Cost of Medical Cannabis in Australia

Medicinal Cannabis and Insomnia

Cases of anxiety are increasing across Australia. Here, Tetra Health explains how medicinal cannabis can treat anxiety.

Struggling to get to sleep, waking up in the middle of the night or anxiously watching the clock are all common features of insomnia – an inability to initiate or maintain sleep, or a lack of refreshing sleep. An estimated 30% of the population experience disrupted sleep, and 10% have associated symptoms of daytime impairment[1]. Although insomnia is the most common sleep complaint, it is only rarely a primary condition, but more commonly a symptom of something else.

What are the Causes of Insomnia?

Psychological concerns, including stress, anxiety, and depression, are the root cause of more than half of all cases of insomnia. Other contributing factors can include medications, medical conditions, and organic disorders such as sleep apnoea or episodic movement disorders[2]. Importantly, however, insomnia can occur in anyone, including healthy people. The current unprecedented global climate can trigger insomnia even in those who were previously good sleepers. Essential workers experiencing pandemic related trauma, and those working extended hours are at high risk of stress-related insomnia. For most of us, short-term insomnia will improve when the stress trigger is resolved. For some, however, insomnia can become chronic, generally if the duration is greater than 3 months.

Medicinal Cannabis For Insomnia

If the above first-line treatments are not tolerated, effective or suitable, some patients may consider cannabis for insomnia, prescribed by and under the supervision of their medical practitioner. The cannabis plant contains hundreds of active compounds, including the primary phytocannabinoids THC and CBD, minor phytocannabinoids, terpenoids, flavonoids and carotenoids.

Scientific research has identified THC as the major player in promoting sleep and restfulness. Multiple unique actions, including direct interaction with receptors in the brain, and potentiation of the body’s own natural sleep-enhancing compounds, contribute to its therapeutic effects. However, THC can cause anxiety and agitation in some people. Another primary cannabinoid, CBD, has been shown in some studies to counter the incidence of these adverse effects by creating a synergistic effect when taken together with THC. In addition to these major cannabinoids, other components of the cannabis plant, including minor cannabinoids such as CBN, and terpenes like linalool, all have proposed sedative and relaxing effects. This balanced action of multiple components of cannabis has been termed “the entourage effect” and suggests that a full-spectrum whole plant extract may be therapeutically superior to isolated compounds[3].

Clinical research has shown that cannabis can improve insomnia, restfulness, and sleep quality. Generally, medicinal cannabis is well tolerated, and unlike typical hypnotic drugs, does not create tolerance, dependence, and is not toxic at therapeutic doses. CBD can interact with some medications, and a thorough medication history should always be taken when considering any cannabis treatment.

Medicinal Cannabis in Australia

Medicinal cannabis is available as a treatment option to eligible patients in Australia and can be prescribed where appropriate under the guidance of a medical practitioner.

If you are experiencing insomnia, or symptoms of anxiety, speak with your doctor and seek support. More tips and advice are available free online from BeyondBlue, Headspace, Head to Health and the Sleep Health Foundation.

[1] Therapeutic Guidelines. eTG complete [digital]. Melbourne: Therapeutic Guidelines Limited; 2019 Jun. Sourced at: tg.org.au, May 2020

[2] National Institutes of Health State of the Science Conference statement on manifestations and management of chronic insomnia in adults, June 13–15, 2005. Sleep. 2005;28(9):1049–57

[3] Siebern A, et al. Non-pharmacological treatment of insomnia. Neurotherapeutics. 2012;9(4):717–27

[4] Schutte-Rodin S, et al. Clinical guideline for the evaluation and management of chronic insomnia in adults. J Clin Sleep Med. 2008;4(5):487–504

[5] National Institute for Clinical Excellence (NICE). Guidance on the use of zaleplon, zolpidem and zopiclone for the short-term management of insomnia (TA77). London: NICE; 2004

[6] Russo E. The case for the entourage effect and conventional breeding of clinical cannabis: no ‘strain’, no gain. Front. Plant Sci 2019(9): 1969

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