Sleep apnea is a type of sleep disorder characterized by pauses in breathing or instances of shallow or infrequent breathing during sleep. Each pause in breathing, called an apnea, can last for several seconds to several minutes, and may occur 5 to 30 times or more in an hour. Similarly, each abnormally shallow breathing event is called a hypopnea. Sleep apnea is classified as a dyssomnia, meaning abnormal behavior or psychological events occur during sleep. When breathing is paused, carbon dioxide builds up in the bloodstream. Chemoreceptors in the blood stream note the high carbon dioxide levels. The brain is signaled to wake the person sleeping and breathe in air. Breathing normally will restore oxygen levels and the person will fall asleep again. Sleep apnea is often diagnosed with an overnight sleep test called a polysomnogram, or “sleep study”.
There are three forms of sleep apnea: central (CSA), obstructive (OSA), and complex or mixed sleep apnea (i.e., a combination of central and obstructive) constituting 0.4%, 84% and 15% of cases respectively. In CSA, breathing is interrupted by a lack of respiratory effort; in OSA, breathing is interrupted by a physical block to airflow despite respiratory effort, and snoring is common.
Regardless of type, an individual with sleep apnea is rarely aware of having difficulty breathing, even upon awakening. Sleep apnea is recognized as a problem by others witnessing the individual during episodes or is suspected because of its effects on the body. Symptoms may be present for years (or even decades) without identification, during which time the sufferer may become conditioned to the daytime sleepiness and fatigue associated with significant levels of sleep disturbance.
Medical Marijuana Efficacy
A limited number of preclinical studies assess the role of cannabinoids on sleep-related apnea.
Writing in the June 2002 issue of the journal of the American Academy of Sleep Medicine, researchers at the University of Illinois (at Chicago) Department of Medicine reported “potent suppression” of sleep-related apnea in rats administered either exogenous or endogenous cannabinoids.
Investigators reported that doses of delta-9-THC and the endocannabinoid oleamide each stabilized respiration during sleep and blocked serotonin-induced exacerbation of sleep apnea in a statistically significant manner. A more recent animal trial also reported that injected doses of synthetic THC mitigates apnea and augments upper airway muscles in rats.
In a clinical trial setting, the administration of synthetic THC/Marinol has similarly been shown mitigate apnea in adults. Writing in the journal Frontiers in Psychiatry in 2013, investigators concluded that THC administration significantly mitigated symptoms of the disorder in patients with Obstructive Sleep Apnea over a three-week period. “Dronabinol treatment may be a viable alternative or adjunctive therapy in selected patients with OSA,” authors concluded.
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