What is Insomnia?
Insomnia is the world’s most prevalent sleep disorder. An estimated 30% of adults experience short-term insomnia and over 20% develop chronic sleep disturbances. The condition is characterized by one’s difficulty to fall asleep, stay asleep, and/or inability to achieve a high-quality slumber. It interferes with daily activity and is often closely correlated to other mental health conditions.
How is it Treated?
Changing sleep habits and addressing underlying issues is the first step in management. Recognizing how our bodies react in different sleep environments is crucial in finding the solution for a good night’s rest. If these methods prove ineffective, providers may recommend cognitive behavioral therapy and medication.
Medical teams shy away from relying on long term pharmacotherapy options, but several approved treatments include Lunesta, Rozerem, Sonata, and Ambien. These are all mechanistically similar as they work on the body’s GABA receptors. This is a class of receptors in the brain that, when activated, cause a cascade of events that induce sleep. These therapies are often limited in use due to their habit-forming nature, increased risk for falls in older patients, and potential for serious drug interactions.
Nonprescription sleep medications have become increasingly popular as well. Antihistamines can make users drowsy, leading many to use this adverse effect to their advantage as sleep aid agents. Some pharmaceutical companies have even rebranded their products as OTC sleep aids. However, this is not intended for long term use, especially in the elderly population. Chronic use can lead to confusion, cognitive decline, and difficulty urinating.
What is the Role of Cannabis?
These treatment strategy downfalls are where cannabis can play a significant role. THC has been successfully used to assist in the treatment of sleep conditions due to its sedative nature and recent studies suggesting endocannabinoid signaling can help modulate sleep.
THC is the psychoactive component of cannabis and is what will be most beneficial in sleep aid. The indica strain type tends to be the most useful for insomnia-related symptoms. These strains offer a true “body high”. They are sedating/calming in nature, offering immediate muscle relaxation and help users achieve full body relaxation before bed. Sativa strains are most likely to be energizing/uplifting and might not be the best initial recommendation. However, while sativas can be stimulating at first, most THC products have some residual sedative properties, still making these candidates for those who prefer their sativa product selection.
The difficulty lies in finding the right dose. Overmedication with cannabis can produce intense psychoactivity, which makes falling asleep difficult and can interfere with normal sleep cycles. For patients new to cannabis, an oral dose of 2.5 to 7.5 mg is the best introduction. This THC dose is the most effective for anxiety or rumination due to insomnia. This can be slowly increased as tolerance develops.
CBD can be an option for patients as well. Observational reports have noted that CBD may make sleep-deprived patients heavy-eyed and assist in calming patients, allowing them to get a better night’s rest.
Choosing Products – What Formulation is Right for Me?
For immediate relief, inhaled or sublingual formulations are optimal. These formulations are ideal for sudden disruption of the sleep cycle, or for sleep onset. The onset of effects is within 15 minutes and may last 4-6 hours, depending on the patient/product.
Oral cannabis preparations are more effective in increasing the quality of rest and sleep, providing longer-lasting relief. The onset of effects is around 60-90 minutes, but lasts much longer at around 8-10 hours, again depending on the patient/product.
Choosing Products – What should I look for?
The “purple” variety of indica strains are noted to be the most effective for sleep disorders. Some variations include Grandaddy Purple, Grape Ape, and Kindu Kush/Bubba Kush. High myrcene (muscle relaxation) and linalool (stress relief) terpene content are consistently noted to be very effective as the two are sedative in nature. Caryophyllene is one to be on the lookout for as well! It is the only terpene that binds directly to cannabinoid receptors. It is thought to soothe inflammation, physical pain, and anxiety – a recipe for great sleep.
Product Recommendations from the CT Medical Program
Indicol Sublingual Spray (AGL) 350mg Indicol 5:1 THC:CBN Micro Tablets (AGL)
This convenient sublingual spray formulation by AGL offers 7mg of THC per spray. This a great recommendation for both newcomers and seasoned cannabis users struggling to fall asleep.
Indicol 5:1 THC:CBN Micro Tablets (AGL)
CBN is a well-known cannabinoid in insomnia management. When used in combination with THC, it potentiates the sedative effects of THC useful for sleep promotion. Each tablet contains about 4 mg of THC and 1 mg of CBN.
Grapeden Flower (CTPharma) 3.5g
This heavy hitting CT Pharma indica is Wedding Crasher x Grape Pie x Ice Cream Cake. This strain is reminiscent of the classic old school purple trains with some fantastic terpene content.
It is important to note that cannabis is never intended to replace therapy options, but used as an adjunct to other pharmacotherapy and behavior therapy treatments. Find out what product might be best for you and speak to a pharmacist at your local CT dispensary! Fine Fettle is more than happy to assist CT medical patients on their cannabis journey.
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