Chapter Three – Green light to sleep: Does cannabis work for insomnia? A case report and brief review

Insomnia is characterized by difficulty initiating or maintaining sleep and affects 10–20 % of adults. Conventional pharmacotherapies for insomnia, initially comprising benzodiazepines and later the Z-drugs, often present significant adverse effects, including dependence and tolerance. Here we provide a brief review on cannabis therapy for insomnia and present a relevant case report. We first discuss the sleep stages and the main clinical aspects of insomnia. Next, we report the case of a 37 year-old patient who, after a grief situation, began to experience insomnia that was resistant to various conventional treatments, even with dosage adjustment. The insomnia diminished after replacing the conventional pharmacotherapies with full spectrum Cannabis sativa oil, rich in cannabidiol (CBD) and tetrahydrocannabinol (THC). Finally, we note that medical societies from several major countries such as England, Australia and Brazil already recommend the use of Cannabis (plants rich in THC and/or CBD) to treat insomnia. These societies base their guidelines on studies that reported a mitigation of the symptoms of insomnia with the use of cannabinoids. However, recent meta-analyses highlight the heterogeneity of the participants, interventions, and results. Further research is essential to elucidate the influence of cannabinoids on both physiological and pathological aspects of sleep.