Cannabis Use and Sleep

Cannabis has long been associated with sleep disturbance, but the precise nature of this relationship remains unclear. The limited effectiveness and tolerability of existing sleep aids indicates a critical need for viable alternatives. Cannabis may prove such an alternative, as a growing proportion of cannabis users report a beneficial effect of cannabis on a range of sleep disturbances. Further, emerging clinical evidence supports the use of cannabis and cannabis-derived compounds in the treatment of sleep disorders, as well as disordered sleep secondary to other diagnoses such as chronic pain, post-traumatic stress disorder (PTSD), and depression. However, these results are often inconsistent across studies, likely due to a combination of varying user characteristics – such as duration and frequency of use – and different formulations and potencies employed by different research designs. Additionally, extensive research supports a bidirectional relationship between sleep and cannabis use, such that sleep disturbance increases cannabis use and risk of misuse, while long-term cannabis use increases risk of sleep disturbance. To explicate the complex relationship between cannabis and sleep, we propose the following directions for future research: 1) comparison of plant-based and synthetic cannabinoids in relation to sleep; 2) comparison of different modes of administration, dosages, and potencies; 3) comparison of different durations of cannabis use (i.e., pre-onset of use, short-term use, and long-term use); 4) comparison of cannabis use exclusively as a sleep aid versus effects of cannabis on sleep outcomes comorbid with other conditions; and 5) comparison of sleep outcomes between recreational and medical cannabis users.