How Older Adults Use Cannabis for Sleep: Patterns from a Geriatrics Clinic | Research

The takeaway

Among elderly patients using cannabis, those treating sleep problems used it more frequently, preferred THC-containing products over CBD-only, and most commonly used it right before bed.

Read this if you're an older adult using cannabis for sleep or a clinician advising elderly patients — the self-medication patterns here are important to understand.

What the researchers found

Cannabis use among older adults is growing fast, and sleep is one of the top reasons cited. This study surveyed 568 patients at a geriatrics clinic and found 83 who had used cannabis in the past three years, then compared those using it for sleep versus other conditions.

The patterns were revealing. Older adults using cannabis for sleep were distinctive: they used it more frequently than those using it for other conditions, strongly preferred THC-containing products (rather than CBD-only), and timed their use close to bedtime. This daily-before-bed pattern suggests these patients are self-medicating sleep problems in a systematic way, not using cannabis casually.

The preference for THC over CBD is notable because THC has sedating properties at certain doses while CBD's sleep effects are less clear. These elderly patients appear to have figured this out on their own — possibly through trial and error — and settled on THC-containing products as more effective for sleep.

The study also found that many of these older adults were navigating cannabis use without much guidance from their healthcare providers, raising concerns about drug interactions, especially in a population typically on multiple prescription medications.

Why it matters

Sleep problems are endemic among older adults, affecting 40-70% of the elderly population. Many standard sleep medications (benzodiazepines, Z-drugs) carry significant risks in older adults, including falls, cognitive impairment, and dependence. Understanding how elderly patients actually use cannabis for sleep — which products, how often, when — is essential for clinicians who will increasingly face questions about it as an alternative.

The numbers in context

568 geriatrics clinic patients surveyed. 83 (14.6%) reported cannabis use in the past 3 years. Sleep users consumed cannabis more frequently (p = .01), preferred THC-containing products over CBD-only (p < .05), and were more likely to use cannabis right before bed (p < .01). The majority (62.7% in related findings) found cannabis overall effective for their conditions.

How the study worked

Cross-sectional anonymous survey of 568 adults seen at a geriatrics clinic, including 83 who reported cannabis use within the past 3 years. Researchers compared cannabis use characteristics (frequency, product type, timing, THC vs. CBD preference) between those using it for sleep disturbance versus all other conditions.

Who was studied

N=568 adults aged 65 and older, 60% female, from a geriatrics clinic

What this study cannot tell us

Cross-sectional survey design — cannot establish whether cannabis actually improved sleep or whether patients just perceived it as helpful. Anonymous survey limits verification of self-reported use patterns. Single geriatrics clinic in one geographic area. Cannabis use was self-reported with no product verification or dosage data. The 83-person cannabis user subgroup is relatively small for making detailed comparisons between sleep and non-sleep users.

How to read the evidence

Cross-sectional survey from a single clinic. Good for describing patterns of use in this population, but cannot determine whether cannabis actually improves sleep in older adults.

When this study was published

Published in 2023. Cannabis use among seniors continues to grow rapidly, and clinician awareness is still catching up.

The bigger picture

This pairs directly with RTHC-00083 (medicinal cannabis for sleep disorders review), which found insufficient clinical trial evidence for cannabis as a sleep treatment. Here we see the patient side: elderly people are already using cannabis for sleep, whether the evidence base supports it or not, and they're settling on THC products based on personal experience. The gap between what patients are doing and what research can guide is a central theme across the RethinkTHC sleep cluster.

Replication

Not stated in abstract.

Funding

Not reported in abstract.

Conflicts of interest

Not reported in abstract.

Questions still open

Are elderly patients using cannabis for sleep getting adequate sleep quality, or just falling asleep faster? Are there drug interactions between bedtime cannabis and common geriatric prescriptions (blood pressure medications, anticoagulants, benzodiazepines)? Would clinician-guided cannabis use for sleep produce better or safer outcomes than the self-directed approach most patients are currently taking?

Read the original research

Cannabis use for Sleep Disturbance Among Older Patients in a Geriatrics Clinic.

International journal of aging & human development, 97(1), 3-17

The International Journal of Aging & Human Development is a peer-reviewed journal focusing on issues related to aging.

View on PubMed ↗Publisher’s paper ↗

Citation

Kaufmann, Christopher N; Malhotra, Atul; Yang, Kevin H; Han, Benjamin H; Nafsu, Reva; Lifset, Ella T; Nguyen, Khai; Sexton, Michelle; Moore, Alison A. (2023). Cannabis use for Sleep Disturbance Among Older Patients in a Geriatrics Clinic.. International journal of aging & human development, 97(1), 3-17. https://doi.org/10.1177/00914150221128971