Review ArticleClinical Management of Sleep and Sleep Disorders With Cannabis and Cannabinoids: Implications to Practicing PsychiatristsMonti, Jaime M. MD∗; Pandi-Perumal, Seithikurippu R. MSc†,‡ Author Information ∗Department of Pharmacology and Therapeutics, School of Medicine Clinics Hospital, University of the Republic, Montevideo, Uruguay †Somnogen Canada, Inc, Toronto, Canada ‡Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India. Address correspondence and reprint requests to Seithikurippu R. Pandi-Perumal, MSc, Somnogen Canada, Inc, College St, Toronto, Canada; E-mail: [email protected] https://orcid.org/0000-0002-8686-7259 S.R.P. is a stockholder and the president and chief executive officer of Somnogen Canada, Inc, a Canadian Corporation. He declares that he has no competing interests that might be perceived to influence the content of this article. This does not alter the authors' adherence to all the journal policies. He receives occasional royalty for the volumes that he edited for other publishers. No data sets were generated or analyzed during the current study. The authors contributed equally to this study. Clinical Neuropharmacology: 3/4 2022 - Volume 45 - Issue 2 - p 27-31 doi: 10.1097/WNF.0000000000000494 Buy Metrics Abstract Phytocannabinoid derivatives are among the several compounds found in the cannabis plant. The phytocannabinoid chemicals Δ9-tetrahydrocannabinol (THC) and cannabidiol are mostly responsible for the drug's behavioral effects. Chronic cannabis administration has been shown to disrupt circadian rhythms and reduce the duration of the deepest phase (stage N3) of nonrapid eye movement sleep. Cannabidiol is thought to be responsible for the disruption of the circadian rhythm, whereas THC is thought to be accountable for the changes in sleep architecture. The quality of one's sleep has a significant impact on cannabis abstinence or relapse. As a result, the diminished sleep-promoting efficiency of cannabis in chronic users, as well as the resulting sleep difficulties once cannabis use is stopped, may sabotage attempts to quit and raise the risk of relapse. In individuals with obstructive sleep apnea who do not complain about the treatment process known as continuous positive airway pressure, cannabinoids are one of the treatments being considered. In this regard, preclinical investigations have demonstrated that combining the agent oleamide and THC aids in the stabilization of respiration in all stages of sleep as well as the maintenance of autonomic stability during sleep. The synthetic THC dronabinol was found to lower the apnea-hypopnea index in a clinical investigation and is regarded safe for the short-term treatment of obstructive sleep apnea. Patients experiencing nightmares who had been diagnosed with posttraumatic stress disorder were given the synthetic endocannabinoid receptor agonist nabilone. When compared with a placebo, the chemical proved helpful in reducing the frequency of nightmares. It is worth noting that a single study that looked at the effects of cannabidiol on REM behavior disorder found that symptoms improved. Based on the available findings, cannabinoids can be used as an alternate treatment for various sleep disorders. However, additional research is needed to corroborate the conclusions of these investigations. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.