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Deepak Cyril D'Souza, Staff Psychiatrist, VA Connecticut Healthcare System; Professor of Psychiatry, Yale University School of Medicine,David Castle, University of Tasmania, Australia,Sir Robin Murray, Honorary Consultant Psychiatrist, Psychosis Service at the South London and Maudsley NHS Trust; Professor of Psychiatric Research at the Institute of Psychiatry
Sleep is a vital biological process, serving an important role in proper neurodevelopment, energy conservation, brain waste clearance, modulation of immune responses, neurocognition, mood, memory consolidation and performance/vigilance. Many of these processes are altered in psychiatric illnesses. There is mounting evidence that the endocannabinoid system (ECS) plays a key role in the sleep/wake cycle. Acute administration and chronic use of THC and cannabis have been shown to alter sleep in small studies of healthy, young people. Sleep disturbances are also part of cannabis withdrawal syndrome and include increased sleep complaints, decreased SWS and increased REM. Sleep disturbances are a promising target for treatment of cannabis use disorder. Given the link between cannabinoids and psychosis, the role of cannabis-induced sleep alterations in psychosis-prone individuals and schizophrenia patients warrants further study.
The impact of prenatal cannabinoid exposure on brain development and interest in understanding its interference with normal adult neurological function has fostered the characterization of the endocannabinoid system (ECS) during nervous system development. Multiple lines of evidences show that the ECS regulates the functionality of neural progenitor cell populations during development and in adult neurogenic areas. CB1 receptors allow crosstalk with growth factor and neurotrophin signaling at different levels. The glutamatergic neuronal dysfunction hypothesis of schizophrenia suggests that malfunction of the developmental role of CB1 receptors in pyramidal neurogenesis may contribute to the pathogenesis of psychoses or schizophrenia symptoms. Recent findings have demonstrated that endocannabinoids and CB1 receptors are crucial regulators of neurogenic processes including neural progenitor cell proliferation and survival, neuronal specification, migration, synapse establishment and the correct connectivity of newly formed cells. The ECS may be considered as a novel regulatory signaling system of neurogenesis and nervous system maturation.