Medicinal Cannabis Shows Promise for Managing Sleep in Children with ASD

Moshin Maqbool, MD

Credit: Texas Child Neurology

Medicinal cannabis at the range of CBD:THC ratios of 1:1 to 4:1 shows promise for managing sleep disturbances in children with autism spectrum disorder (ASD), according to a late breaker abstract, written by Moshin Maqbool, MD, from Texas Child Neurology, at SLEEP 2024, the 38th annual meeting of the Associated Professional Sleep Societies.¹

Children with ASD often experience sleep disturbances that impair their daily functioning and quality of life.² Children with ASD may have irregular sleep and waking patterns, sleeping much less than expected for their age, or getting up and doing their favorite active for ≥ 1 hour during the night. Sleep issues in ASD may stem from bedtime habits, daytime habits, anxiety, bedwetting, biological causes, illness, night terrors and nightmares, restless sleep, snoring, and social communication difficulties.

However, since conventional treatments are often ineffective for these individuals, alternative methods need to be explored. Currently the first line sleep treatment for children with ASD is introducing sleep hygiene rules to create better sleep-related habits like not viewing screens before bed and making sure the room is dark.³

According to the National Autistic Society, the sleep hygiene rules might put pressure on them to follow yet another mainstream rule. A study found 4 things might help children with ASD fall asleep: engaging in focused interests or sensory autonomy before bedtime and having more control and choice in daily lives, such as around physical activity.

Recently, medicinal cannabis has emerged as a potential therapeutic option.¹

Maqbool and colleagues sought to assess the efficacy of specific CBD:THC ratios in improving sleep parameters—sleep onset latency, quality, and duration—among children with ASD. The study included 80 children, aged 3 – 17 years, who were diagnosed with ASD and experienced sleep disturbances.

The team randomized the participants to receive medicinal cannabis oil with CBD:THC ratios ranging from 0:1 to 19:1. Randomization was tailored to individual’s treatment needs.

The primary endpoint was assessing the overall effectiveness of medicinal cannabis with the several ratios of CBD and THC. Secondary endpoints included assessing onset latency, quality, and duration with actigraphy, parental diaries, and validated questionnaires at baseline and after the 12-week treatment period.

Investigators saw significant improvements in sleep onset latency, quality, and duration. Participants had the most improvements in sleep disturbances at CBD:THC ratios of 1:1 to 4:1.

“These findings suggest that these ratios might offer an optimal balance for therapeutic effects in children with ASD,” Maqbool wrote in the late breaker abstract.

Maqbool and colleagues observed the effectiveness of medicinal cannabis reduced at the extreme ratios of CBD:THC ratios of 0:1 and 19:1, once again suggesting the significance of optimal balance. Ultimately, the intervention as well-tolerated with limited adverse events.

Overall, medicinal cannabis at the range CBD:THC ratios of 1:1 to 4:1 shows promising therapeutic potential for managing sleep disturbances in children with ASD.

“This study highlights the importance of cannabinoid profiling in developing effective treatments,” Maqbool concluded. “Further research is warranted to explore long-term impacts and mechanistic insights.”

References

1. ^{Maqbool, M. The Effect of Medicinal Cannabis on Sleep in Children with Autism Spectrum Disorder. Abstract presented at SLEEP 2024. Houston, TX. June 1-5, 2024.}
2. ^{Sleep Problems and Solutions: Autistic Children. Raising Children. https://raisingchildren.net.au/autism/health-wellbeing/sleep/sleep-problems-children-with-asd. Accessed June 1, 2024.}
3. ^{Pavlopoulou, G. Autistic Teenagers and Sleep. National Autistic Society. April 9, 2021. https://www.autism.org.uk/advice-and-guidance/professional-practice/teenagers-sleep. Accessed June 1, 2024.}