Feasibility of real-time monitoring of posttraumatic stress disorder symptoms, sleep quality among patients on medical marijuana

Krishna Vaddiparti
University of Florida

Posttraumatic stress disorder (PTSD) is a debilitating disorder that occurs following a life-threatening trauma. PTSD is associated with sleep disturbances, nightmares, and poor mental health quality of life. Medical marijuana (MMJ) is often used to improve sleep and other PTSD- related symptoms, but at this point, we lack evidence on its effectiveness as a therapy for PTSD.

Objective: This presentation will demonstrate the feasibility of engaging persons with PTSD in a follow-up study and assessing in real-time using smartphones, and present the main outcomes of the study.

Methods: Fifteen persons who met PTSD criteria and seeking to start MMJ for their symptoms were recruited from medical cannabis clinics in North-Central Florida. Participants were assessed at three-time points: baseline – before starting MMJ, and 30- and 70-days after MMJ initiation using PTSD checklist for DSM-5 (PCL-5), Pittsburgh Sleep Quality Index (PSQI), Positive and Negative Affect Schedule (PANAS), and PROMIS Global Health. Ecological Momentary Assessment (EMA) was conducted using smartphones longitudinally four-times a day for one week at baseline, dose-adjustment, and stable-dose phases respectively.

Results: We have screened 61 individuals, of which 24 (39%) were eligible; 17/24 (71%) consented to participate in the study. One participant withdrew after consent; 16/17 (94%) completed the Baseline Assessment. One participant was lost to follow-up after the baseline survey; 15/17 (88%) completed the Baseline survey and EMA. All 15 (100%) completed all study assessments (Dose-Adjustment EMA, 30- day survey, Stable-Dose EMA, and 70-day survey). Participants’ mean age was 44 years (SD 11.9), 80% were white, and 60% were female. Majority (73%) used other drugs in their lifetime Results demonstrated significant improvements at 30- and 70-day follow-up in PTSD score [F(2,24)=13.25], PSQI score [F(2,25)=16.54], Sleep quality [F(2,27)=22.57], Sleep duration [F(2,27)=8.33], nightmares [F(2,26)=13.87], negative affect [F(2,26)=9.82], and mental health [F(2,27)=8.44]. All outcomes were statistically significant at p<0.05.

Conclusion: This pilot demonstrated the feasibility of engaging persons with PTSD on MMJ in a study involving daily EMA assessments and surveys at follow-up. This pilot also demonstrated improvements in sleep and well-being, and decreases in PTSD symptoms and nightmares following MMJ, with effects lasting at least 70 days after initiation.

Co-authors: Carly Crump1, Zhi Zhou1, Yan Wang1, John Williamson1, Robert Cook1
1University of Florida

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