Sleep disorders and plant-based therapy

With more than one in five Australians estimated to live with a major sleep disorder, research and interest in plant-based therapies¹ as a treatment for sleep disorders is increasing.

In addition to an individual’s wellbeing, sleep disorders affect the broader community impacting productivity, alertness and safety. A world-first 2018 parliamentary inquiry into sleep health awareness in Australia² found that poor sleep quality, a sleep disorder or interrupted sleep result in negative long-term health implications.

Besides exhaustion, fatigue and sleepiness, sleep disorders contribute to health conditions like diabetes, obesity, mental health and cardiovascular disease, which can further compound sleep health.

Common sleep disorders

A sleep disorder is more than just a bad night’s sleep. A sleep disorder³ is characterised by persistent problems in falling asleep, being able to stay asleep or getting a restful sleep.

Environmental, physical and mental factors can all contribute to inadequate sleep. According to Sleep Disorders Australia⁴, some common sleep disorders include (but are not limited to) obstructive sleep apnoea (OSA), restless legs syndrome (RLS), insomnia, narcolepsy, idiopathic hypersomnia and circadian rhythm disorder.

The cost of sleep disorders

As part of the government’s inquiry into sleep health, the Royal Australasian College of Physicians (RACP) submission⁵ found that sleep disorders result in a number of negative outcomes. These include increased morbidity and mortality and “small but measurable increases in risk of heart attacks, stroke, hypertension, obesity, diabetes, [and] depression”.

Over and above the individual’s health cost of suboptimal sleep, sleep disorders heavily impact the Australian economy. The total cost of sleep disorders for 2019–2020 was estimated at $51 billion⁶.

Diagnosing a sleep disorder

The upside is that, once correctly diagnosed, a doctor can usually treat a sleep disorder. Diagnosis may include a conversation, an overnight sleep study at home or, depending on the severity, an evaluation in a sleep laboratory.

While each sleep disorder has a unique set of symptoms, some general signs of sleep disorders⁷ include:

• Excessive daytime sleepiness or fatigue
• Irregular breathing during sleep
• Increased movement during sleep
• Irregular sleep and wake cycle
• Difficulty falling asleep
   

Other signs of sleep disorders include:

• Irritability
• Depression
• Weight gain
• Snoring
• Decreased productivity at work or at school
• Lack of focus, concentration and daytime functioning

Sleep disorders and the endocannabinoid system

The body’s internal balance, including sleep regulation, is controlled by the endocannabinoid system (ECS). Endocannabinoids occur naturally in our bodies. Phytocannabinoids are found in plants and can mimic the action of endocannabinoids. The body recognises phytocannabinoids as endocannabinoids⁸.

A 2020 study titled ‘Cannabinoids, Endocannabinoids and Sleep’⁹ acknowledges the increased use of phytocannabinoids as sleep aids and found that “endocannabinoids play a prominent role in sleep and sleep neurophysiology, and cannabinoid drugs alter these processes”.

This study also noted that even though there’s been renewed research into cannabis and sleep, there is a continued need for clinical research into the cannabinoid/sleep relationship.

Australian-based Cannatrek¹⁰ supports the call for research. “The medicinal cannabis industry needs data,” said Tommy Huppert, CEO of Cannatrek — one of Australia’s first companies to hold a federally approved medicinal cannabis license to develop, cultivate, manufacture and research plant-based therapies¹¹. “Any way we can assist the gathering of data is important and helpful. We can support doctors and help them to find appropriate doses and strains for different patients and different medical conditions.”

Traditional treatments for sleep disorders

Traditional treatments for sleep disorders include medication for underlying health conditions, over-the-counter and pharmaceutical sleeping pills, natural melatonin supplements, an assistive breathing device (for sleep apnoea), a dental guard (for teeth grinding), diet, exercise and lifestyle adjustments.

Plant-based therapies for sleep disorders

For centuries, plant-based therapies¹² have been used to treat various conditions, including the use of cannabis to promote sleep. In recent years, the Australian Government has approved the use of doctor-prescribed medicinal cannabis for qualifying patients within the TGA regulated framework. Because medicinal cannabis is not without side effects, eligible patients are encouraged to visit the TGA website¹³ to seek out more information.

Research continues into the use of plant-based therapies for various conditions, including sleep disorders. A 2020 study conducted by The University of Western Australia¹⁴ found that “medicinal cannabis can be used as a novel treatment for adults suffering from chronic insomnia”. Additional trials and research¹⁵ are ongoing into the use of plant therapies for sleep disorders in Australia and globally.

References

1. Cannatrek. https://cannatrek.com/
2. Parliament of Australia Sleep Health Awareness Report (2018). https://www.aph.gov.au/Parliamentary_Business/Committees/House/Health_Aged_Care_and_Sport/SleepHealthAwareness/Report/section?id=committees%2Freportrep%2F024220%2F26954#footnote61target
3. Health Direct Sleep Disorders (2020, August). https://www.healthdirect.gov.au/sleep-disorders
4. Sleep Disorders Australia. https://www.sleepoz.org.au/
5. RACP Submission to Parliamentary Inquiry into Sleep Health Awareness in Australia (2018, November). https://www.racp.edu.au/docs/default-source/advocacy-library/racp-submission-to-parliamentary-inquiry-into-sleep-health-awareness-in-australia.pdf
6. Deloitte Access Economics Sleep Health Foundation Report (2021, April). https://www.sleephealthfoundation.org.au/files/Special_reports/Social_Economic_Cost_of_sleep_disorders_20042021.pdf
7. Mayo Clinic Sleep Disorders (2019, August 10). https://www.mayoclinic.org/diseases-conditions/sleep-disorders/symptoms-causes/syc-20354018
8. Journal of Young Investigators (2018, June 1). https://www.jyi.org/2018-june/2018/6/1/the-endocannabinoid-system-our-universal-regulator
9. NCBI: Cannabinoids, Endocannabinoids and Sleep (2020, July 22). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7388834/
10. Cannatrek. https://access.cannatrek.com/
11. Cannatrek. https://cannatrek.com/news-media/cannatrek-and-ryah-medtech-inc-to-provide-australian-patients-with-dose-measuring-inhalers-and-cartridges/
12. NCBI: Observations on the medicinal properties of the Cannabis Sativa of India (1843, May 9). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2116906/?page=1
13. TGA Medicinal Cannabis Information. https://www.tga.gov.au/medicinal-cannabis-information-consumers
14. The University of Western Australia (2020, April 7). https://www.news.uwa.edu.au/archive/2020040711981/research/cannabis-proven-help-insomniacs-sleep/
15. Australian New Zealand Clinical Trials Registry. https://anzctr.org.au/trial/registration/trialreview.aspx?id=379003&isreview=true

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