Acute Effects of Oral Cannabinoids on Sleep and High-Density EEG in Insomnia: A Pilot Randomised Controlled Trial
Anastasia Suraev 1 2 3 4, Iain S McGregor 2 3 4, Danielle McCartney 2 3 4, Nathaniel S Marshall 1 5, Chien-Hui Kao 1, Rick Wassing 1 6 7, Angela L D'Rozario 1 6, Keith K H Wong 1 8 9, Brendon J Yee 1 8 9, Sheila Sivam 1 8 9, Richard C Kevin 2 10 11, Ryan Vandrey 12, Christopher Irwin 13, Christopher J Gordon 1 5, Delwyn Bartlett 6, Jonathon C Arnold 2 4 14, Ronald R Grunstein 1 9, Camilla M Hoyos 1 5
- 1Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia.
- 2University of Sydney, Lambert Initiative for Cannabinoid Therapeutics, Sydney, New South Wales, Australia.
- 3University of Sydney, Faculty of Science, School of Psychology, Sydney, New South Wales, Australia.
- 4University of Sydney, Brain and Mind Centre, Sydney, New South Wales, Australia.
- 5Macquarie University, Faculty of Medicine, Health and Human Sciences, Department of Health Science, Sydney, New South Wales, Australia.
- 6Macquarie University, Faculty of Medicine, Health and Human Sciences, School of Psychological Sciences, Sydney, New South Wales, Australia.
- 7Sydney Local Health District, Sydney, New South Wales, Australia.
- 8University of Sydney, Faculty of Medicine and Health, Sydney, New South Wales, Australia.
- 9Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
- 10St Vincent’s Hospital Sydney, Sydney, New South Wales, Australia.
- 11Faculty of Medicine, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia.
- 12Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, Baltimore, Maryland, USA.
- 13Griffith University, School of Health Sciences and Social Work, Gold Coast, QLD, Australia.
- 14University of Sydney, Faculty of Medicine and Health, Sydney Pharmacy School, Sydney, New South Wales, Australia.
Affiliationer
Cannabinoids, particularly Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD), have gained popularity as alternative sleep aids; however, their effects on sleep architecture and next-day function remain poorly understood. Here, in a pilot trial, we examined the effects of a single oral dose containing 10 mg THC and 200 mg CBD (THC/CBD) on objective sleep outcomes and next-day alertness using 256-channel high-density EEG in 20 patients with DSM-5 diagnosed insomnia disorder (16 female; mean (SD) age, 46.1 (8.6) years). We showed that THC/CBD decreased total sleep time (-24.5 min, p = 0.05, d = -0.5) with no change in wake after sleep onset (+10.7 min, p > 0.05) compared to placebo. THC/CBD also significantly decreased time spent in REM sleep (-33.9 min, p < 0.001, d = -1.5) and increased latency to REM sleep (+65.6 min, p = 0.008, d = 0.7). High-density EEG analysis revealed regional decreases in gamma activity during N2 sleep, and in delta activity during N3 sleep, and a regional increase in beta and alpha activity during REM sleep. While there was no observed change in next-day objective alertness, a small but significant increase in self-reported sleepiness was noted with THC/CBD (+0.42 points, p = 0.02, d = 0.22). No changes in subjective sleep quality, cognitive performance, or simulated driving performance were observed. These findings suggest that a single dose of cannabinoids, particularly THC, may acutely influence sleep, primarily by suppressing REM sleep, without noticeable next-day impairment (≥ 9 h post-treatment).
