Medical Cannabis and the Treatment of Obstructive Sleep Apnea: An American Academy of Sleep Medicine Position Statement

Abstract

The diagnosis and effective treatment of obstructive sleep apnea (OSA) in adults is an urgent health priority. Positive airway pressure (PAP) therapy remains the most effective treatment for OSA, although other treatment options continue to be explored. Limited evidence citing small pilot or proof of concept studies suggest that the synthetic medical cannabis extract dronabinol may improve respiratory stability and provide benefit to treat OSA. However, side effects such as somnolence related to treatment were reported in most patients, and the long-term effects on other sleep quality measures, tolerability, and safety are still unknown. Dronabinol is not approved by the United States Food and Drug Administration (FDA) for treatment of OSA, and medical cannabis and synthetic extracts other than dronabinol have not been studied in patients with OSA. The composition of cannabinoids within medical cannabis varies significantly and is not regulated. Synthetic medical cannabis may have differential effects, with variable efficacy and side effects in the treatment of OSA. Therefore, it is the position of the American Academy of Sleep Medicine (AASM) that medical cannabis and/or its synthetic extracts should not be used for the treatment of OSA due to unreliable delivery methods and insufficient evidence of effectiveness, tolerability, and safety. OSA should be excluded from the list of chronic medical conditions for state medical cannabis programs, and patients with OSA should discuss their treatment options with a licensed medical provider at an accredited sleep facility. Further research is needed to understand the functionality of medical cannabis extracts before recommending them as a treatment for OSA.

“Recognition and Diagnosis of Obstructive Sleep Apnea in Older Americans”

“…For example, the incidence of endstage renal disease peaks at approximately age 80 to 85 and is higher in men 5 , and approximately 53% of persons with Stage 5 chronic kidney disease had anemia. 6 Also, malnutrition in older persons is common 7 and may be related to pathogenesis of chronic conditions such as inflammatory bowel disease 8 or directly related to anemia 2 .…”

“…They cited unreliable delivery methods and insufficient evidence of safety, effectiveness, and tolerability. 7 Braley and colleagues' 1 article was the first step in addressing knowledge and practice gaps regarding OSA risk and evaluation in older adults, but as awareness of the prevalence of OSA increases, it is important to recognize the important role that medications have in exacerbating this potentially fatal condition. To the Editor: The prevalence of anemia is known to increase with age and is associated with negative health outcomes, including greater risk of hospitalizations and greater mortality.…”

Hemp and Its Use in Health

“…Nabilon ve dronabinol ile yapılan kısa süreli tedavilerin obstrüktif uyku apnesinde yararlı olabileceği ile ilgili çalışmalar bulunmaktadır [100,101]. Nabilonun aynı zamanda post-travmatik stres bozukluğuna bağlı kabusları azalttığı ve kronik ağrısı olan hastalarda uyku kalitesini artırdığı yapılan çalışmalarla kanıtlanmıştır [102].…”

Medical Cannabis for the Primary Care Physician

“…40 Despite this, though, the American Academy of Sleep Medicine has advised that further research is needed prior to recommending cannabis for the management of obstructive sleep apnea. 41…”