The American Academy of Sleep Medicine warned against the use of medical cannabis in the treatment of sleep apnea. The AASM said in a position statement that sleep apnea should not be included in the list of medical conditions for state cannabis programs.
The AASM position statement was published in the Journal of Clinical Sleep Medicine’s April 15 issue.
What is sleep apnea?
Sleep apnea is a potentially serious sleep disorder wherein a person’s breathing is interrupted – or repeatedly stops and starts – during sleep. Because of this interrupted breathing, the brain and the other organs may not get enough oxygen.
Common warning signs of sleep apnea include snoring and excessive sleepiness during the day. Early animal studies had shown that synthetic cannabis extract dronabinol helps improve respiratory stability.
There are different types of sleep apnea. There’s obstructive sleep apnea, which is the more common form and which occurs when one’s throat muscles relax. Then there’s central sleep apnea, which takes place when the brain does not send proper signals to the muscles in charge of breathing. The other type is complex sleep apnea syndrome, which is also called treatment-emergent central sleep apnea and which takes place when the patient has both central sleep apnea and obstructive sleep apnea.
According to estimates, nearly 30 million adults in the United States have obstructive sleep apnea. There are more than 2,500 sleep facilities that are AASM-accredited across the country. Accredited treatment options for the condition include CPAP therapy, which makes use of mild levels of air pressure delivered through a mask in order to keep the throat open during sleep.
Sleep apnea as qualifying condition for medical cannabis
In November last year, the Minnesota Department of Health decided to add obstructive sleep apnea as one of the qualifying conditions for the state’s current medical cannabis program. The change is effective July 1, 2018.
As is customary, the Minnesota health department employed a formal petitioning process in soliciting public input on potential qualifying conditions. The process included gathering public comments, forming a citizen’s review panel, and preparing research summaries for the particular condition. State residents were invited to submit their petitions to add qualifying medical conditions.
This means that patients certified to be suffering from obstructive sleep apnea will be eligible to apply for the program on July 1 and have access to medical cannabis from Minnesota’s two medical cannabis manufacturers. For patients to qualify, they will first need to meet published diagnostic criteria for sleep apnea and go through a formal sleep study.
Why not include sleep apnea???
Medical cannabis, including synthetic cannabis extracts, should be avoided in the treatment of obstructive sleep apnea.
According to the AASM, sleep apnea should not be among the ceaseless restorative conditions covered under any state medical cannabis program because of inadequate confirmation of the adequacy of treatment and because of temperamental conveyance techniques.
While recent clinical studies have explored the use of dronabinol as alternative treatment for sleep apnea, the drug is still not endorsed for the treatment of the condition by the U.S. Food and Drug Administration. This is because dronabinol’s long-haul fairness and security are still not known. Moreover, there haven’t been any investigations on the viability and the security of other conveyance strategies, like vaping or liquid administration.
Additionally, using restorative cannabis for treatment has shown unpleasant effects, like daytime languor, which may cause unintended results.
Dr. Kannan Ramar, lead author and professor of medicine in pulmonary and critical care medicine at Mayo Clinic in Rochester, said that until they have further evidence of the efficacy of medical cannabis as a treatment option for sleep apnea and until the drug’s safety profile is established, sleep apnea patients should go to a licensed medical professional at an accredited sleep facility to discuss proven treatment options.