Megan Brooks

June 04, 2014

MINNEAPOLIS — Marijuana use may make it harder to get to sleep and stay asleep, especially for those who started smoking at a young age, a new study suggests.

"Since marijuana use is relatively widespread and even legal in some states, and is often described as 'relaxing,' I thought it would be interesting to see how typical marijuana use was associated with quality of sleep," Jilesh Chheda, research assistant at the University of Pennsylvania in Philadelphia, who worked on the study, told Medscape Medical News.

"My initial thought was that [it] would be associated with enhanced sleep quality, since it has been portrayed that way by different types of media, and it is commonly thought by the general population to be something that improves sleep," Chheda said. But that's not what the study found.

Chheda presented the study results here on June 4 at SLEEP 2014, the 28th annual meeting of the Associated Professional Sleep Societies.

Working with senior author Michael Grander, PhD, from the Division of Mood and Anxiety Disorders, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Chheda analyzed data on 1811 adults, aged 20 to 59 years, who responded to the 2007-2008 National Health and Nutrition Examination Survey and reported a history of drug use. 

Any history of cannabis use was associated with an increased likelihood of reporting difficulty falling asleep, difficulty maintaining sleep, experiencing nonrestorative sleep, and daytime sleepiness. In particular, using marijuana for roughly 3 days per month, on average, was associated with severe difficulty falling asleep, the researchers found.

Jilesh Chheda

However, "the most surprising finding was that there was a strong relationship with age of first use, no matter how often people were currently using marijuana," said Chheda.

Specifically, the researchers found that adults who started using marijuana before age 15 were about twice as likely as nonusers to have severe problems falling asleep (odds ratio [OR], 2.28; P = .001), experience nonrestorative sleep (OR, 2.25; P < .0001), and feel overly sleepy during the day (OR, 1.99; P = .013). The results were adjusted for potential confounding factors, including age, sex, race/ethnicity, and education. Sleep-related problems were considered severe if they occurred at least 15 days per month.

"People who started using early were more likely to have sleep problems as an adult. This may just be a case of people who are predisposed to sleep problems self-medicating with marijuana, or it may be a case of the drug causing sleep problems. This study cannot answer that," Chheda explained.

Findings "Provocative"

"In a clinical context, I am seeing more and more adults who are reporting that they are using marijuana to assist with sleep difficulties. So these findings are provocative because [they suggest] that this is counterproductive and perhaps exacerbating sleep difficulties," Eric Zhou, PhD, who wasn't involved in the study, told Medscape Medical News.

Dr. Zhou is a clinical psychology fellow with the Perini Family Survivor's Center at Dana-Farber Cancer Institute and research fellow with Harvard Medical School in Boston, Massachusetts.

The study "can't say whether marijuana use is the cause of these sleep difficulties or if it's actually a marker for another mediating variable, such as other substance use, behavioral issues, general life distress, or mood-related disturbances that later on in life may precipitate the development of insomnia," said Dr. Zhou.

All these are good questions for further study, he said.

The study was supported by the National Heart, Lung, and Blood Institute; the National Institute of Environmental Health Sciences; and the University of Pennsylvania Clinical and Translational Science Award. The authors and Dr. Zhou have disclosed no relevant financial relationships.

SLEEP 2014: 28th Annual Meeting of the Associated Professional Sleep Societies. Poster 0817. Presented June 4, 2014.  


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