Insomnia and Cannabis Medications in Australia

By: Chronic Therapy Team

  1. What is Insomnia
  2. Causes of Insomnia
  3. How common is Insomnia in Australia?
  4. Symptoms of Insomnia
  5. Insomnia and Mental Health
  6. Tips for Managing Insomnia
  7. Is Insomnia a Disability in Australia?
  8. Treatments for Insomnia
  9. CBD Oil and Insomnia
  10. Medical Cannabis and Insomnia
  11. How to support someone with Insomnia
  12. Conclusion

1. What is Insomnia

Insomnia is a sleep disorder characterised by persistent difficulty in falling asleep, staying asleep, or achieving restorative sleep despite having adequate time and opportunity for sleep. This can lead to daytime sleepiness, fatigue, and impairments in cognitive function, mood, and overall quality of life[1]. Insomnia can be categorised as either acute or chronic, depending on the duration of the sleep disturbance. Acute insomnia typically lasts for a few days to a few weeks, while chronic insomnia lasts for at least three months and occurs at least three times per week[2].


2. Causes of Insomnia

The causes of insomnia can be complex and multifaceted, often involving a combination of factors. Some common causes of insomnia include[3]:

  • Stress and anxiety: Anxiety disorders, worry, or stressful events can lead to trouble falling asleep and staying asleep.
  • Poor sleep habits: Irregular sleep schedules, stimulating activities before bedtime, and an uncomfortable sleep environment can disrupt sleep patterns.
  • Medical conditions: Certain medical conditions, such as chronic pain, asthma, or gastroesophageal reflux disease (GERD), can cause sleep disturbances.
  • Medications: Some prescription drugs and over-the-counter medications can interfere with sleep.
  • Sleep disorders: Other sleep disorders, such as sleep apnea or restless leg syndrome, can contribute to insomnia.
  • Mental health disorders: Depression, bipolar disorder, and other mental health conditions can affect sleep quality.
  • Substance use: Alcohol, caffeine, and nicotine can disrupt sleep, especially when consumed close to bedtime.


3. How common is Insomnia in Australia?

Insomnia is a common sleep disorder in Australia, affecting approximately 33% of the adult population[4]. Chronic insomnia is estimated to affect around 10% of adults, while the remaining 23% experience acute or short-term insomnia[4]. The prevalence of insomnia is higher among women, older adults, and individuals with a history of mental health disorders or chronic health conditions[4].


4. Symptoms of Insomnia

Common insomnia symptoms include[5]:

  • Difficulty falling asleep
  • Waking up during the night and having trouble falling back asleep
  • Waking up too early in the morning
  • Feeling tired upon waking
  • Daytime sleepiness, fatigue, or irritability
  • Difficulty concentrating, memory problems, or poor decision-making
  • Frequent mistakes or accidents
  • Anxiety, depression, or mood swings

5. Insomnia and Mental Health

Insomnia and mental health are closely related. Insomnia can be both a cause and a consequence of mental health disorders[6]. For example, insomnia may exacerbate symptoms of depression, anxiety, and other mental health conditions, while these conditions may also contribute to sleep disturbances. Furthermore, chronic insomnia can increase the risk of developing a mental health disorder[6]. It is essential to address both insomnia and any underlying mental health conditions when seeking treatment for either issue.


6. Tips for Managing Insomnia

Several lifestyle changes and behavioural techniques can help improve sleep quality and reduce insomnia symptoms. Some tips for managing insomnia include[8]:

  • Establishing a regular sleep schedule: Going to bed and waking up at the same time each day can help regulate the sleep-wake cycle.
  • Creating a comfortable sleep environment: A dark, quiet, and cool bedroom can promote better sleep.
  • Limiting exposure to screens and electronic devices before bedtime: The blue light emitted by screens can interfere with the production of the sleep hormone melatonin.
  • Engaging in relaxation techniques: Deep breathing, progressive muscle relaxation, or mindfulness meditation can help reduce stress and promote sleep.
  • Exercising regularly: Regular physical activity can improve sleep quality, but avoid vigorous exercise close to bedtime.
  • Limiting caffeine, alcohol, and nicotine: These substances can disrupt sleep, especially when consumed in the evening or close to bedtime.
  • Avoiding long naps during the day: Daytime napping can make it more challenging to fall asleep at night.
  • Establishing a bedtime routine: Engaging in relaxing activities, such as reading or taking a warm bath before bedtime, can signal to the body that it is time to sleep.


