Parasomnia
Understanding Parasomnia
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What is parasomnia?
Parasomnia is the term for a group of sleep disorders featuring abnormal movements, behaviours, emotions, perceptions, and dreams that occur during sleep or the transition to or from sleep [12].
These disorders can be disruptive to sleep quality and can lead to physical or emotional harm to the individual or others around them. Parasomnias can be classified as either non-rapid eye movement (NREM) or rapid eye movement (REM) parasomnias, depending on the stage of sleep in which they occur.
The causes of parasomnia
Science is yet to confirm the exact cause of parasomnia. Currently, they are believed to be associated with disturbances in the parts of the brain that control sleep and wake cycles.
Some of the factors that may contribute to the development of parasomnia include:
- Genetics
- Medications
- Substance use
- Medical conditions
- Sleep deprivation
In some cases, parasomnia may be triggered by stress, anxiety, or other emotional factors.
Symptoms of parasomnia
Symptoms can vary depending on the type of parasomnia; however, they may include:
- Sleepwalking
- Night terrors
- Sleep talking
- Bedwetting
- Teeth grinding
People with parasomnia often do not remember their episodes, but their sleep quality and daily functioning can be severely affected. These symptoms can lead to physical injury and emotional distress.
Treatment for parasomnia
Traditional treatment options
The treatment for parasomnia may depend on the type and severity of the disorder. Some common treatments include sleep hygiene, medication, therapy, and lifestyle changes.
Sleep hygiene involves creating a sleep-friendly environment by reducing noise, light, and distractions. Medications, such as benzodiazepines and antidepressants, may help reduce symptoms of parasomnia, but they can also cause side effects and may not be suitable for everyone.
Therapy, such as cognitive behavioural therapy, can help address underlying psychological factors that may contribute to parasomnia. Lifestyle changes, such as reducing stress and avoiding substance abuse, can also help improve sleep quality and reduce parasomnia symptoms [13].
Alternative treatment options
If you’re suffering from parasomnia, or another type of sleep disorder, and have found yourself to be treatment-resistant, it’s important to know that there are alternative options available. As with any medical treatment, it’s essential to discuss the potential benefits and associated risks with a qualified healthcare professional.
For some patients, natural remedies may offer a solution to improve overall sleep quality and duration.
There is growing evidence that medicinal cannabis may be effective in treating parasomnia for some patients. THC, for example, has been shown to increase slow-wave sleep, which is important for restorative sleep. CBD, on the other hand, has been shown to have anxiolytic and sedative effects, which may help reduce anxiety and improve sleep quality [14].
In addition to improving sleep quality, medicinal cannabis may also have other potential benefits for people with parasomnia. For example, it may help reduce pain, anxiety, and depression, which are common comorbidities in people with sleep disorders [15].
How medicinal cannabis works
Before diving into the pros and cons of using medicinal cannabis, it’s helpful to understand how cannabis works in the body.
The human body has an endocannabinoid system (ECS) that regulates various physiological processes, including pain, mood, appetite, and sleep. The ECS consists of a network of receptors and enzymes that interact with endocannabinoids, which are naturally occurring compounds in the body that are similar to the cannabinoids found in cannabis.
When cannabis is consumed, the THC and CBD in the plant interact with the ECS in the body. THC binds to cannabinoid receptors in the brain and body, producing various effects, including pain relief, relaxation, and altered perception. Conversely, CBD does not bind to cannabinoid receptors but instead interacts with other body receptors involved in inflammation, pain, and mood regulation.
Potential benefits of medical cannabis for parasomnia
Improve sleep quality
Some studies show that medicinal cannabis may be a suitable treatment for improving overall sleep quality and duration. In 2017, a review article summarised the available evidence on the effects of cannabis and cannabinoids on sleep. The authors conclude that cannabis use may improve sleep quality, increase total sleep time, and reduce sleep onset latency, but caution that more research is needed [16].
Increase alertness
In addition to poor sleep, many patients with sleep disorders often experience daytime drowsiness and inability to focus. These symptoms may negatively impact overall quality of life.
A recent study found that cannabidiol (CBD), a non-psychoactive compound found in cannabis, may have wake-inducing properties and could potentially be used to improve alertness and reduce daytime sleepiness [15].
These studies suggest that medicinal cannabis, particularly the cannabinoids THC and CBD, may have potential benefits for people with parasomnia. However, more research is needed to fully understand the efficacy and safety of this treatment option.
*The above studies highlight the potential benefits of medicinal cannabis, but do have some limitations that need to be considered. These limitations may include: a relatively small sample size, use of self-reported data rather than objective measures, and not measuring the long-term effects of cannabis use or exploring the different strains/types of cannabis used, which may have an impact on the observed effects.
Potential side effects
Like any medication, medicinal cannabis can have side effects. While medicinal cannabis may benefit some patients, it is vital to understand the potential risks and side effects. Common side effects of cannabis use include dry mouth, dizziness, and increased heart rate. Some people may also experience anxiety or paranoia.
It is important to note that medicinal cannabis should only be used under the guidance of a qualified healthcare professional and in accordance with local laws and regulations.
Finding the right dose
When using medicinal cannabis, finding the correct dose that provides maximum benefits with minimal side effects is essential. Everyone’s tolerance and sensitivity to cannabis are different, so finding the right dose may take some trial and error.
Working with a healthcare provider who specialises in medicinal cannabis can be helpful in finding the correct dose and product for your specific needs.
The legal status of medicinal cannabis in Australia
In Australia, the use of medicinal cannabis is legal under certain circumstances. In 2021, the Australian government amended its Narcotics Drugs Act to allow for the cultivation and manufacture of medicinal cannabis products for therapeutic use [1].
To access medicinal cannabis in Australia, patients must have a valid prescription from a healthcare provider and obtain their medication from a licensed medicinal supplier. Medicinal cannabis is unavailable over the counter and cannot be legally grown or produced by patients for personal use.
While the legal framework for medicinal cannabis in Australia is still relatively new, there is growing awareness of its therapeutic potential for various medical conditions, including fibromyalgia.
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While there are different treatments available for parasomnia, medicinal cannabis may be a promising option for some people. Research shows that this alternative treatment option has the potential to improve overall sleep quality and increase daytime alertness for some patients.
If you’re considering using medicinal cannabis for parasomnia, it’s essential to work with a healthcare provider, to better understand your options and to determine if you are a suitable candidate for medical cannabis treatment.
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