Sleep problems and substance use disorders fuel each other in both directions | Research

The takeaway

Sleep disturbance is both a common consequence of substance use and withdrawal and an independent risk factor for relapse, with cannabis withdrawal showing measurable effects on both subjective and objective sleep measures.

Read this if you have trouble sleeping when you stop using cannabis or other substances.

Sleep disruption both results from and promotes substance use relapse

What the researchers found

This review examined the bidirectional relationship between sleep disorders and substance use. For cannabis specifically, research had progressed beyond subjective reports to demonstrate that marijuana withdrawal produces measurable changes on objective sleep measures including polysomnography and actigraphy.

The review highlighted an interactive effect: substance use disrupts sleep through direct effects on neurotransmitter systems regulating the sleep-wake cycle, while poor sleep during withdrawal increases relapse vulnerability. Treatment studies had focused primarily on alcohol use disorders, with therapies for insomnia in cannabis disorders identified as a significant gap.

Why it matters

Sleep disturbance is one of the most frequently reported symptoms of cannabis withdrawal and one of the longest-lasting. Understanding it as both a consequence and a risk factor for continued use has implications for treatment design.

The numbers in context

No specific statistics were reported. The review identified cannabis withdrawal sleep research as a growing field and insomnia treatment for cannabis disorders as a gap.

How the study worked

Narrative review of recent research findings on sleep disturbance in substance use disorders, with emphasis on alcohol and cannabis. Covered neurobiological mechanisms, clinical findings, and treatment approaches.

What this study cannot tell us

Narrative review without systematic methodology. Treatment evidence was largely limited to alcohol disorders. The specific mechanisms by which cannabis withdrawal disrupts sleep were not fully characterized.

How to read the evidence

Narrative review of a growing evidence base, highlighting the bidirectional sleep-substance use relationship.

When this study was published

Published in 2014.

The bigger picture

The recognition that sleep disruption actively promotes relapse suggests that treating sleep problems should be integrated into substance use treatment rather than treated as a secondary symptom. This is particularly relevant for cannabis, where sleep disturbance can persist for weeks after cessation.

Questions still open

Would treating insomnia during cannabis withdrawal improve quit rates? Are sleep-focused interventions more effective than general withdrawal management for cannabis cessation? How long do sleep disturbances persist after quitting cannabis?

Common questions

Does quitting cannabis affect sleep?

Yes. This review noted that cannabis withdrawal produces measurable changes on both subjective and objective sleep measures. Sleep disruption is one of the most common and persistent withdrawal symptoms.

Can poor sleep cause relapse?

The review highlighted an interactive effect: substance use disrupts sleep, and poor sleep during withdrawal increases the risk of relapse. This bidirectional relationship suggests that treating sleep problems may help prevent relapse.

Read the original research

Sleep and substance use disorders: an update.

Current psychiatry reports, 16(10), 487

View on PubMed ↗Publisher’s paper ↗

Citation

Conroy, Deirdre A; Arnedt, J Todd. (2014). Sleep and substance use disorders: an update.. Current psychiatry reports, 16(10), 487. https://doi.org/10.1007/s11920-014-0487-3