7. Is Insomnia a Disability in Australia?

Insomnia is not considered a disability in Australia per se. However, if the symptoms of insomnia significantly impact an individual's ability to work, study, or perform daily activities, they may be eligible for support through the National Disability Insurance Scheme (NDIS)[11]. Additionally, individuals with insomnia may be entitled to accommodations or modifications in the workplace under the Disability Discrimination Act of 1992, particularly if the sleep disorder is related to an underlying medical or mental health condition[9].


8. Treatments for Insomnia

Insomnia treatment often involves a combination of lifestyle changes, behavioral therapies, and medications, depending on the severity and underlying causes of the sleep disorder. Some common treatments for insomnia include[10]:

  • Cognitive-behavioural therapy for insomnia (CBT-I): CBT-I is a first-line treatment for chronic insomnia that addresses the thoughts, behaviours, and habits that contribute to sleep disturbances.
  • Sleep restriction therapy: This involves limiting the amount of time spent in bed to improve sleep efficiency.
  • Stimulus control therapy: This aims to reassociate the bed and bedroom with sleep by limiting activities in the bedroom and only going to bed when sleepy.
  • Pharmacological treatments: Prescription medications, such as benzodiazepines, non-benzodiazepine hypnotics, and melatonin receptor agonists, may be used for short-term treatment of insomnia. However, sleep medicine should be used with caution due to the potential for side effects and dependency.
  • Over-the-counter sleep aids: Antihistamines and other over-the-counter sleep aids can provide short-term relief from insomnia symptoms but should not be used long-term without consulting a health professional.

9. CBD Oil and Insomnia

Cannabidiol (CBD) oil, a non-psychoactive compound derived from the cannabis plant, has been gaining attention as a potential treatment for insomnia and other sleep disorders. Preliminary research suggests that CBD may help improve sleep quality by reducing anxiety and promoting relaxation[11]. A review of clinical trials found that CBD may have a modest effect on sleep duration and sleep onset latency, though more research is needed to determine the optimal dosage and administration method for treating insomnia[12].



10. Medical Cannabis and Insomnia

Medical cannabis, which contains the psychoactive compound tetrahydrocannabinol (THC), has been used to treat various medical conditions, including sleep disorders. Some studies have reported that medical cannabis may improve sleep quality, decrease the time it takes to fall asleep, and reduce the frequency of night waking in individuals with insomnia[13]. However, the long-term use of cannabis for sleep disorders may lead to tolerance, dependency, and worsening sleep quality over time[13]. More research is needed to understand the risks and benefits of using medical cannabis for insomnia, as well as to establish guidelines for its safe and effective use.


11. How to support someone with Insomnia

Supporting a loved one with insomnia can be beneficial in helping them manage their sleep disorder and improve their overall quality of life. Some ways to support someone with insomnia include[14]:

  • Encouraging them to seek professional help: A health professional or sleep specialist can help identify the underlying causes of insomnia and develop an appropriate treatment plan.
  • Being understanding and empathetic: Recognize the impact of insomnia on their daily life and offer emotional support.
  • Listening actively: Offer a non-judgmental space for your loved one to share their feelings and experiences related to insomnia.
  • Promoting healthy sleep habits: Encourage your loved one to establish a regular sleep schedule, create a comfortable sleep environment, and engage in relaxing activities before bedtime.
  • Participating in relaxation techniques together: Practicing deep breathing exercises, mindfulness meditation, or progressive muscle relaxation with your loved one can help reduce stress and promote better sleep.
  • Avoiding criticism or blame: Insomnia can be a complex disorder with various contributing factors. Avoid assigning blame or suggesting that the person is not trying hard enough to sleep.
  • Providing practical assistance: Offer to help with daily tasks that may be difficult for your loved one due to fatigue or sleep deprivation.


