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Suk Sai-Yad, a cannabis-containing traditional remedy, is indicated to be used for insomnia. However, scientific data on its effectiveness and safety were lacking as the use of cannabis, a schedule 5 narcotic, was prohibited by the Narcotic Act for 60 years. Method: A preliminary retrospective study was therefore conducted by assessing medical records of chronic insomnia patients in Thai traditional cannabis clinic at Chao Phya Abhaibhubejhr Hospital. The inclusion criteria were patients having insomnia for at least one month, Pittsburgh Sleep Quality Index (PSQI) more than 5, and coming back for follow-up at least once. Results: Twenty-five patients, 13 females and 12 males, with a mean age of 56 ± 13.08 years were identified. The average global PSQI score before treatment (visit 0) was 14.76 ± 3.07 and the average PSQI scores upon follow-up (visits 1-6) were 10.56 ± 3.69, 7.70 ± 3.54, 9.30 ± 3.56, 8.71 ± 4.38, 7.20 ± 3.89, and 8.00 ± 5.29, respectively. The comparison of global PSQI scores before and after treatment showed a significant decrease (p < 0.05) in every visit, except for the last visit (visit 6). After treatment, 6 patients were classified as good sleep quality (global PSQI score ≤ 5). The quality of life, as determined by EQ-5D-5L, only slightly increased, probably because the quality of life had been good since the beginning. Gastrointestinal tract irritation was the most common side effect found in 64% of patients. Conclusion: Suk Sai-Yad traditional remedy was significantly effective for chronic insomnia during the first 5 months of the treatment. Further prospective study in a larger population should be conducted to ensure its efficacy and safety and a modification of dosage form should be considered to reduce side effects.
The Nation. 19 million Thais suffer from insomnia, says hospital director. [Internet]. 2019 Mar [cited 2020 Dec
; Available from: https://www.nationthailand.com/national/30365890
Lo CM, Lee PH. Prevalence and impacts of poor sleep on quality of life and associated factors of good sleepers
in a sample of older Chinese adults. Health Qual Life Outcomes. 2012;10:72.
Kim CE, Shin S, Lee HW, Lim J, Lee JK, Shin A, Kang D. Association between sleep duration and metabolic
syndrome: a cross-sectional study. BMC Public Health. 2018;18(1):720.
Hafner M, Martin S, Jirka T, Wendy MT, Christian VS. Why sleep matters—the economic costs of insufficient
sleep: A cross-country comparative analysis. RAND Europe [Internet]. 2016 [cited 2020 Dec 18]; [81 screens].
Available from: https://www.rand.org/pubs/research_reports/RR1791.html.
Market Think. Sleeping aids market overview. [Internet]. 2020 Oct [cited 2020 Dec 18]; Available from: https://
Soonthornvej S. Thai traditional medicine textbook “Paet Tam-Bon”. 1st ed. Bangkok: Ak-Sorn-Ni-Dti Printing;
138 p. (in Thai)
Watpo Thai traditional medical school, editor. Medicinal plant properties textbook (Part1). Bangkok: Bopit Kaanpim Printing; 1964. 53 p. (in Thai)
Office of the Nacrotics Control Board (North Region), editor. Marijuana-Hemp. 1st ed. 2001. 28 p. (in Thai)
Babson KA, Sottile J, Morabito D. Cannabis, cannabinoids, and sleep: A review of the literature. Curr
Psychiatry Rep. 2017;19(4):23.
Kuhathasan N, Dufort A, MacKillop J, Gottschalk R, Minuzzi L, Frey BN. The use of cannabinoids for sleep:
A critical review on clinical trials. Exp Clin Psychophar macol. 2019;27(4):383-401.
Notification of the Ministry of Public Health on Prescribing schedule 5 narcotic medicines containing cannabis
as an ingredient that can be consumed for the treatment of diseases or for research B.E. 2562. (2019, 29 March).
Government Gazette. Vol. 136. Special Section 94 Ngor. 11 April 2019.
Methipisit T, Mungthin M, Saengwanitch S, Ruangkana P, Chinwarun Y, Ruangkanchanasetr P, Panichkul S,
Ukritchon S, Mahakit P, Sithinamsuwan P. The development of sleep questionnaires Thai version (ESS, SASDQ,
and PSQI): Linguistic validation, reliability analysis and cut-off level to determine sleep related problems in
Thai population. J Med Assoc Thai. 2016;99(8):893-903.
