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Cancer Patients Get Sleep Benefits From Medical Cannabis, Finds Study

By Alexander Beadle

Published: Apr 22, 2021   
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Cancer patients are turning to medical cannabis to tackle persistent sleeping problems. In a new study, many such patients reported significant improvements in sleep disruptions and a decreased use of other medication for insomnia.

Published as a brief report in the Journal of Psychosocial Oncology, researchers from the Dana-Farber Cancer Institute and Harvard Medical School detail the result of interviews with cancer patients who report using cannabis medicinally. They found that the majority used medical cannabis to improve sleep with great effect with no undesirable effects.

Given the prevalence of sleeping problems in cancer patients – continuing for many even once in remission – and the apparent prevalence of patients using cannabis medicinally, the researchers encourage clinicians to learn more about the medical and recreational cannabis use laws in their area, and to create an environment where patients would feel comfortable speaking to them about their possible cannabis use.

Cannabis, cancer, and sleep

Even prior to beginning cancer treatments such as chemotherapy, as many as one-in-eight cancer patients report experiencing significant sleep problems. After initiating treatment, this can rise to up to 87 percent of patients.

While cancer patients can use other sleep aids, a cancer diagnosis is recognized as a qualifying condition for medical cannabis use under almost all state laws. As a result, the drug is increasingly being used by cancer patients to manage the side effects of treatment, including disturbed sleep and insomnia. In states with legal recreational cannabis, cancer patients can also buy commercial products to experiment with self-medicating before officially registering as a medical cannabis patient.

“Poor sleep is common among cancer patients. Some are choosing medical cannabis to treat their poor sleep and it appears that this has beneficial effects for their ability to fall asleep and to stay asleep,” lead author Eric Zhou, an assistant professor at Harvard Medical School and a staff psychologist at the Dana-Farber Cancer Institute, told Analytical Cannabis.

“The use of prescription medication sleep aids are associated with a side effect profile that may not be desirable for some patients,” Zhou explained. “After discussion with their medical providers, some patients may feel that medical cannabis is preferred.”

Patients tell of good effectiveness with no side effects

The newly published brief report comes out of a larger study, aimed more broadly at understanding the experiences of cancer patients using medical cannabis.

A total of 24 participants were enrolled in the study, all from regions where medical cannabis was legal and readily available through state-sanctioned dispensaries. All participants were actively using cannabis medicinally and the participants group included a range of cancer types and stages, including some who were in remission. The participants took part in a semi-structured interview with the researchers, which were recorded, transcribed, de-identified, and analyzed.

The experiences reported by the patients were positive, with many endorsing cannabis use as being responsible for resolving difficulties with insomnia and with staying asleep through the night. Most participants also initially volunteered poor sleep as a reason for using medical cannabis without any prompting from the interviewing researcher.

Remarkably, not a single patient felt that their cannabis use had been ineffective at addressing their sleep problems and zero side-effects were reported. Furthermore, no patients believed that their improved sleep was due to the cannabis improving other symptoms (pain, for example) which would then have a knock-on effect on sleep quality. Instead, the opposite was often reported – where cannabis use improved sleep, this better sleep led to reductions in anxiety and a more positive emotional outlook.

“In some cases, the use of medical cannabis [also] reduced the use of prescription medication sleep aids,” Zhou added.

There were also severely commonly shared beliefs among patients using cannabis for sleep, including a preference for indica strains over sativa strains. They also reported a tendency to avoid high doses in case it brought about drowsiness before their desired bedtime. For similar reasons, the participants also frequently reported self-experimenting with their dosage and administration time.

The researchers do note limitations on this research arising from a relatively small sample of patients who were already interested in participating in research. Additionally, as the interviews considered here were done with cancer patients, the findings are not generalizable to other patient groups who are able to access medical cannabis. Still, the researchers believe the findings represent a compelling need to conduct more formal studies concerning the effectiveness and prevalence of cannabis use among cancer patients for sleep.

“It is likely that oncology clinicians are currently treating patients who are consumers of medical cannabis, though it may not be something that they have discussed during their appointments,” Zhou said. “Clinicians are encouraged to learn more about the benefits and drawbacks of using medical cannabis to manage symptoms commonly associated with cancer treatment, and to encourage an open environment so that patients feel comfortable discussing any possible use of medical cannabis.”

Cannabis as a long-term sleep aid

To date, published literature on the effectiveness of cannabis to treat sleep problems has had mixed conclusions. While patients and recreational users often report good experiences using cannabis for sleep in surveys, other work has suggested that the long-term use of cannabis for this purpose might become ineffective as users build up a tolerance to the drug.

In a study of 128 individuals with chronic pain, researchers found that medical cannabis use was generally associated with less waking during the night as compared to non-users.

But while this study did show medical cannabis to have an overall positive effect on sleep, the researchers also noted that frequent medical cannabis use over the course of many years appeared to be associated with more trouble waking up in the night and more problems falling asleep.

Just like the authors of this new brief report, the scientists behind the chronic pain study believe that more research is needed to conclusively determine the effectiveness in cannabis treatment for sleeping problems. For example, while longer-term use appeared to result in tolerance in their study, the chronic pain researchers also say that there is the possibility that the more frequent cannabis users may have been suffering from greater levels of pain and that this could have been the underlying cause of the additional sleep problems.

While observational studies that rely on patient self-reporting can be helpful in terms of evaluating patient experience, more clinical study is needed to determine whether cannabis directly benefits sleep or instead addresses other health problems that can contribute to disturbed sleep. Likewise, the effects of cannabis tolerance on sleep are worthy of investigation, especially for cancer patients whose sleeping problems may continue post-treatment.


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