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Does cbd increase deep sleep11/24/2023 The patient onboarding questionnaire contained in the AdvancedCare platform was a descriptive form completed individually by the patient. Self-reported diagnosed conditions on initial intake questionnaire can be seen in Table 1. Electronic databases, consisting of patient questionnaires and charts, community pharmacy patient profiles and health care professional documentation found in Kroll Pharmacy Management Software, AdvancedCare and CannScript, were all used to collect information. Pharmacists also conducted follow-up appointments with the patients to assist in medication counselling, including product selection, dosing, side effects and drug interactions. Patients were reassessed by a nurse practitioner 3 months after starting medical cannabis, once their initial medical document had expired. 20 Because of the preliminary evidence from small-scale randomized controlled trials suggesting cannabis can provide treatment benefits in sleep disorders, along with the downfalls of current pharmacologic therapy, it is reasonable to conduct a review of patients using cannabis for sleep and assess their sleep scores, along with other measures of improvement or adverse effects of cannabis use. 19īased on the available evidence, THC and THC derivatives, used either alone or in combination with CBD, have been shown to improve self-reported sleep scores. Overall, cannabis may have a short-term benefit on improving sleep time, where evidence has shown reductions in sleep onset latency. It can increase total sleep time and decrease the frequency of arousals during the night. At lower doses, CBD can have a stimulating effect however, at higher doses, it can have more of a sedating effect. 18ĬBD, the second most abundant cannabinoid found in cannabis, has been shown to have a dual effect on sleep latency. 15 - 17 At higher doses, THC-predominant cannabis has demonstrated a reduction in total rapid eye movement (REM) sleep and REM density. 13 THC acts on the CB1 receptors in the central nervous system and can yield a biphasic effect on sleep 14 such that THC, at lower doses, can reduce sleep onset latency and has been associated with greater ease of falling asleep, increased slow-wave sleep and increased total sleep time. 12 Cannabis, specifically with strains containing higher levels of THC, is known to have a dose-dependent effect on sleep. The cannabis flower contains more than 120 different phytocannabinoids, with delta-9 tetrahydrocannabinol (THC) and cannabidiol (CBD) being the most studied cannabinoids of interest. Many patients who seek medical cannabis for sleep and related disorders have often tried many of these medications and have experienced undesirable side effects. 12 However, many of these medications have unwanted adverse effects, including dizziness, cognitive impairment, daytime sedation, weight gain, metabolic syndromes and the potential for addiction and dependency. Other medications are used off-label for sleep, including antidepressants (e.g., trazodone, mirtazapine) and second-generation antipsychotics (e.g., quetiapine). 11 Currently, the available pharmacologic treatments for insomnia and sleep disorders include H1-antagonists, benzodiazepines and hypnotics (e.g., zopiclone, zolpidem, etc.). Patients often report using medical or recreational cannabis to treat multiple symptoms 10 patients may be using cannabis for a primary sleep disorder (e.g., insomnia) or secondary to another medical condition or psychiatric condition (e.g., depression, anxiety, chronic pain, fibromyalgia, etc.). Cannabinoids are gaining acceptance for use as medicines in the treatment of insomnia. 6 - 9 Despite advances in pharmacotherapy and psychotherapy, insomnia and sleep disorders remain a significant burden to society. Sleep is essential for health and involves factors such as quality and duration, 4 and recent research has shown that later sleep timing and greater variability in sleep are associated with adverse health outcomes such as increased risk of depression 5 and cardiovascular diseases. 2 Indeed, sleep disorders are one of the most common reasons individuals report using cannabis for medicinal purposes, alongside chronic pain and mental health–related disorders. pointing out that while there are data to show a positive effect of cannabis on outcomes in patients living with insomnia, it is still low quality because of small sample sizes and short treatment periods. 1 Data on the potential impact of cannabis to treat insomnia remains equivocal, however, with a recent meta-analysis by Bhagavan et al. Cannabis has been used in Canada for medical purposes since being sanctioned by Health Canada in 2001 under the Medical Access Regulation Act.
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