HOWMEDICALCANNABISCANHELPINSOMNIADoyouhaveconstantsleeplessnights?Andnomatterwhatyoudo,youcan’tgettosleep(orstayasleep)?–Maybeyouhaveinsomnia.Beforewejumptoconclusions,let’sunderstandwhatinsomniais…WhatisInsomnia?Insomnia is themost commonsleepdisorderand isamong themostprevalentofmentalhealth disorders. The International Classification of Sleep Disorders defines insomnia asdifficultyinitiatingormaintainingsleeponthreeormorenightsperweekforatleastthreemonths.Peoplewithinsomniacanfeeldissatisfiedwiththeirsleepandusuallyexperiencethefollowingsymptoms:fatigue, lowenergy,difficultyconcentrating,mooddisturbances,anddecreasedperformanceinworkoratschool1.Australiansurveyshaveshownthat13-33%of theadultpopulationhaveregulardifficultygettingtosleeporstayingasleep2.70-90%ofInsomniadisordersusuallyoccurinthecontextofanotherdisorderormedicalproblemsuchasanxiety,depression,andposttraumaticstressdisorder,stroke,pain,cardiovasculardisease,diabetesorasthma3.InAustralia,thefinancial

1NationalSleepFoundation.(2017).WhatisInsomnia.Retrievedathttps://sleepfoundation.org/insomnia/content/what-is-insomnia.2CunningtonD,J.M.(2013).Insomnia:Prevalence,ConsequencesandEffectiveTreatment.(S36-S40,Ed.)TheMedicalJournalofAustralia,199(8).3LichsteinKL,T.D.(2016).Insomnia:EpidemiologyandRiskFactors(Chapter81).InPrinciplesandPracticeofSleepMedicineSixthEdition.(R.D.Kryger,Ed.)Philadelphia:Elsevier.

burdenandindirectcostsassociatedwithinsomniawereestimatedtobe$AU$1.5billionin20104.

Aretheretreatmentsavailable?Currenttreatmentsof insomnia includenon-pharmacological treatmentssuchascognitivebehaviourtherapy(CBT-i)andpharmacotherapies.CBT-iisabehaviouraltherapythattargetspsychological,behaviouralandcognitivefactorsthatmayhavedevelopedduringinsomniaorcontributedtoitsdevelopment.CBT-iisveryeffectiveandconsideredtobethegoldstandardintreatinginsomnia5.However, individual face-to-faceCBT is typicallydeliveredbyatrainedhealthprofessionalwhich makes it expensive, labour intensive and less accessible. Pharmacotherapeuticapproaches include using drugs such as benzodiazepines (BZD) and non-BZD hypnotics,however the side effects from long term use of these drug including abuse potential,dependence, tolerance, daytime sedation, increased risk of psychomotor impairment,includingfallsespeciallyinolderpeopleandincreasedriskofcognitiveimpairment,haveledtonewtreatmentapproaches5.Howcanmedicalcannabishelp?

Theuseofcannabishasbeenusedmedicinallyforthousandsofyears inChinaandIndia,butrecentlytheplantderivedcannabinoids,knownas phytocannabinoids, have been gaininginterest due to anecdotal clinical studies andmorerecentlyclinicaltrialsindiseasesincludingepilepsy, multiple sclerosis, chemotherapyinducednauseaandvomiting,pain,andsleepdisorders.Cannabinol (CBN) is also another cannabinoidwhichisaproductofdegradationoroxidationofTHCshowntohavesleepinducingeffectsinmice and research suggests that theimprovementsinsleepseenwithTHCareevengreaterwhenCBNiscombinedwithTHC6.

4HillmanDR,L.L.(2013).PublicHealthImplicationsofSleepLoss:TheCommunityBurden.TheMedicalJournalofAustralia,199(8),S7S10.doi:doi:10.5694/mja13.106205Kay-StaceyM.(2016).AdvancesintheManagementofChronicInsomnia.TheBritishMedicalJournal,353(i2123),1-14.doi:10.1136/bmj.i21236Karniol,I.,Shirakawa,I.,Takahashi,R.,Knobel,E.,&Musty,R.(1975).Effectsofdelta9-tetrahydrocannabinolandcannabinolinman.Pharmacology,13(6),502-512.

WhoisZeldaTherapeuticsandhowaretheyinvolved?

Zelda Therapeutics (Zelda) is an Australian listed company(ASX:ZLD) engaged in preclinical and clinical research of itscannabis basedproducts for the treatment of specificmedicaldisorders, including insomnia. The company will undertakeclinicaltrialsinAustraliaandChilewiththeirmedicinalcannabisproduct for the treatment of chronic insomnia in adults. Toundertake clinical trials, Zelda must submit its proposedprocesses and research to various regulatorybodies (includingethicscommittees)forapproval.

ZeldaTherapeuticsshouldhaveresultsfromitsclinicaltrialsbytheendoftheyear,andwithpositiveresultsinhanditwillthenmovequicklytoregisteritsproductsformarketinganddistributionpurposes,expectedin2018.So if you are suffering from insomnia and arewanting a natural alternative to the drugscurrently available in the market, stay tuned for more updates or visitwww.zeldatherapeutics.com.