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Cannabinoids Exposure Levels and its Relation to Anxiety Symptoms and Sleep Disturbances: A Scoping Review

Gabriela A Garcia
University of Florida

Co-authors: Juan Guillermo Perez-Carreno1, Krishna Vaddiparti1, Elizabeth Castaneda1, Pranav Sai Gupta1, Ryan Hossain2, Benjamin Z Churba1, Catalina Lopez-Quintero1
1University of Florida 2University of Central Florida

Background
At least 60% of individuals with anxiety disorders report sleep disturbances, which might be explained by shared physiological mechanisms, including cortisol dysregulation and executive function skills disruption (1–3). The scientific literature regarding medical cannabis as a potential therapeutical candidate for these conditions increased about 15 times in the last 10 years. (3–5). However, assessments of cannabinoid exposure, anxiety, and sleep are inconsistent across studies, and the quality of the evidence is not often assessed.

Methods
We developed a Scoping Review protocol to examine the current knowledge on cannabinoid use for anxiety and sleep disturbances.  A search strategy was run on PubMed, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, CINAHL, LILACS, and PsycINFO. We calibrated the screening process in 5% of the results using Rayyan. Papers were selected by duplicate using PRISMA guidelines. Quality assessment was conducted for included studies and data extraction and charting were performed according to our predefined protocol.

Results
The proposed search algorithms retrieved 1113 documents. The calibration helped to reduce discrepancies from 32% to 10.7%. A total of 319 documents were selected after reviewing titles and abstracts (22 trial protocols and 297 observational and intervention studies). At the point of this abstract, 40 papers with clear cannabis exposure measures and their association with sleep and anxiety were selected based on full content: 31 observational studies and 9 clinical trials. We plan to finish the quality assessment and data charting by the conference date.


Conclusion
We showed Scoping Reviews are subject to iterative changes, leading to a more informed protocol. We will provide evidence of the relationship between cannabis dosage and anxiety and/or sleep effects. Based on the screening phase we anticipate difficulties establishing dosage and heterogeneity in anxiety and sleep assessments among selected studies.

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