Does Cannabis Help Sleep, Depression, and Quality of Life?

As cannabis products become legal in more states, an ever-larger number of people are trying to manage the symptoms of depression, anxiety, insomnia, and more using cannabis. A PsyPost article reported on the findings of a study to determine the effectiveness of cannabis for these conditions.

Cannabis is not only marijuana. While some cannabis contains the THC associated with marijuana’s high, some products do not. CBD products contain the active ingredients of cannabis without THC. 

People are trying both THC and CBD cannabis products to see if they help manage symptoms of depression, anxiety, and sleep problems. While many report positive results, studies are relatively scarce and their results are not clear.

The authors of the study examined in PsyPost set out to determine if medicinal cannabis is an effective treatment for anxiety and depression. They also looked at the quality of life and sleep.

The Study

The longitudinal study covered approximately four years. The participants were all either already using cannabis products or considering using them. Some started using cannabis after the study began. A control group of sorts was formed from participants who did not initiate the use of cannabis. There was not a placebo group.

The study relied on participant-reported assessments to evaluate depression, anxiety, quality of life, sleep, and pain. The baseline assessment indicated the following.

  • 15% of participants reported depression
  • 34% of participants reported anxiety
  • 51% of participants reported having both depression and anxiety
  • 69% of participants reported chronic pain disorders
  • 36% of participants were taking prescribed medication to manage depression, anxiety, or both

Most of the study participants using cannabis products at the baseline assessment, over 80%, were using CBD products. 32% reported THC product use, and 7% were using products with equal amounts of CBD and THC.

The Results

Depression and Anxiety

The baseline assessments of the study participants showed lower levels of depression in those using cannabis products, particularly CBD. Cannabis users did not have a lower baseline level of anxiety.

Participants who began using cannabis at the onset of the study reported decreased depression and anxiety as the study progressed. Their counterparts who were already using cannabis also reported improvements, but they were not as substantial.

The group that did not use cannabis reported no change in depression or anxiety during the study.

The authors were able to conclude that medical use of cannabis products appeared to decrease symptoms of depression and, to a lesser extent, anxiety. Because of the observational nature of the study, they conceded that many confounding factors could have influenced the results.

Overall, the study did support cannabis as decreasing symptoms of depression. The group that initiated cannabis use during the study saw the greatest benefits. Sustained use also showed benefits. This suggests continued value over time.

Sleep

The study authors used the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality in study participants. The PSQI is used to measure sleep quality during one month. It was designed for use within psychiatric populations.

The PSQI is a questionnaire that generates scores related to overall sleep quality as well as specific components of sleep. Those components include sleep duration, latency, efficiency, disturbances, and the use of sleep medication.

The PSQI also measures daytime dysfunction. Sleepiness or drowsiness during social activities, while driving, or while eating are all assessed. 

Those who were using cannabis at the time of the baseline assessment had better scores on the PSQI than those who were not. They also reported better sleep. Those who initiated the use of cannabis during the study also reported improved sleep.

Insomnia has been linked to psychiatric disorders like depression. Relieving the symptoms of depression could, in turn, lead to longer REM sleep or faster sleep onset.

The sleep components of medical cannabis research tend to be secondary. Sleep doctors need to do more studies with sleep as the primary focus before more conclusions can be drawn.    

Quality of Life and Pain

Participants were also given assessments of both chronic pain and quality of life. Quality of life was evaluated by participants filling out the WHOQOL-BREF. This basic assessment tool was developed by the World Health Organization. 

Medical cannabis users reported better quality of life at baseline and throughout the study than non-users.

Pain was assessed using the NPRS. This is the Numerical Pain Rating Scale, with values from one to ten. Medical cannabis users reported less pain at baseline assessment.

The authors noted that the quality of life and pain findings are not surprising. The correlation between depression, pain, and quality of life is fairly well established. When depression symptoms were lower, less pain and a better quality of life were also reported.    

Conclusions

An observational study is limited in the conclusions it can draw. Without a controlled placebo group or non-participant reported assessments, it is difficult to make any bold statements from this research.

However, there does appear to be a positive correlation between medical cannabis use, particularly CBD use, and decreased depression, increased sleep quality, and a better quality of life.

Further research with sleep as the primary focus would be able to determine which aspects of sleep are most affected by medical cannabis. A sleep doctor would be unable to determine who would be a good candidate for medicinal cannabis based on the study discussed by PsyPost. 

The positive effects on depression are promising, as depression, anxiety, and sleep disorders often co-occur. As more controlled studies are done, questions about dosage, strength, and product type will be answered.

This type of research is new enough that solid, fact and science-based answers about the benefits of medicinal cannabis are few and far between. The results of observational studies like the one discussed here make the case for further research. 

People are going to continue to use cannabis. Controlled studies will help them use it wisely. Medicinal cannabis may become part of the overall toolkit used to treat depression and sleep disorders, leading to a better quality of life for millions of people. 

Sources

https://www.psypost.org/2021/10/cannabis-products-may-help-treat-symptoms-of-depression-improve-sleep-and-increase-quality-of-life-study-suggests-62014

https://www.frontiersin.org/articles/10.3389/fpsyt.2021.729800/full

https://www.med.upenn.edu/cbti/assets/user-content/documents/Pittsburgh%20Sleep%20Quality%20Index%20(PSQI).pdf

http://depts.washington.edu/seaqol/WHOQOL-BREF

https://www.physio-pedia.com/Numeric_Pain_Rating_Scale

https://academic.oup.com/painmedicine/article/4/4/331/1893886

https://pubmed.ncbi.nlm.nih.gov/31120284/

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