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Does Weed Help You Sleep? Probably Not

SPH study: daily marijuana use leads to more insomnia

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Marijuana users may believe that frequent use helps them sleep, but that perception has been challenged by a BU School of Public Health study.

The study, published in the Journal of Addictive Diseases, was coauthored by Michael Stein, an SPH professor and chair of health law, policy, and management. It found that daily marijuana users actually scored higher on the Insomnia Severity Index and on sleep-disturbance measures than those who did not use it daily. The study’s 98 subjects were broken into three groups: daily users of marijuana (49 people); those who were not daily users (29), defined as those who smoked at least one day in the past month and up to five days a week; and a control group who didn’t use the drug at all (20). Most of the study participants were in their early 20s.

“Better sleep is one of the positive effects that marijuana users swear by, but there has been relatively little careful research on this topic,” says Stein, the study’s principal investigator.

In the study, he and colleagues cite previous research indicating that as many as one-third of young adults, ages 18 to 25, complain of sleep problems. The study findings show that while occasional marijuana use doesn’t disrupt sleep, heavy (or daily) marijuana use is associated with sleep difficulties.

“The effects of marijuana on sleep in intermittent users may be similar, in part, to those of alcohol, where improvements in sleep continuity measures have been reported with intermittent use,” the researchers wrote. But “daily use results in the worsening of sleep.”

The study examined sleep patterns in the three groups of young adults. The researchers found no significant differences in the sleep characteristics of those who did not use marijuana daily compared to those who did not use it at all. Daytime sleepiness also did not differ among heavy users, lighter users, and nonusers.

“Sleep disturbance, which is common in this age group, may not be increased by non-daily use,” the authors wrote.

While 20 percent of the nonsmokers met the criteria for clinical insomnia, for the daily users meeting those criteria, it was 39 percent. Similarly, sleep disruption measures were worse for daily users than for occasional users.

The researchers noted that daily marijuana users typically reported smoking marijuana in the daytime and at night, and less frequent users smoked primarily at night.

“Study participants who didn’t smoke every day usually smoked in the evening,” Stein says. “But once you’re smoking multiple times a day, there’s a greater chance that you’ll report disturbed sleep. Only by stopping marijuana completely, and waiting some time without using at all, will a person be able to determine how marijuana was affecting, or not affecting, his or her sleep.”

The research team cited previous studies showing an association between higher marijuana use and higher rates of anxiety, which may be a factor in disrupted sleep.

“It remains possible that the [insomnia] scores might have been higher in the daily marijuana users because marijuana was contributing to anxiety, which in turn may have exacerbated the severity of insomnia,” they wrote. But, as Stein notes, “only by doing prospective longitudinal studies can we begin to get at the causal chain here.”

Stein and colleagues recommend that future studies look at mood disorders as a factor in the relationship between marijuana use and sleep. People with anxiety may be heavier users of marijuana because they are trying to mitigate their sleep problems, they said.

In terms of gender (45 men and 53 women participated in the study), the research team found that women reported more sleep disturbance problems than men on several measures. That finding was expected, Stein says, as insomnia is more common in women than men. Also, marijuana use has been shown to affect women’s performance on neurological tasks more than it affects men’s.

The research team urges more study of the issue, so that health providers can talk more clearly to marijuana users about its effects on sleep, and drug-treatment providers can “meaningfully target sleep” among heavy marijuana users.

Marijuana is one of the most commonly used drugs in the United States, especially among young adults 18 to 25. Many users report turning to the drug to alleviate a variety of medical and psychiatric symptoms, including pain, anxiety, and post-traumatic stress disorder.

“The biopsychosocial changes of young adulthood affecting sleep are well known and may contribute to marijuana use,” the authors wrote.

The analysis was led by Dierdre Conroy of the University of Michigan Addiction Research Center; coauthors were from Brown University and the University of California, San Diego.

Lisa Chedekel can be reached at chedekel@bu.edu.

13 Comments

13 Comments on Does Weed Help You Sleep? Probably Not

  • Anonymous on 10.17.2016 at 7:42 am

    Did they completely ignore the possibility that people with higher rates of insomnia may be more likely to smoke marijuana in order to get help sleeping? I learned about this type of false decision making in a BU statistics course, yet the SPH professor and chair of health law, policy, and management is going to use it to further vilify marijuana use. Unbelievable

    • Anonymous on 10.17.2016 at 8:22 am

      Either the author isn’t providing all the details of the study making it worthy of a solid critique, or the research itself is failing to account for the endless variables that could influence the outcome.

      For example, when do those involved in the study actually indulge? This is probably the single most important factor. When a user of MMJ smokes just before bed, it is likely to prevent the user from entering REM stage of sleep, the stage where sleep is most beneficial to the body. It is also likely to keep the person awake a bit longer until the MMJ’s effect on the person’s heart rate reduces, MMJ does increase heart rate and can leave a person in an excited state immediately after use thereby preventing a person from going right to sleep.

      On the flip side, people with high energy that have an inability to fall right to sleep and often toss and turn for a bit can benefit from the use of MMJ at an earlier time in the evening which would leave the person tired and ready for sleep as it wears off, which is a natural reaction to it, MMJ will make anyone who indulges tired after a few hours when the “buzz” begins to wear off.

