O006 Acute effects of combined cannabidiol (CBD) and ∆9-tetrahydrocannabinol (THC) in insomnia disorder: A randomised, placebo-controlled trial using high-density EEG

Abstract

Abstract Introduction Medicinal cannabis is often cited as a popular alternative to common sleep aids; however, there are limited studies using complex sleep EEG methods examining its’ effects in insomnia disorder. Methods Twenty patients (16 female; median [IQR] age, 47 [13.8] years) with insomnia disorder (mean ISI=20.8) completed two 24-hour in-laboratory visits during which they received a single oral dose of ‘CBD/THC’ containing 200 mg cannabidiol (CBD) and 10 mg delta9-tetrahydrocannabinol (THC) or placebo. Co-primary outcomes were total sleep time (TST) and wake after sleep onset (WASO). Secondary outcomes included next-day neurobehavioural function and sleep microarchitecture metrics determined using overnight polysomnography with 256-channel high-density EEG. Results Compared to placebo, CBD/THC significantly decreased TST (-24.5 min, p=0.047) with no significant change to WASO (+10.7 min, p=0.422). CBD/THC significantly decreased time spent in REM sleep (-33.9min, p<0.001) and increased REM sleep latency (+65.6 min, p=0.008). Preliminary high-density EEG analysis revealed increased alpha activity during REM sleep overlying the parietal cortex (p<0.05). CBD/THC did not impair next-day (+12 h post-treatment) cognitive performance, alertness or simulated driving performance (all p’s>0.05). Eighty-five mild, non-serious, adverse events were reported (55 during CBD/THC; most common dry mouth, drowsiness, and fatigue). Conclusions An acute dose of 200 mg CBD and 10 mg THC reduced TST and the time spent in REM sleep. Analysis of all high-density EEG outcomes is ongoing. CBD/THC did not affect next-day performance. Further research is required to determine the impact of chronic cannabinoid dosing on REM sleep and other objective sleep outcomes in insomnia disorder.