The American Academy of Sleep Medicine (AASM) recently published a position statement regarding medical cannabis and the treatment of obstructive sleep apnoea (OSA).
The AASM is a United States professional society for the medical subspecialty of sleep medicine, which was established in 1975. As a leading voice in the sleep field, the AASM sets standards and promotes excellence in sleep medicine health care, education, and research.
The effects of medical cannabis on sleep vary depending on acute versus chronic use, withdrawal after chronic use, the type of cannabinoids and the types of synthetic extracts1. Research on the effects of medical cannabis and synthetic extracts in patients with OSA is extremely limited though, particularly long-term use of these products. As such, further research is required prior to endorsement as a treatment for OSA. Full abstract of Medical cannabis and the treatment of obstructive sleep apnea: an American Academy of Sleep Medicine position statement can be found below, however in short;
It is the position of the AASM:
- That medical cannabis and/or its synthetic extracts should not be used for the treatment of OSA due to unreliable delivery methods and insufficient evidence of treatment effectiveness, tolerability, and safety, and OSA should be excluded from the list of chronic medical conditions for state medical cannabis programs.
- That patients with OSA should be advised to discuss their treatment options with a licensed medical provider at an accredited sleep facility.
The Australasian Sleep Association (ASA) is the AUS/NZ equivalent to AASM, however is yet to release its own positional statement regarding use of medical cannabis for the treatment of OSA under Australian standards and regulations.
Abstract
The diagnosis and effective treatment of obstructive sleep apnea (OSA) in adults is an urgent health priority. Positive airway pressure (PAP) therapy remains the most effective treatment for OSA, although other treatment options continue to be explored. Limited evidence citing small pilot or proof of concept studies suggest that the synthetic medical cannabis extract dronabinol may improve respiratory stability and provide benefit to treat OSA. However, side effects such as somnolence related to treatment were reported in most patients, and the long-term effects on other sleep quality measures, tolerability, and safety are still unknown. Dronabinol is not approved by the United States Food and Drug Administration (FDA) for treatment of OSA, and medical cannabis and synthetic extracts other than dronabinol have not been studied in patients with OSA. The composition of cannabinoids within medical cannabis varies significantly and is not regulated. Synthetic medical cannabis may have differential effects, with variable efficacy and side effects in the treatment of OSA. Therefore, it is the position of the American Academy of Sleep Medicine (AASM) that medical cannabis and/or its synthetic extracts should not be used for the treatment of OSA due to unreliable delivery methods and insufficient evidence of effectiveness, tolerability, and safety. OSA should be excluded from the list of chronic medical conditions for state medical cannabis programs, and patients with OSA should discuss their treatment options with a licensed medical provider at an accredited sleep facility. Further research is needed to understand the functionality of medical cannabis extracts before recommending them as a treatment for OSA.
Reference
- Ramar K, Rosen IM, Kirsch DB, Chervin RD, Carden KA, Aurora RN, Kristo DA, Malhotra RK, Martin JL, Olson EJ, Rosen CL, Rowley JA; American Academy of Sleep Medicine Board of Directors. Medical cannabis and the treatment of obstructive sleep apnea: an American Academy of Sleep Medicine position statement. J Clin Sleep Med. 2018;14(4):679–681.
