Impact of Dronabinol on Quantitative Electroencephalogram (qEEG) Measures of Sleep in Obstructive Sleep Apnea Syndrome

Abstract

To determine the effects of dronabinol on quantitative electroencephalogram (EEG) markers of the sleep process, including power distribution and ultradian cycling in 15 patients with obstructive sleep apnea (OSA). EEG (C4-A1) relative power (% total) in the delta, theta, alpha, and sigma bands was quantified by fast Fourier transformation (FFT) over 28-second intervals. An activation ratio (AR = [alpha + sigma] / [delta + theta]) also was computed for each interval. To assess ultradian rhythms, the best-fitting cosine wave was determined for AR and each frequency band in each polysomnogram (PSG). Fifteen subjects were included in the analysis. Dronabinol was associated with significantly increased theta power (p = 0.002). During the first half of the night, dronabinol decreased sigma power (p = 0.03) and AR (p = 0.03), and increased theta power (p = 0.0006). At increasing dronabinol doses, ultradian rhythms accounted for a greater fraction of EEG power variance in the delta band (p = 0.04) and AR (p = 0.03). Females had higher amplitude ultradian rhythms than males (theta: p = 0.01; sigma: p = 0.01). Decreasing AHI was associated with increasing ultradian rhythm amplitudes (sigma: p < 0.001; AR: p = 0.02). At the end of treatment, lower relative power in the theta band (p = 0.02) and lower AHI (p = 0.05) correlated with a greater decrease in sleepiness from baseline. This exploratory study demonstrates that in individuals with OSA, dronabinol treatment may yield a shift in EEG power toward delta and theta frequencies and a strengthening of ultradian rhythms in the sleep EEG.