Trouble sleeping had opposite effects on cannabis use at daily vs. person levels in youth | Research

The takeaway

Youth who generally had more sleep trouble used more cannabis overall, but on specific nights of poor sleep, they were actually less likely to use cannabis the next day, revealing opposite patterns at the person vs. day level.

Youth who use cannabis for sleep, sleep researchers, cannabis treatment providers

Opposite effects at person vs. day level

What the researchers found

At the person level, trouble sleeping was associated with higher cannabis craving and negative affect (large effects, rs 0.34-0.48). Paradoxically, at the day level, more trouble sleeping was associated with lower likelihood of cannabis use the next day (beta=-0.65, p<0.001). Trouble sleeping was not indirectly linked to cannabis through negative affect, risk-taking, or craving.

Why it matters

Many cannabis users report using for sleep, but the daily-level finding that poor sleep actually decreases next-day use suggests the relationship is more complex than simple self-medication. This has implications for how sleep is addressed in cannabis treatment.

The numbers in context

86 participants (ages 15-24, 48.8% female, 58.8% White). Person-level correlations: 0.34-0.48 for sleep-craving and sleep-negative affect. Day-level: beta=-0.65 (p<0.001) for sleep trouble predicting less next-day use.

How the study worked

Ecological momentary assessment study of 86 youth ages 15-24 who regularly used cannabis, surveyed over 1 week before an intervention. Multilevel structural equation modeling evaluated day-level and person-level associations.

What this study cannot tell us

Small sample from an intervention study. Only 1 week of EMA data. Self-reported trouble sleeping, not objective sleep measurement. Cannot determine causation. Regular cannabis users only.

How to read the evidence

EMA design captures real-time data with multilevel modeling, but small sample, short duration, and pre-intervention context limit generalizability.

When this study was published

2024 EMA study of youth ages 15-24

The bigger picture

The disconnect between person-level and day-level findings is a methodological cautionary tale. People who sleep badly may use more cannabis overall, but the daily mechanism is not straightforward self-medication. Fatigue from a bad night may actually reduce motivation or opportunity to use.

Questions still open

Does the day-level reduction in use after poor sleep reflect fatigue or recovery behavior? Would longer EMA periods reveal different patterns?

Common questions

Do people use more cannabis when they sleep badly?

It depends on the level of analysis. People who generally have sleep problems used more cannabis overall, but on specific nights of poor sleep, youth were actually less likely to use cannabis the next day.

Does cannabis craving explain the sleep-use link?

Surprisingly, no. The study tested whether craving, negative affect, or risk-taking mediated the sleep-cannabis relationship at the daily level, and none of these pathways were significant.

Read the original research

A test of competing mediators linking trouble sleeping to cannabis use in adolescents and emerging adults.

Experimental and clinical psychopharmacology, 32(3), 316-328

View on PubMed ↗Publisher’s paper ↗

Citation

Berey, Benjamin L; Meisel, Samuel; Pielech, Melissa; Parnes, Jamie E; Treloar Padovano, Hayley; Miranda, Robert. (2024). A test of competing mediators linking trouble sleeping to cannabis use in adolescents and emerging adults.. Experimental and clinical psychopharmacology, 32(3), 316-328. https://doi.org/10.1037/pha0000693