Abstracts

Rationale: The use of cannabidiol (CBD) for the treatment of epilepsy has increased in recent years, and with the recent FDA-approval of a pharmaceutical-grade CBD, this trend is expected to continue. We are increasingly recognizing the importance of the relationship between sleep and epilepsy, yet the impact of newer epilepsy treatments on sleep architecture and efficiency, including CBD, is poorly understood. Methods: Medical records from Children’s Hospital Colorado were screened to identify patients aged 3–18 who had received a diagnosis of epilepsy and had also undergone full-night diagnostic polysomnography (PSG). This population was then further screened for patients who had CBD use contemporaneous with their PSG. Based on the initial power analysis, age-matched controls were identified for an approximately 2-to-1 ratio of controls to study subjects. Upon being assigned to a cohort, PSG reports were reviewed to obtain quantitative measures of sleep quality and architecture. Documentation from the patient’s neurologist at the time of his or her PSG was also reviewed to extract general clinical information related to sleep and epilepsy. Results: Screening procedures resulted in the identification of 21 case subjects and 41 control subjects. The percentage of total sleep time spent in each stage is reported in Table 1. Controlling for age, there was a statistically significant decrease in N2 sleep (CBD 42.8%, non-CBD 49.1%, p value 0.023) and a trend of increasing N3 sleep (CBD 32.4%, non-CBD 27.9%, p value 0.086) among individuals taking CBD.  Conclusions: These findings suggest that CBD use might lead to a decrease in N2 sleep with a greater amount of time spent in N3 sleep. As N2 and N3 sleep appear to play differing roles in memory consolidation and learning, the clinical impact of this shift remains to be elucidated. Given the limitations of this retrospective chart review, further research on the effects of CBD on sleep architecture and associated clinical measures is needed. Funding: This work was supported in part by the Children's Hospital Research Institute. JJB also receives financial support from the NINDS CNCDP-K12 program (K12NS089417-03).