Is cannabis the new buzzword for the treatment of obstructive sleep apnea or is there really some merit to this as a treatment option for CPAP-intolerant patients?
The American Academy of Sleep Medicine’s latest position statement is that this is a no-go.
Maybe you’ve heard that the Minnesota Department of Health in November 2017 announced its decision to add obstructive sleep apnea to the list of qualifying medical conditions for the state’s medical marijuana program.
But the AASM believes that obstructive sleep apnea should not be on this list because there just isn’t enough evidence that cannabis effectively treats this disorder.
There’s also insufficient evidence that it’s safe or that it can be delivered reliably to the patient (e.g., vaping, liquid).
Patients should instead discuss proven treatments for sleep apnea with their doctors at an accredited sleep facility, advises Dr. Kannan Ramar, lead author of the study, and professor of medicine in the division of pulmonary and critical care medicine at Mayo Clinic in Rochester, Minnesota. The full report is in the Journal of Clinical Sleep Medicine (April 15, 2018).
The synthetic cannabis extract of dronabinol was shown in past animal studies to improve respiratory stability. The question then became: Could this cannabis extract treat obstructive sleep apnea?
After all, a significant percentage of people who are diagnosed with OSA cannot tolerate CPAP, or, if they do use it, do so only for part of the night.
The FDA has not approved dronabinol for OSA treatment. Its safety is not known. Neither is its long-term tolerability.
It’s no secret that when people use cannabis for other medical conditions, they can suffer from daytime sleepiness – which is the very situation that someone with sleep apnea is trying to avoid.
“Until there is sufficient scientific evidence of safety and efficacy, neither marijuana nor synthetic medical cannabis should be used for the treatment of sleep apnea,” explains AASM president Dr. Ilene Rosen in the report.
Treatments for Sleep Apnea
Other than CPAP
Overall, these alternative treatments are not as effective as CPAP, but for some patients with mild sleep apnea, they may be able to work well enough to keep the apnea-hypopnea index (AHI) under five per hour. This would need to be verified with a sleep study while using one of the alternative treatments.