Cannabis Helped Sleep in the First Week of Treatment but Hurt It by Week Two | Research

The takeaway

In a daily tracking study of 65 young people in cannabis treatment, cannabis use was associated with less sleep trouble in the first two weeks, but the sleep duration relationship flipped from positive to negative by week two.

Young people trying to quit cannabis, addiction treatment clinicians, sleep researchers

Cannabis-sleep relationship reversed from benefit to harm by week 2 of treatment

What the researchers found

During the first week of treatment, more cannabis use was associated with longer sleep for those with severe cannabis use disorder, but shorter sleep for those with mild CUD. By week two, more cannabis use was associated with shorter sleep regardless of severity. During the first two weeks, cannabis use was associated with less trouble sleeping. After week two, cannabis use had no significant association with sleep.

Why it matters

Sleep disruption is one of the most commonly reported cannabis withdrawal symptoms and a barrier to treatment success. Understanding exactly when and how cannabis affects sleep during treatment can help clinicians prepare patients for sleep difficulties in early recovery.

The numbers in context

N=65, ages 15-24, 51% female, 57% White. 42-day EMA study. Week 1: cannabis associated with longer sleep in severe CUD and shorter sleep in mild CUD. Week 2: cannabis associated with shorter sleep regardless of severity. Weeks 1-2: cannabis associated with less trouble sleeping. After week 2: no significant cannabis-sleep associations.

How the study worked

Ecological momentary assessment study with 65 adolescents and young adults (ages 15-24) in CUD treatment, completing daily reports over 42 days while receiving cognitive behavioral therapy plus motivational enhancement therapy. Time-varying effect modeling examined how cannabis-sleep associations changed across treatment.

What this study cannot tell us

Small sample (N=65). Self-reported daily measures of both cannabis use and sleep. Treatment-seeking sample may not generalize to all young cannabis users. Cannot control for all confounding factors in daily data. Specific to CBT+MET treatment context.

How to read the evidence

Moderate evidence from a well-designed daily assessment study, though limited by small sample size and self-reported measures.

When this study was published

2025 publication analyzing data collected 2009-2012.

The bigger picture

This is one of the first studies to examine day-level cannabis-sleep associations during treatment. The finding that the relationship changes over the course of treatment suggests that sleep interventions should be front-loaded, with the most intensive sleep management support provided in the first two weeks.

Questions still open

Would providing dedicated sleep hygiene interventions in the first two weeks of treatment improve cannabis treatment retention? Does the cannabis-sleep relationship during treatment differ by cannabis product type? Are the early-treatment sleep benefits of cannabis use due to withdrawal avoidance?

Common questions

Does quitting cannabis make sleep worse?

In this study, cannabis use was associated with less trouble sleeping during the first two weeks of treatment, suggesting that stopping cannabis may indeed worsen sleep difficulties initially. However, by week three, cannabis use no longer had any significant relationship with sleep.

When is sleep worst during cannabis treatment?

The first two weeks appear to be the critical window. The study found that cannabis-sleep associations were only significant during this early treatment period, suggesting clinicians should provide the most intensive sleep support at the start of treatment.

Read the original research

Dynamic associations between cannabis use and sleep in adolescents and young adults during a cannabis intervention trial.

Journal of research on adolescence : the official journal of the Society for Research on Adolescence, 35(4), e70083

View on PubMed ↗Publisher’s paper ↗

Citation

Parnes, Jamie E; Smith-LeCavalier, Kirstyn N; Meisel, Samuel N; Miranda, Robert. (2025). Dynamic associations between cannabis use and sleep in adolescents and young adults during a cannabis intervention trial.. Journal of research on adolescence : the official journal of the Society for Research on Adolescence, 35(4), e70083. https://doi.org/10.1111/jora.70083