The recent trend for legalization of medicinal cannabis and cannabinoid-containing products, together with their soporific effects, has led to a surge of interest of their potential therapeutic role in the management of some common sleep disorders, such as insomnia, sleep disordered breathing, and restless legs syndrome, and less common disorders such as narcolepsy and parasomnias. Although much of the pre-clinical and clinical data were derived from studies with relatively small sample sizes and limited by biases in assessment, and in clinical trials lack of allocation concealment, as a whole, the results indicate a potential therapeutic role for cannabinoids in the management of some sleep disorders. Clinical trials are underway for insomnia and obstructive sleep apnea management, but there remains a substantial need for rigorous large multi-center studies to assess the dose, efficacy, and safety of the various types of cannabinoids on sleep disorders. This review aims to summarize the modulatory effects of cannabinoids on sleep physiology and provide a critical evaluation of the research on their potential therapeutic benefit in various sleep disorders.

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BackgroundA knowledge gap exists in understanding the beneficial use and duration of domiciliary supplemental oxygen (DSO) therapy among survivors of COVID-19 hospitalisations with persistent hypoxemia upon discharge. The purpose of this single center study was to begin to address this issue.MethodsIn this retrospective study we report features of U.S. military veterans residing in metropolitan Chicago with no prior DSO therapy who survived COVID-19 hospitalisation, were discharged on DSO, and were followed for 6 months.ResultsWe found that the majority of the 65 elderly patients (median age, 70 years), predominantly obese Black males, who survived COVID-19 hospitalisations at the Jesse Brown VA Medical Center and discharged on DSO did not undergo a formal 6-min walk test (6 MWT) to re-assess ongoing ambulatory supplemental oxygen requirements (46 patients or 71%). Nonetheless, DSO therapy was discontinued in most patients predominantly within 8 weeks of hospital discharge (34 patients, 52%). In addition, a large proportion of patients, obese Blacks in particular, who survived COVID-19 hospitalisations and were treated with DSO for at least 8 weeks thereafter developed post-acute sequelae of COVID-19 infection (PASC) (30 patients, 46%).ConclusionsGiven these findings, we recommend that healthcare providers be appraised about proper monitoring and evaluation, including timely performance of 6 MWT, of patients who survived COVID-19 hospitalisations and treated with DSO for persistent hypoxemia upon discharge. Whether obese Black males who survived COVID-19 hospitalisations and are treated with DSO thereafter have an elevated risk in developing PASC remains to be determined in larger, prospective studies.

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