Children exposed to cannabis before birth had more sleep problems at ages 9-10

In a large study of nearly 12,000 children, prenatal cannabis exposure was associated with multiple sleep disturbances at ages 9-10, including difficulty falling asleep, staying asleep, and excessive daytime sleepiness.

Winiger, Evan A et al.·Sleep health·2020·Moderate EvidenceCross-Sectional
RTHC-02919Cross SectionalModerate Evidence2020RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Moderate Evidence
Sample
N=11,875

What This Study Found

Any prenatal cannabis exposure was associated with disorders of initiating and maintaining sleep, disorders of arousal, sleep-wake disorders, disorders of excessive somnolence, and a summed sleep disorder score (all p<0.03). Daily prenatal cannabis use was specifically associated with excessive daytime sleepiness (beta=0.29, p=0.03). All associations controlled for other prenatal substance exposures and demographic factors.

Key Numbers

11,875 children studied. Prenatal cannabis exposure associated with multiple sleep disorder categories (all beta>0.10, p<0.03). Daily prenatal cannabis use associated with excessive somnolence (beta=0.29, p=0.03).

How They Did This

Analysis of 11,875 children ages 9-10 from the Adolescent Brain Cognitive Development (ABCD) Study. Maternal reports of prenatal cannabis use. Child sleep outcomes assessed by parent report. Controlled for prenatal exposure to other substances, maternal education, income, marital status, race, child sex, and age.

Why This Research Matters

Sleep disturbances in childhood affect cognitive development, behavior, and health. If prenatal cannabis exposure contributes to persistent sleep problems, it adds urgency to counseling pregnant individuals about cannabis use.

The Bigger Picture

Cannabis use during pregnancy is increasing as perceptions of harm decrease. Long-lasting effects on offspring sleep add to a growing list of potential consequences that should inform prenatal counseling.

What This Study Doesn't Tell Us

Cross-sectional analysis within a longitudinal study cannot establish causation. Maternal cannabis use was retrospectively self-reported, subject to recall bias. Sleep outcomes were parent-reported, not objectively measured. Residual confounding possible despite controlling for multiple factors.

Questions This Raises

  • ?Are these sleep effects mediated by changes in endocannabinoid system development?
  • ?Do sleep disturbances from prenatal exposure improve or worsen as children age?
  • ?Would objective sleep measurements (polysomnography) confirm parent-reported findings?

Trust & Context

Key Stat:
Prenatal cannabis linked to sleep problems in 9-10 year olds (n=11,875)
Evidence Grade:
Large well-controlled epidemiological study, but cross-sectional analysis with self-reported exposures and outcomes.
Study Age:
2020 study using ABCD Study data. Adds sleep to the list of potential long-term effects of prenatal cannabis exposure.
Original Title:
Prenatal cannabis exposure and sleep outcomes in children 9-10 years of age in the adolescent brain cognitive development SM study.
Published In:
Sleep health, 6(6), 787-789 (2020)
Database ID:
RTHC-02919

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

A snapshot of a population at one point in time.

What do these levels mean? →

Frequently Asked Questions

What types of sleep problems were found?

Children with prenatal cannabis exposure had more difficulty falling and staying asleep, more arousal disorders, more sleep-wake transition issues, and more excessive daytime sleepiness compared to unexposed children.

Could other factors explain these sleep problems?

The researchers controlled for prenatal exposure to other substances (alcohol, tobacco), maternal education, income, marital status, race, child sex, and age. The associations persisted after accounting for these factors.

Read More on RethinkTHC

Cite This Study

RTHC-02919·https://rethinkthc.com/research/RTHC-02919

APA

Winiger, Evan A; Hewitt, John K. (2020). Prenatal cannabis exposure and sleep outcomes in children 9-10 years of age in the adolescent brain cognitive development SM study.. Sleep health, 6(6), 787-789. https://doi.org/10.1016/j.sleh.2020.05.006

MLA

Winiger, Evan A, et al. "Prenatal cannabis exposure and sleep outcomes in children 9-10 years of age in the adolescent brain cognitive development SM study.." Sleep health, 2020. https://doi.org/10.1016/j.sleh.2020.05.006

RethinkTHC

RethinkTHC Research Database. "Prenatal cannabis exposure and sleep outcomes in children 9-..." RTHC-02919. Retrieved from https://rethinkthc.com/research/winiger-2020-prenatal-cannabis-exposure-and

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.