Sleep and Medicinal Cannabis

May 18, 2011

Recently, there has been renewed sci­en­tific inter­est in exam­in­ing the med­ical effi­cacy of cannabis in spe­cific patient pop­u­la­tions. For, exam­ple, both the Insti­tute of Med­i­cine and the NIH recently reported med­i­c­i­nal cannabis might be use­ful in the treat­ment of pain in HIV+ patients. HIV+ patients expe­ri­ence a num­ber of clin­i­cal seque­lae to the infec­tion, even when they are oth­er­wise con­sid­ered clin­i­cally “asymp­to­matic.” Per­haps one of the ear­li­est seque­lae is sleep abnor­mal­ity. It is esti­mated that 73% to 90% of HIV+ patients expe­ri­ence sig­nif­i­cantly dis­rupted sleep and sleep qual­ity has been shown to pre­dict long-term out­come in HIV+ patients. This study exam­ines the effects of day­time med­i­c­i­nal cannabis admin­is­tra­tion on sub­se­quent noc­tur­nal sub­jec­tive and objec­tive mea­sures of sleep in patients with HIV-associated DSPN. We will recruit 15 patients who are enrolled in a study cur­rently funded by the CMCR (PI: Dr. Ellis; Award # C00-SD-104). Dr. Ellis’ study exam­ines the effi­cacy of med­i­c­i­nal cannabis vs. placebo in treat­ing pain in patients with HIV-associated DSPN. Here, sub­jec­tive sleep will be mea­sured for three 1-week peri­ods: a wash-in week, a week of cannabis admin­is­tra­tion, and a week of placebo admin­is­tra­tion. Objec­tive sleep will be stud­ied for two con­sec­u­tive nights under both cannabis admin­is­tra­tion and placebo con­di­tions. We hypoth­e­size that, com­pared to placebo, cannabis will increase slow wave sleep and sleep effi­ciency and decrease REM sleep. Sub­jec­tively, patients will report increased global sleep qual­ity, decreased sleep latency, and increased total sleep time with cannabis admin­is­tra­tion. If these hypothe­ses are borne out, it will pro­vide evi­dence that cannabis has pos­i­tive med­i­c­i­nal qual­i­ties beyond those for­mally sug­gested. Improved sleep may directly affect prog­no­sis in these patients and may have sev­eral indi­rect ben­e­fits as well. Regard­less, this study should pro­vide pilot data for sub­se­quent grant appli­ca­tions focus­ing on the direct effects of med­i­c­i­nal cannabis on sleep in patient populations.


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