Recent Cannabis Use Linked to More Extreme Sleep Duration

NEW YORK (Reuters Health) – Recent cannabis users were more likely than non-users to report extremes of sleep duration – less than six hours or more than nine hours – and the patterns were even more pronounced among heavy users, researchers have found.

“Individuals who recently used cannabis were more likely to report worse sleep when compared to survey respondents who had not used cannabis within the past thirty days,” said Dr. Karim Ladha of St. Michael’s Hospital and the University of Toronto, in Canada, who worked on the study.

“This was an observational study and therefore we cannot determine whether this relationship was causal or simply a correlation,” he told Reuters Health by email. “However given that both sleep and cannabis are widespread issues that affect public health, it is important to investigate this association further.”

The findings were published in Regional Anesthesia and Pain Medicine.

To explore the impact of cannabis on sleep, Dr. Ladha and his team turned to data from the National Health and Nutrition Examination Survey (NHANES). The researchers note that NHANES is designed to yield nationally representative data for the non-institutionalized civilian population in the continental U.S.

From 2005 to 2018, NHANES surveyed participants about cannabis use and the researchers identified 21,729 adults with complete data, of whom 3,132 (14.5%) reported cannabis use in the past 30 days.

Comparing participants with no cannabis use in the past 30 days to recent users, the researchers found recent users were significantly more likely to report sleeping less than six hours per night (15.7% vs. 11.6%) or more than nine hours (6.5% vs. 3.1%).

After adjusting for covariates, recent cannabis users had 34% greater odds of reporting short sleep (P<0.001) and 56% greater odds of reporting long sleep (P<0.001).

Dr. Ladha and his colleagues also found other signs of disturbed sleep in the recent cannabis users. They were significantly more likely to report difficulty falling asleep, staying asleep, or sleeping too much in the past two weeks (adjusted odds ratio, 1.31) and having ever told a physician they were having trouble with sleep (aOR, 1.29). However, recent cannabis use was not associated with frequent daytime sleepiness.

The impact of cannabis on sleep duration was more pronounced with increasing days of use. Heavy use, that is 20 or more of the previous 30 days, was associated with a greater likelihood of reporting both short (aOR, 1.64) and long sleep (aOR, 1.76) compared with non-users.

“Previous literature has suggested that THC may cause hyper excitability and in turn disrupt sleep,” Dr. Ladha said. “However at this point it is an area of active investigation.”

The study findings do not suggest people never use cannabis as a sleep aid, he added.

“Indeed, I have prescribed cannabis to numerous chronic pain patients who have reported improved sleep as a result of cannabis use,” Dr. Ladha said. “Rather, the findings highlight the fact that the relationship between sleep and cannabis use is a complicated issue that individuals should discuss with their healthcare provider. There are likely strains or types of cannabis that can help individuals sleep, but we need more research to determine which ones and which patients will obtain the benefit instead of harm.”

SOURCE: Regional Anesthesia and Pain Medicine, online December 6, 2021.

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