Dozens of clinical research studies have found that medical cannabis can help treat symptoms of chronic pain. There's also a wealth of anecdotal evidence showing that pot can help insomnia. But can weed help chronic pain patients get better sleep?
A team of Israeli researchers set out to find the answer to that question. In short, the answer is yes — but there are some caveats. The research team recruited 128 chronic pain patients from the Rambam Institute for Chronic Pain in Haifa, Israel. Out of these participants, 66 were using medical cannabis, while 62 were not. For the medical marijuana group, the researchers only accepted subjects who used cannabis for at least one year prior to the start of the study.
All of the subjects were age 50 or older, but researchers discovered that patients who chose not to use cannabis tended to be slightly older on average than those who used pot. Researchers also noted that 58 percent of the non-cannabis group were male, versus only 40 percent of the medical marijuana group. The two groups had similar pain levels, education levels, medication use, and patterns of alcohol and cigarette use.
During the study, the participants were asked to rate their responses to three insomnia-related questions on a 7-point Likert scale. These questions asked patients how often they woke up during the night, how often they woke up early and were unable to fall back asleep, and how often they had problems trying to fall asleep. The researchers then made adjustments for age, sex, pain level, and use of traditional sleep medications.
Overall, 27.2 percent of the study group reported always waking up at night, 24.1 percent said they always woke up early and couldn't fall back asleep, and 20.2 percent said they always had trouble falling asleep. But when comparing the two groups, researchers found that medical marijuana users were less likely to wake up in the middle of the night. For the other two categories, there was no difference between the groups.
However, the study also reports that medical cannabis users who reported frequent use actually had more problems falling asleep or woke up more during the night than non-users. The researchers theorize that this increased insomnia could be due to patients developing tolerance to the sleep-aid characteristics of cannabis.
The study also investigated how frequently patients consumed medical cannabis, and how much they used. Overall consumption varied, but the medical marijuana group used pot for around four years, and consumed 31 grams a month on average. Researchers also analyzed the medical marijuana users' preferred products, and found an average THC-level of 15.6 percent and an average CBD level of 2.84 percent.
“This study is among the first to test the link between whole plant MC [medical cannabis] use and sleep quality,” the researchers conclude. “In our sample of older (50+ years) chronic pain patients we found that MC may be related to fewer awakenings at night. Yet, patients may also develop a tolerance to the sleep-aid characteristics of MC. These findings may have large public health impacts considering the aging of the population, the relatively high prevalence of sleep problems in this population along with increasing use of MC.”
The researchers also note the limitations of their study, including the limited size and diversity of the subjects and the fact that they had no control over the timing, dosage, or strain of medical cannabis that the subjects used. The study recommends that further research be conducted using randomized control trials on human or animal subjects to more fully explore the efficacy of cannabis on insomnia.