Sleep disturbance and the effects of extended-release zolpidem during cannabis withdrawal.
Level 2 - randomized trial
Controlled crossover clinical trial in humans
PubMed 21296508 · doi:10.1016/j.drugalcdep.2011.01.003
What was done
Twenty daily cannabis users completed a within-subject crossover study alternating between ad libitum cannabis use and short-term (3-day) cannabis abstinence. During the abstinence periods, participants received either bedtime placebo or extended-release zolpidem (a non-benzodiazepine GABA-A receptor agonist). Polysomnographic sleep architecture, subjective sleep ratings, and cognitive performance were assessed daily.
What was found
The abstract reports directional findings without numerical values. Relative to ad libitum cannabis use, placebo-treated abstinence led to decreased sleep efficiency, total sleep time, Stage 1 and Stage 2 sleep percentages, REM latency, and subjective sleep quality, as well as increased sleep latency and REM sleep duration. Extended-release zolpidem attenuated these sleep architecture disruptions and normalized sleep efficiency, but had no effect on sleep latency. Zolpidem was not associated with significant side effects or next-day cognitive impairments.
Why it matters
This study provides objective polysomnographic evidence that acute cannabis abstinence disrupts sleep architecture and demonstrates that extended-release zolpidem can partially mitigate these disruptions without causing next-day cognitive impairment.
Limits
The sample size was small (n = 20), the abstinence window was very short (3 days), and the abstract provides no exact numerical data, effect sizes, or p-values. It remains unknown whether short-term zolpidem treatment reduces relapse rates or aids long-term cannabis cessation.
Cited by
- supports THC decreases sleep onset latency, increases nocturnal awakenings, suppresses REM sleep, and causes rebound insomnia upon cessation.