12. Conclusion

Insomnia is a prevalent sleep disorder that can significantly impact an individual's quality of life, both physically and mentally. Understanding the causes and symptoms of insomnia is crucial for developing effective treatment strategies, which may include lifestyle changes, behavioural therapies, and medications. Recent interest in the use of CBD oil and medical cannabis for insomnia highlights the need for further research to determine the safety and efficacy of these treatments. Supporting a loved one with insomnia involves understanding, empathy, and encouragement to seek professional help and adopt healthy sleep habits.

If you are suffering from insomnia and would like to speak to a doctor about potential treatments, we would recommend booking an initial consultation with a Chronic Therapy Doctor. Our doctors will screen you for all appropriate treatments including the use of cannabis medications to manage your insomnia.


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References

  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
  2. National Sleep Foundation. (n.d.). What is Insomnia? Retrieved from https://www.sleepfoundation.org/insomnia
  3. Harvard Medical School. (2019). Insomnia: Restoring restful sleep. Harvard Health Publishing. Retrieved from https://www.health.harvard.edu/staying-healthy/insomnia-restoring-restful-sleep
  4. Adams, R., Appleton, S., Taylor, A., McEvoy, R., & Antic, N. (2016). Report to the Sleep Health Foundation 2016 Sleep Health Survey of Australian Adults. Sleep Health Foundation. Retrieved from https://www.sleephealthfoundation.org.au/pdfs/surveys/SleepHealthFoundation-Survey.pdf
  5. National Sleep Foundation. (n.d.). What is Insomnia? Retrieved from https://humanrights.gov.au/our-work/legal/legislation#dda
  6. Baglioni, C., Battagliese, G., Feige, B., Spiegelhalder, K., Nissen, C., Voderholzer, U., ... & Riemann, D. (2011). Insomnia as a predictor of depression: a meta-analytic evaluation of longitudinal epidemiological studies. Journal of affective disorders, 135(1-3), 10-19.
  7. Harvard Medical School. (2019). Insomnia: Restoring restful sleep. Harvard Health Publishing. Retrieved from https://www.health.harvard.edu/staying-healthy/insomnia-restoring-restful-sleep
  8. National Disability Insurance Scheme. (n.d.). Eligibility. Retrieved from https://www.ndis.gov.au/applying-access-ndis/am-i-eligible
  9. Australian Human Rights Commission. (n.d.). Disability Discrimination Act 1992. Retrieved from https://humanrights.gov.au/our-work/legal/legislation#dda
  10. Qaseem, A., Kansagara, D., Forciea, M. A., Cooke, M., & Denberg, T. D. (2016). Management of chronic insomnia disorder in adults: a clinical practice guideline from the American College of Physicians. Annals of internal medicine, 165(2), 125-133.
  11. Babson, K. A., Sottile, J., & Morabito, D. (2017). Cannabis, cannabinoids, and sleep: a review of the literature. Current Psychiatry Reports, 19(4), 23.
  12. Kuhathasan, N., Dufort, A., MacKillop, J., Gottschalk, R., Minuzzi, L., & Frey, B. N. (2019). The use of cannabinoids for sleep: A critical review on clinical trials. Experimental and Clinical Psychopharmacology, 27(4), 383-401.
  13. Babson, K. A., Sottile, J., & Morabito, D. (2017). Cannabis, cannabinoids, and sleep: a review of the literature. Current Psychiatry Reports, 19(4), 23.
  14. National Sleep Foundation. (n.d.). Supporting a Family Member or Friend with Insomnia.