      As a regular user, I can attest that both lack of rest and added rest can occur from daily use of MMJ. There will be times when you feel you aren’t getting enough sleep, and times where you feel extremely well rested. Studies that don’t take into account the countless variables miss the mark every time and end up being a worthless waste of time.

      I think a better way to approach a study of this nature is through detailed interviews with long time users of MMJ who are high functioning, meaning they hold good jobs, maintain stable lives, and are capable of intelligently discussing the effects of their daily use.

    • AnonymousToo on 10.17.2016 at 8:44 am

      “People with anxiety may be heavier users of marijuana because they are trying to mitigate their sleep problems, they said.” …sounds like the researchers were at least aware of this, although the authors do acknowledge that we don’t have the full picture.

  • Dan Brooks on 10.17.2016 at 8:06 am

    In reply to Anonymous, you may not have seen this section of the article:

    “It remains possible that the [insomnia] scores might have been higher in the daily marijuana users because marijuana was contributing to anxiety, which in turn may have exacerbated the severity of insomnia,” they wrote. But, as Stein notes, “only by doing prospective longitudinal studies can we begin to get at the causal chain here.”

    Stein and colleagues recommend that future studies look at mood disorders as a factor in the relationship between marijuana use and sleep. People with anxiety may be heavier users of marijuana because they are trying to mitigate their sleep problems, they said.

    As you no doubt learned in the MPH program, they are addressing the difficulty of establishing the direction of causation between exposure (marijuana use) and outcome (sleep) in cross-sectional studies. That’s why they cite the need for prospective longitudinal studies. It seems that they have appropriately cited the potential limitations of this study.

    • Matthew Meyer on 10.17.2016 at 12:43 pm

      Indeed, that was the closest the article comes to recognizing the limitation noted by the first commenter.

      However, the authors’ proposed scenario is that cannabis increases anxiety, thus worsening sleep. The authors seem to fail entirely to consider an alternative scenario, which I believe the first comment is suggesting:

      Namely, people who have insomnia for reasons unrelated to cannabis use may seek out cannabis to address their sleep problems.

      It really is a logical scenario that should have been more explicitly considered in the article.

  • Matthew Meyer on 10.17.2016 at 12:47 pm

    One more point: the study’s inability to decisively state the direction of causality needs much more explicit emphasis, as evidenced by the headline writer’s confusion: “daily marijuana use leads to more insomnia.”

    There is no way to read this other than as a statement that cannabis use causes more insomnia, which in no way is shown by the study.

    Such imprecision does a disservice to the public discussion of cannabis policy, and observers would be forgiven if, in their darker moments, they suspected researchers and headline writers of more than simple laziness in producing such confusion.

  • Nominals on 10.17.2016 at 12:56 pm

    The “Journal of Addictive Diseases” and the “University of Michigan Addictive Research Center” sound a bit biased towards finding harms associated with anything that they would study.

  • Old Hippie on 10.18.2016 at 4:07 pm

    The basic premise of this study is flawed. The researchers are conflating recreational usage of cannabis by their subjects with theoretical medical usage for insomnia, with absolutely no mention of strains or even the knowledge that different types and doses of cannabis can either cause or relieve insomnia and anxiety.

    For example, as a medical marijuana patient, I regularly microdose sativa strains during the day, but switch to indicas in the evening at a much higher dosage level. It may not “cure insomnia”, but I can say that before I started, I would toss and turn for hours, but now I sleep soundly within 15 minutes.

  • Jose Artigas on 10.21.2016 at 10:14 pm

    Like many studies, this one misses the main reason people smoke marijuana: it’s fun.

    Vote Yes on question 4! Surely it’ll provide more subjects for research.

  • Su Kim on 10.27.2016 at 12:07 pm

    The fact that a university page is reporting on this and further convoluting a study that has its own very obvious shortcomings is ridiculous. Sure, the MIT review has its own crap that comes out every now and then, but seriously? Daily marijuana causes insomnia? This is as baseless as the Today Show.

  • Stan on 12.26.2016 at 5:52 am

    A lot of doctors would have differing opinions on this. Could pain be causing the increased usage, and leading to sleep problems?

  • David Roppo on 01.08.2017 at 5:00 pm

    To even suggest that marijuana could help one sleep, I believe is careless and irresponsible. Addiction is, in essence, a form of emotional escape. So, why would you suggest that one should use marijuana to alleviate anxiety and emotional distress. Is that really the message we want to send to teens and young adults?

  • Normal Pal on 04.13.2017 at 5:05 am

    Nowadays everybody can easily inspect their sleep patterns with smart phone apps. I have done that and results show single-minded that time spent on deep sleep fell dramatically when consuming cannabis on same day. Results show that time spent on deep sleep was even low as 7 minutes per night. (Normal time should be around 1 h to 1,5 h per night.) I can only imagine what that does to body and mind in long-term. Of course results may wary individually but I recommend trying (apps) and see for yourselves what cannabis usage does to your sleep. I hope to see more real scientific studies on this subject in future!

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