Pattanaphesaj J, Thavorncharoensap M, Ramos-Goñi JM, Tongsiri S, Ingsrisawang L, Teerawattananon Y.
The EQ-5D-5L valuation study in Thailand. Expert Rev Pharmacoecon Outcomes Res. 2018;18(5):551-8.
Manjavong M, Limpawattana P, Mairiang P, Anutrakulchai S. Prevalence of insomnia and related impact: An
analysis from a university community. Int J Psychiatry Med. 2016;51(6):544-53.
Bhaskar S, Hemavathy D, Prasad S. Prevalence of chronic insomnia in adult patients and its correlation
with medical comorbidities. J Family Med Prim Care. 2016;5(4):780-4.
Chinvararak C, Tangwongchai S, Dumrongpiwat N. Sleep quality and its associated factors in the elderly
at Pracha Niwet Village. J Psychiatr Assoc Thailand [Internet]. 2018 Jun 29 [cited 2020 Dec 16]; 63(2): [12
screens]. Available from: https://he01.tci-thaijo.org/index.php/JPAT/article/view/131532 (in Thai)
Foundation of Thai Traditional Medicine. Constitutional examination. Thai traditional textbook. Bangkok: Chulalongkorn University Printing House; 2004. p. 9-10. (in Thai)
Chaiarj S., Panya P. Insomnia and related factors. The Thai Journal of Nursing Council. 2005;20(2):1-12. (in Thai)
Dos Santos RG, Guimarães FS, Crippa JAS, Hallak JEC, Rossi GN, Rocha JM, Zuardi AW. Serious adverse effects
of cannabidiol (CBD): a review of randomized controlled trials. Expert Opin Drug Metab Toxicol. 2020;16(6):517-
Policy-driven Committee in Public Relation for Medical use of Cannabis Ministry of Public Health. Thai traditional cannabis remedies: Suk-Sai-Yad. [Internet]. [cited 2020 Dec 16]; Available from: http://www.medcannabis.go.th. (in Thai)
Pattanacharoenchai N, Itharat A. Anti-allergic activity of Trikatuk Tripha and Trisarn remedies. Thammasat
Medical Journal. 2017;17(4):548-56. (in Thai)
Taqvi SI, Shah AJ, Gilani AH. Blood pressure lowering and vasomodulator effects of piperine. J Cardiovasc
Hasani H, Arab A, Hadi A, Pourmasoumi M, Ghavami A, Miraghajani M. Does ginger supplementation lower
blood pressure? A systematic review and meta-analysis of clinical trials. Phytother Res. 2019;33(6):1639-47.
Sheriff OL, Olatubosun OT, Okesina K, Owoyele B. The effect of Zingiber officinale (ginger) extract on blood
pressure and heart rate in healthy humans. IOSR Journal of Dental and Medical Sciences. 2014;13(10):76-8
Inchan A, Promma P, Yoysungnoen B, Chootip K. Cardiovascular action of Piper longum. Planta Medica.
Dinakorn Na Ayudhaya K (editor). Medical use of cannabis. Academic Conference for Medical use of Cannabis
in Thai Traditional Medicine; 2019 Apr 29-30; TK Palace Convention Hotel, Bangkok. (in Thai)
Amorndoljai P. The use of ginger (Zingiber officinale Roscoe) in treatment and relieves symptom of osteoarthritis. Journal of Health and Health Management. 2016;3(2):12-22. (in Thai)
Kumar S, Kamboj J, Suman, Sharma S. Overview for Various Aspects of the Health Benefits of Piper Longum
Linn. Fruit. J Acupunct Meridian Stud. 2011;4(2):134-40.
Whiting PF, Wolff RF, Deshpande S, Di Nisio M, Duffy S, Hernandez AV, Keurentjes JC, Lang S, Misso K, Ryder S,
Schmidlkofer S, Westwood M, Kleijnen J. Cannabinoids for medical use: A systematic review and meta-analysis.
Latif Z, Garg N. The impact of marijuana on the cardiovascular system: A review of the most common
cardiovascular events associated with marijuana use. J Clin Med. 2020;9(6):1925.