In the American population, sleep deprivation has become a major public health concern, with only two-thirds of the adult population reporting the recommended 7–9 hours of sleep nightly. Cannabis is commonly used in the US as a sleep aid, despite there being mixed findings in the scientific literature in regard to its efficacy.
At the same time, cannabis use in North America has also increased dramatically. Approximately 45 million adults in the USA reported cannabis use in 2019, which is double the prevalence reported in the early 2000s. This increase is due in part to the widespread decriminalization of the drug during the past decade, but also due to research that shows cannabinoids may have therapeutic value in relieving pain, and in treating anxiety and sleep disorders. Evidence of the effective use of cannabis to normalize sleep patterns is, however, usually derived from small studies that show inconclusive results.
New research, published today in the online journal Regional Anesthesia & Pain Medicine makes use of data on sleep duration and cannabis use from US adults who took part in the biennial National Health and Nutrition Examination Survey (NHANES) for the years 2005 to 2018. The purpose of this study was to determine the relationship between cannabis use and nightly sleep duration in a nationally representative dataset.
“Despite the current literature demonstrating mixed effects of cannabis and various cannabinoid formulations on sleep architecture and quality, these agents are being increasingly used as both prescribed and unprescribed experimental therapies for sleep disturbances,” said the study authors.
The researchers categorized participants as non-users of cannabis, or as recent users if they had used in the past 30 days. Among those, moderate users were defined as those who had used cannabis on fewer than 20 of those days, while heavy users were those who had used on 20 or more of the past 30 days.
Sleep duration was defined as short (less than 6 hours), optimal (6–9 hours), or long (more than 9 hours). Participants were asked whether they had difficulty falling asleep, staying asleep, or sleeping for too long in the past 2 weeks. They were also asked whether they had ever consulted a doctor about a sleep problem.
Surveys from a total of 21,729 participants were used in the analysis, and the researchers state that these people were representative of an estimated 146.5 million US adults. Of these participants, 3,132 (14.5%) reported that they had used cannabis in the preceding 30 days, while the rest were non-users.
The average nightly sleep duration for all participants was just less than 7 hours but recent users were 34 percent more likely to report short sleep and 56 percent more likely to report long sleep than non-users. They were also 31 percent more likely to report difficulty falling asleep, staying asleep, or sleeping too much in the preceding 2 weeks, and 29 percent more likely to have discussed a sleeping problem with a doctor.
Furthermore, moderate users were 47 percent more likely to sleep 9 or more hours a night compared with non-users, while heavy users were 76 percent more likely to experience long sleep. Heavy users were also 64 percent more likely to experience short sleep.
The analysis took into consideration other factors that could potentially influence the relationship, such as: age; race; educational attainment; weekly working hours; a history of high blood pressure, diabetes, and coronary artery disease; weight (BMI); smoking; heavy alcohol use (4 or more drinks daily); and prescriptions for opioids, benzodiazepines, ‘Z drugs’ (approved for insomnia), barbiturates, other sedatives, and stimulants.
The findings indicate that recent cannabis use is linked to extremes of nightly sleep duration, with users being more likely to experience less than six hours or more than nine hours of sleep a night. No clear relationship between cannabis use and improved sleep patterns was observed.
“Our findings highlight the need to further characterize the sleep health of regular cannabis users in the population,” wrote the study authors. “Sleep-wake physiology and regulation is complex and research about related endocannabinoid pathways is in its early stages.”