Cannabis helps UK patients with treatment-resistant insomnia
Sleep disturbances affect a lot of people. Some experts estimate it could be as high as 33% of the population, while 10% of adults actually meet the criteria for insomnia disorder. This study examined sleep‐specific health‐related quality of life (HRQoL) for those prescribed cannabis‐based medicinal products (CBMPs) for insomnia. It was published in the journal Brain and Behavior in February 2024.
The patients' outcomes were measured by the following commonly-used scales:
- Single‐Item Sleep‐Quality Scale (SQS)
- Generalized Anxiety Disorder‐7 (GAD‐7)
- EQ‐5D‐5L (a self-assessed, health related, quality of life questionnaire)
- Patient Global Impression of Change (PGIC)
All 61 patients included had to "previously demonstrate a prior diagnosis of insomnia that had failed to improve following administration of more than two licensed treatments". So they ALL had tried at least two other standard treatments that did not work well.
The average age of the participants was 41 and 72% were male.They reported at 1, 3, and 6 months after starting cannabinoid treatment. About 43% had also been diagnosed with depression or anxiety.
The prescriptions were divided among several different product types provided by the same manufacturer:
- Dry cannabis flower alone (42%)
- Sublingual oils (tinctures) alone (28%)
- Both flower & sublingual oil (30%)
The average daily doses of THC and CBD were:
- Oils: 20mg CBD, 10mg THC
- Flower: 1.5mg CBD, 150mg THC
- Oils + Flower: 20mg CBD, 140mg THC
Results:
More than 40% of participants who completed each PROM round reported clinically significant improvement in their sleep quality at each time period.
Participants reported improvements in anxiety symptoms at each follow‐up.
Improvements in GAD‐7, SQS, and EQ‐5D‐5L Index values at 1, 3, and 6 months (p < .050) were witnessed after CBMP commencement.
EQ‐5D‐5L subscores for usual activity, pain and discomfort, and anxiety and depression also improved at 1 and 3 months (p < .050)
Fewer than 15% of participants reported one or more adverse events.
This case series showed improvements in sleep and quality of life for those that participated. However, the authors caution about drawing more general conclusions due to the limitations of the study design.
Of note is that the most common adverse event was insomnia (experienced by 5 patients). This reinforces the biphasic and unique nature of cannabinoids' effects on different individuals. The correct dose is very important as the wrong dose can have the opposite of the intended effect.
Authors' conclusions:
Patients with insomnia experienced an improvement in sleep quality following the initiation of CBMPs
This novel case series assessed patients suffering from insomnia prescribed CBMPs for up to 6 months, showing an associated improvement in self‐reported sleep quality, generalized anxiety and general HRQoL.
further investigation is required before definitive conclusions can be drawn on the efficacy of CBMPs in treating insomnia.
The full text article is here at PubMed Central.
Source:
Vivek K, Karagozlu Z, Erridge S, Holvey C, Coomber R, Rucker JJ, Weatherall MW, Sodergren MH. UK Medical Cannabis Registry: Assessment of clinical outcomes in patients with insomnia. Brain Behav. 2024 Feb;14(2):e3410. doi: 10.1002/brb3.3410. PMID: 38337193; PMCID: PMC10858318.