
Sznitman and colleagues also conducted an analysis with only the medicinal cannabis users. This analysis showed that the more frequently that medicinal cannabis was used, the more likely the patient was to wake up at night and have problems falling asleep.
“These findings have large public health impacts considering the aging of the population, the relatively high prevalence of sleep problems in this population, along with the increasing use of medicinal cannabis,” Sznitman and colleagues wrote.
A systematic review and meta-analysis in the same journal also examined cannabinoids’ potential in relieving pain in nearly 2,900 adults with cancer. As Healio previously reported, that study showed no significant difference between cannabinoids and placebo in average Numeric Rating Scale pain score. The cannabinoid cohort also demonstrated a higher risk for somnolence and dizziness. However, the researchers noted that their analysis may not have included all relevant studies and there were variations among the studies in terms of the patients included, interventions, comparators and outcomes. – by Janel Miller
Disclosures: The authors report no relevant financial disclosures.