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Insomnia, the inability to fall or stay asleep, affects approximately\n30% of adults in the\nU.S.\nNinety-five percent of insomnia sufferers take a pharmacologic sleep\naid, such as hypnotics and antidepressants, which can produce various\nside effects, from dizziness to irregular heartbeats, addiction and\npotential overdose.

\n

As an alternative, medical marijuana eases the symptoms of insomnia\nthrough its compound delta-9-tetrahydrocannabinol (THC). THC acts on the\ncentral nervous system, and at the right dosage, it produces a sedating\neffect. Cannabidiol (CBD),\nanother major component, triggers vascular or smooth muscle\nrelaxation\nand reduces\nanxiety at the\nsame time.

\n

Cannabis has also demonstrated promising results in sleep apnea, one of\nthe common causes of sleep disturbance. Sleep apnea, a disorder\ncharacterized by repeated pauses in breathing or shallow breaths during\nsleep, is often due to a collapsed airway. Classified as obstructive\nsleep apnea (OSA), it leads to an insufficient supply of oxygen to the\nbrain. A 2013\nstudy\nconducted by the University of Illinois in Chicago found that\ndronabinol, the synthetic form of cannabinoid, significantly reduced\nApnea Hypopnea Index (AHI) by 32% in adults with moderate to severe OSA.\nAHI refers to the number of apnea episodes per hour, with 15 to 30\nepisodes considered moderate, and more than 30 as severe. The 17\nsubjects, aged 21 to 65, exhibited no serious adverse effects throughout\nthe dose escalation intervention that lasted 21 days.

\n

Dronabinol\nis FDA-approved for the treatment of chemotherapy side effects, such as\nnausea and vomiting. Its muscle-toning action on the upper airway is\nsimilar to that induced by the Continuous Positive Airway Pressure\n(CPAP) machine used in the treatment of OSA. Dronabinol is a viable\noption for patients who cannot tolerate long-term usage of the mask. The\nPACE\nClinical Trial, a larger study funded by the National Institutes of\nHealth, is also underway to determine dronabinol's efficacy and safety\nin OSA, and the biomechanisms involved.

\n

Insomnia and other sleep disorders are prevalent in cases of\nfibromyalgia,\na syndrome that presents chronic muscle and soft tissue pain,\ntenderness, and fatigue, affecting 5 million adults in America. A\nrandomized, controlled\ntrial demonstrated that\nnabilone, another FDA-approved cannabinoid for cancer-related nausea, is\neffective in enhancing sleep in patients with fibromyalgia. As\nresearchers at McGill University Health Centre in Canada noted, although\nnabilone and the antidepressant amitriptyline improved sleep, nabilone\nhad a greater effect on the Insomnia Severity Index. Since it was well\ntolerated by the 32 subjects, the authors recommended that low-dose\nnabilone be considered as a treatment alternative.

\n

Between 54% to 63% of Americans who experience chronic and acute pain\nreport experiencing sleep disturbances, the National Sleep Foundation\nrevealed in the 2015 Sleep in America\nPoll.\nPain management is therefore crucial to restoring better quality sleep.\nSeveral studies\nhave already confirmed the analgesic effect of marijuana in chronic pain\nassociated with neuropathy (peripheral nerve dysfunction) and spasticity\n(muscle control disorder), conditions that manifest in a host of\ndiseases, like cardiovascular, diabetes, and HIV. As science reveals,\nmedical marijuana does have a role in pain and sleep management.

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