Introduction and objective:
Obstructive sleep apnea syndrome (OSAS) is becoming increasingly more prevalent in the general population. Its negative impact on the cardiovascular system and patients’ non-compliance to validated treatment options is a stimulus for research on novel OSAS therapies, including pharmacotherapy. The aim of the study was to discuss the possibility of using cannabinoids, such as cannabidiol (CBD), delta – 9 tetrahydrocannabinol (THC) and their synthetic analogues, as a form of OSAS treatment.

Review methods:
The Pubmed database and Clinical Trial Registries were searched and reviewed for pilot studies, review articles, preclinical and clinical trials concerning using cannabinoids as an OSAS treatment option. The following key words and their combinations were used: „OSAS pharmacotherapy”, „cannabinoids”, and „sleep apnea”. The selected original articles were published between 2010 – 2021, and focused on the effect of dronabinol and synthetic THC analogue on qualitative and quantitative sleep quality parameters.

Abbreviated description of the state of knowledge:
Data concerning cannabinoids as an OSAS treatment option are scarce; however, show promising results confirming their effectiveness. Synthetic analogue of THC (dronabinol) was confirmed to reduce the number of apnoea episodes during sleep, improve the quality of sleep, and increase slowwave sleep time in clinical trials. During trials the drug was considered safe and well-tolerated.

Despite the fact that current results of research show that cannabinoids are effective in the treatment of OSAS, there is a substantial need for a multi-centre, long-term study on a large sample of patients, safety, long-term effects and dosing. The phenotype of patients who would benefit most by complying to such therapy should be determined.

Akashiba T, Inoue Y, Uchimura N, et al. Sleep Apnea Syndrome (SAS) Clinical Practice Guidelines 2020. Sleep and Biological Rhythms. 2022; 20(1): 5–37. doi: 10.1016/j.resinv.2021.08.010.
Zou S, Kumar U. Cannabinoid Receptors and the Endocannabinoid System: Signaling and Function in the Central Nervous System. International Journal of Molecular Sciences. 2018; 19(3): 833. doi: 10.3390/ijms19030833.
Kaul M, Zee P, Sahni A. Effects of Cannabinoids on Sleep and their Therapeutic Potential for Sleep Disorders. Neurotherapeutics. 2021; 18(1): 217–227. doi: 10.1007/s13311-021-01013-w.
Calik M, Carley, D. Intracerebroventricular injections of dronabinol, a cannabinoid receptor agonist, does not attenuate serotonin-induced apnea in Sprague-Dawley rats. Journal of Negative Results in BioMedicine. 2016; 15(8). doi: 10.1186/s12952-016-0052-1.
Sativex (kannabidiol + delta-9-tetrahydrokannabinol) aerozol do stosowania w jamie ustnej – działanie, dawkowanie, cena, refundacja. Medycyna Praktyczna online. (access: 2022.01.17).
Ward S, Lichtman A, Piomelli D, et al. Cannabinoids and Cancer Chemotherapy-Associated Adverse Effects. JNCI Monographs. 2021; 58: 78–85. DOI: 10.1093/jncimonographs/lgab007.
O›Donnell B, Meissner H, Gupta V. Dronabinol. In: StatPearls. Treasure Island (FL): StatPearls Publishing, 2022.
Calik M, Carley D. Cannabinoid Type 1 and Type 2 Receptor Antagonists Prevent Attenuation of Serotonin-Induced Reflex Apneas by Dronabinol in Sprague-Dawley Rats. PLoS ONE. 2014; 9(10). doi: 10.1371/journal.pone.0111412.
Carley D, Pavlovic S, Janelidze M, et al. Functional Role for Cannabinoids in Respiratory Stability During Sleep. Sleep. 2002; 25(4): 388–395.
Calik M, Radulovacki M, Carley D. Intranodose ganglion injections of dronabinol attenuate serotonin-induced apnea in Sprague-Dawley rat. Respiratory Physiology & Neurobiology. 2014; 190: 20–24. doi: 10.1016/j.resp.2013.10.001.
Prasad B, Radulovacki M, Carley D. Proof of Concept Trial of Dronabinol in Obstructive Sleep Apnea. Frontiers in Psychiatry. 2013; 4: 1–5. doi: 10.3389/fpsyt.2013.00001.
Carley D, Prasad B, Reid K, et al. Pharmacotherapy of Apnea by Cannabimimetic Enhancement, the PACE Clinical Trial: Effects of Dronabinol in Obstructive Sleep Apnea. Sleep. 2017; 41(1). doi: 10.1093/sleep/zsx184.
Farabi S, Prasad B, Quinn L, et al. Impact of Dronabinol on Quantitative Electroencephalogram (qEEG) Measures of Sleep in Obstructive Sleep Apnea Syndrome. Journal of Clinical Sleep Medicine. 2014; 10(01): 49–56. doi: 10.5664/jcsm.3358.
ANZCTR – Registration. (access: 2022.01.17).
Ramar K, Rosen I, Kirsch D, et al. Medical Cannabis and the Treatment of Obstructive Sleep Apnea: An American Academy of Sleep Medicine Position Statement. Journal of Clinical Sleep Medicine. 2018; 14(04): 679–681. doi: 10.5664/jcsm.7070.
Kolla B, Mansukhani M, Olson E, et al. Medical Cannabis for Obstructive Sleep Apnea: Premature and Potentially Harmful. Mayo Clinic Proceedings. 2018; 93(6): 689–692. doi: 10.1016/j.mayocp.2018.04.011.
Jumpertz R, Wiesner T, Blüher M, et al. Circulating Endocannabinoids and N-acyl-ethanolamides in Patients with Sleep Apnea – Specific Role of Oleoylethanolamide. Experimental and Clinical Endocrinology & Diabetes. 2010; 118(09): 591–595. doi: 10.1055/s-0030-1253344.
Calik M, Carley D. Effects of Cannabinoid Agonists and Antagonists on Sleep and Breathing in Sprague-Dawley Rats. Sleep. 2017; 40(9). doi: 10.1093/sleep/zsx112.
Kuiken D. Dream Function. Reference Module in Neuroscience and Biobehavioral Psychology. 2017.
Journals System - logo
Scroll to top