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Original research
Medical cannabis and insomnia in older adults with chronic pain: a cross-sectional study
  1. Sharon R Sznitman1,
  2. Simon Vulfsons2,3,
  3. David Meiri4 and
  4. Galit Weinstein1
  1. 1 School of Public Health, University of Haifa Faculty of Social Welfare and Health Sciences, Haifa, Israel
  2. 2 Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel
  3. 3 Institute of Pain Medicine, Rambam Health Care Campus, Haifa, Israel
  4. 4 Department of Biology, Technion Israel Institute of Technology, Haifa, Israel
  1. Correspondence to Dr Sharon R Sznitman, School of Public Health, University of Haifa Faculty of Social Welfare and Health Sciences, Haifa 3498838, Israel; sznitmans{at}gmail.com

Abstract

Objectives Medical cannabis (MC) is increasingly being used for treatment of chronic pain symptoms. Among patients there is also a growing preference for the use of MC to manage sleep problems. The aim of the current study was to examine the associations between use of whole plant cannabis and sleep problems among chronic pain patients.

Methods A total of 128 individuals with chronic pain over the age of 50 years were recruited from the Rambam Institute for Pain Medicine in Haifa, Israel. Of them, 66 were MC users and 62 were non-users. Regression models tested the differences in sleep problems between the two groups. Furthermore, Pearson correlations between MC use measures (dose, length and frequency of use, number of strains used, tetrahydrocannabinol/cannabidiol levels) and sleep problems were assessed among MC users.

Results After adjustment for age, sex, pain level and use of sleep and anti-depressant medications, MC use was associated with less problems with waking up at night compared with non-MC use. No group differences were found for problems with falling asleep or waking up early without managing to fall back asleep. Frequent MC use was associated with more problems waking up at night and falling asleep.

Conclusions MC use may have an overall positive effect on maintaining sleep throughout the night in chronic pain patients. At the same time, tolerance towards potential sleep-inducing properties of MC may occur with frequent use. More research based on randomised control trials and other longitudinal designs is warranted.

  • medical cannabis
  • chronic pain
  • sleep
  • insomnia

https://doi.org/10.1136/bmjspcare-2019-001938

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    Footnotes

    • Contributors SS participated in the conceptualisation and design of the study as well as the analysis and interpretation of data. SS has led the drafting of the article and approved the final version. GW has participated in the conceptualisation and design of the study as well as the analysis and interpretation of data. GW lead the drafting of the article and approved the final version. SV has substantially contributed to the acquisition of data and drafting the paper. SV has seen and approved the final version. DM has substantially contributed to the acquisition of data and drafting the paper. DM has seen and approved the final version.

    • Funding This study was partly funded by a research collaboration grant provided by the University of Haifa and Rambam Hospital. There is no specific grant number for the funding mechanism. Additionally, David Meiri received grant funding from the Evelyn Lipper Foundation, grant nr: 2027093. The funding agencies were not involved in the design, analyses or interpretation of results.

    • Competing interests None declared.

    • Patient consent for publication On agreement to participate, the patients gave oral consent and a time was scheduled to conduct a phone or face-to-face interview.

    • Ethics approval The study protocol was approved by the institutional ethics committee.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement No data are available.