Cannabis Use Was Linked to Poorer Sleep Quality in Adults With Type 1 Diabetes | Research

The takeaway

In a Canadian registry of over 1,300 adults with type 1 diabetes, cannabis users had 58% higher odds of poor sleep quality, making cannabis one of several modifiable factors associated with sleep problems in this population.

Endocrinologists, diabetes educators, T1D patients who use cannabis, and sleep medicine specialists.

What the researchers found

Cannabis use was independently associated with poor sleep quality (OR 1.578; 95% CI: 1.152–2.161) in adults with type 1 diabetes, alongside other correlates including being female, overweight/obesity, depression, fear of hypoglycemia, bedtime snacking, and low physical activity.

Why it matters

Sleep quality matters enormously for diabetes management — poor sleep worsens blood sugar control. Identifying cannabis use as an independent risk factor for poor sleep in this population provides actionable information for clinicians counseling T1D patients.

The numbers in context

1,322 participants (mean age 45, 66.9% female). Mean PSQI score: 6.0. 47.3% had poor sleep quality. Cannabis use OR for poor sleep: 1.578. Depression OR: 6.160 (strongest correlate). Always snacking before bed OR: 1.706.

How the study worked

Cross-sectional analysis of 1,322 adults with type 1 diabetes from the Canadian BETTER Registry. Sleep quality measured by the Pittsburgh Sleep Quality Index (PSQI > 5 = poor). Multivariate logistic regression adjusted for sociodemographic, diabetes-related, psychological, and behavioral variables.

What this study cannot tell us

Cross-sectional — cannot determine whether cannabis causes poor sleep or people with poor sleep use cannabis. Self-reported cannabis use without details on type, dose, or timing. Canadian sample. PSQI is subjective.

How to read the evidence

Large registry-based cross-sectional study with multivariate adjustment, but cross-sectional design and self-reported measures limit causal inference.

When this study was published

Published 2025.

The bigger picture

Nearly half of adults with type 1 diabetes have poor sleep quality. While cannabis is one of several contributing factors (and not the strongest), its identification as an independent risk factor is notable given increasing cannabis use and the common belief that cannabis improves sleep.

Questions still open

Does the timing of cannabis use relative to bedtime matter for sleep quality in T1D? Is cannabis use in T1D patients an attempt to self-medicate sleep problems or pain? Would objective sleep measurement confirm the PSQI findings?

Common questions

Should people with type 1 diabetes avoid cannabis for sleep?

This study found cannabis use was associated with worse sleep quality in T1D, but it cannot prove causation. Cannabis users may have been using it because they already had poor sleep. Discuss sleep concerns with your diabetes care team.

What was the biggest factor in poor sleep for T1D adults?

Moderate-to-severe depression was by far the strongest correlate (OR 6.16). Cannabis (OR 1.58), bedtime snacking (OR 1.71), being female (OR 1.42), and low physical activity (OR 1.56) were also significant independent factors.

Read the original research

BETTER sleep: Sleep quality among adults living with type 1 diabetes in Canada.

Journal of diabetes and its complications, 39(10), 109137

View on PubMed ↗Publisher’s paper ↗

Citation

Vézina-Im, Lydi-Anne; Turcotte, Anne-Frédérique; Messier, Virginie; Turcotte, Stéphane; Brossard, Ariane; Pelletier, Jacques; Nassar, Tara; Rabasa-Lhoret, Rémi; Brazeau, Anne-Sophie. (2025). BETTER sleep: Sleep quality among adults living with type 1 diabetes in Canada.. Journal of diabetes and its complications, 39(10), 109137. https://doi.org/10.1016/j.jdiacomp.2025.109137