Cannabis helps people fall asleep but may harm sleep quality

A new study reports that about 22 percent of young adults in the United States use cannabis or alcohol to fall asleep.

The research team analyzed a national sample of 19 to 30 year olds and found that cannabis was the more common sleep aid.

How cannabis links to sleep

Megan E. Patrick, research professor at the University of Michigan Institute for Social Research (ISR), led the analysis of a long running national panel that follows teens into adulthood.

The panel is part of Monitoring the Future, a program that conducts repeated follow-ups with the same people over time, a panel design that reveals habits as they change.

The new analysis focused on sleep initiation, not on overall sleep satisfaction or daytime performance.

It showed that cannabis was used for sleep more often than alcohol, and that specific groups reported using substances for sleep at different rates.

Cannabis patterns for sleep

Women were nearly twice as likely as men to use cannabis to fall asleep, and participants who identified as another gender were more than four times as likely.

Black young adults were three times as likely as white peers to use alcohol for sleep, a pattern that warrants attention to access, stigma, and care quality.

How sleep gets disrupted

Alcohol can shorten sleep latency, the time it takes to fall asleep, but it fragments the second half of the night.

That fragmentation includes more awakenings and less consolidated sleep in later hours, which undercuts how rested people feel the next day.

A key target of alcohol’s impact is REM sleep, the stage linked to dreaming and memory consolidation.

When REM sleep is delayed or suppressed early, rebound effects can appear later in the night with more wakeups and lighter sleep.

“Using these substances to get to sleep can backfire because they can interfere with the ability to stay asleep and with the quality of sleep,” said Patrick.

Cannabis sleep effects

Clinical groups have cautioned that evidence for cannabis as a sleep therapy is limited, and that risks include daytime sleepiness and impaired alertness.

Laboratory and wearable based data have found minimal or inconsistent changes in sleep stages after cannabis use near bedtime, and no robust improvement in sleep quality in most healthy adults.

“Long-term, regular use of these substances to get to sleep may lead to worse sleep problems and increased risk for substance use disorder,” said Patrick.

One driver is tolerance – needing more of a substance for the same effect – which can set off a cycle of escalating use and lighter, more disrupted sleep.

How the body reacts

Substances may reduce pre-sleep arousal at first, but they also shift the body’s homeostasis, the internal balance that stabilizes sleep and wake.

As the body metabolizes alcohol overnight, sympathetic activity rises and heart rate increases, which tracks with the bursts of wakefulness many users notice late at night.

Cannabis can alter sleep architecture, the proportion and sequence of sleep stages across the night.

When the profile of stages is skewed, people can hit their pillow faster but wake less refreshed, even when total time in bed looks normal.

Better options that work

Experts recommend starting with cognitive behavioral therapy for insomnia, a clinical guideline that puts non drug strategies first for adults with persistent trouble sleeping.

CBT-I, structured therapy that retrains sleep habits and thoughts, teaches time in bed control, consistent wake times, and targeted strategies for worry at night.

It also addresses learned patterns that keep insomnia going, which medications and substances do not target.

People often see gains that last for months, since the skills reduce the pressure to chase sleep with chemicals.

What cannabis means for sleep

These results do not claim that every person who uses cannabis or alcohol at bedtime will develop insomnia or addiction.

They do show that a sizable slice of young adults is self treating a sleep problem with substances, despite better evidence based options.

Clinicians should ask about sleep and substance use together, since both track closely in this age range.

Brief counseling can clarify near term effects, including lighter second half sleep after alcohol and variable next day alertness after cannabis.

Switching the focus to sleep quality

Young adults who struggle to sleep most nights for more than two weeks should speak with a clinician about CBT-I, short term relief strategies, and follow up.

Screening for anxiety, depression, and circadian rhythm disorders, patterns of timing problems in the body clock, can uncover fixable drivers that mimic insomnia.

If someone already uses substances at bedtime, harm reduction starts with cutting frequency, avoiding mixing, and keeping sleep schedules steady on weekdays and weekends.

Switching the focus from falling asleep faster to sleeping more soundly is a small shift with big payoff, especially when combined with a realistic plan.

The study is published in the journal JAMA Pediatrics.

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