Cannabis use for sleep and stress by veterans may create a cycle that worsens both problems | Research

The takeaway

In 1,105 post-9/11 veterans tracked over 12 months, insomnia drove stress increases, stress drove cannabis use increases, and cannabis use in turn worsened both stress and insomnia, creating a reinforcing cycle.

People interested in cannabis for sleep, veteran health, and the complex relationships between insomnia, stress, and substance use.

Cannabis use predicted worsening of both stress and insomnia over time

What the researchers found

Higher prior insomnia levels predicted greater increases in perceived stress. Greater prior stress predicted greater increases in cannabis use. Critically, cannabis use also predicted greater increases in both stress and insomnia severity, suggesting a bidirectional, self-perpetuating cycle rather than a simple self-medication pattern.

Why it matters

Many veterans use cannabis for sleep and stress relief. This study reveals a paradox: while cannabis may provide short-term relief, over time it appears to worsen the very problems it is used to treat, creating a cycle that could sustain both insomnia and stress.

The numbers in context

1,105 post-9/11 veterans. 4 assessment points over 12 months. Insomnia predicted stress increases. Stress predicted cannabis use increases. Cannabis use predicted increases in both stress and insomnia.

How the study worked

Longitudinal study of 1,105 post-9/11 veterans assessed at 4 time points across 12 months. Latent difference score modeling examined proportional change relationships between insomnia, perceived stress, and cannabis use.

What this study cannot tell us

Observational study cannot establish true causation. Self-reported measures may not capture objective sleep quality. Cannot distinguish between different cannabis products, doses, or timing of use. Veteran population may not generalize to civilians.

How to read the evidence

Longitudinal design with advanced statistical modeling in a large veteran sample. Limited by self-report and inability to control for cannabis product specifics.

When this study was published

Published in 2024 in the Journal of Sleep Research.

The bigger picture

Veterans have among the highest rates of both insomnia and cannabis use of any population. Understanding that cannabis may be sustaining a sleep-stress-use cycle has implications for VA treatment approaches and challenges the assumption that cannabis is a benign sleep aid.

Questions still open

Would evidence-based insomnia treatments (CBT-I) break the cycle more effectively than cannabis? Does the type of cannabis product matter for the insomnia-worsening effect? Would combining cannabis with sleep hygiene practices prevent the cycle?

Common questions

Does cannabis help with sleep?

This study found a paradox: while veterans may use cannabis for sleep relief, over 12 months cannabis use predicted worsening insomnia and stress. The short-term benefit may come at the cost of longer-term sleep problems.

Why might cannabis worsen sleep over time?

The study found cannabis created a cycle: insomnia led to stress, stress led to more cannabis use, and more cannabis use worsened both stress and insomnia. This bidirectional pattern suggests the relief is temporary while the underlying problems compound.

Read the original research

Longitudinal associations between insomnia, cannabis use and stress among US veterans.

Journal of sleep research, 33(1), e13945

View on PubMed ↗Publisher’s paper ↗

Citation

Davis, Jordan P; Prindle, John; Saba, Shaddy K; Castro, Carl A; Hummer, Justin; Canning, Liv; Pedersen, Eric R. (2024). Longitudinal associations between insomnia, cannabis use and stress among US veterans.. Journal of sleep research, 33(1), e13945. https://doi.org/10.1111/jsr.13945