Cannabis, Cannabinoids, and Sleep: a Review of the Literature

Babson, Kimberly A.; Sottile, James E.; Morabito, Danielle M.

doi:10.1007/s11920-017-0775-9

Cited by 373 publications

(265 citation statements)

References 60 publications

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“…Many individuals use marijuana to cope with various degrees of depression, anxiety, and sleep problems and therefore the potential medical application of marijuana for treatment of mental health symptoms continues to be explored despite mixed findings (Babson et al 2017; Feingold et al 2017; Haj-Dahmane and Shen 2014), however this study supports the extant adolescent research literature that consistently shows marijuana use during neurodevelopment likely has a deleterious impact on neural health and emotional functioning (Lisdahl et al 2013; Volkow et al 2014). Future work in our laboratory will continue to explore treatment approaches that target substance misuse and substance-related processes and treatment barriers in the context of neurodevelopmental vulnerabilities and the neurobiology of addiction.…”

Section: Discussionsupporting

confidence: 56%

Changes in marijuana use symptoms and emotional functioning over 28-days of monitored abstinence in adolescent marijuana users

et al. 2017

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Rationale Advancing marijuana prevention and intervention efforts is important given decreasing perception of harm among adolescents and increasing marijuana legalization. Objectives This study evaluates how a monitored abstinence protocol may contribute to emotional functioning and changes in marijuana problems that can enhance successful outcomes for non-treatment seeking adolescent marijuana users. Methods Adolescent marijuana users (n=26) and demographically matched controls (n=30) completed 28-days of monitored abstinence confirmed by bi-weekly urine toxicology. Participants were given measures of emotional functioning, marijuana use symptoms, and reward sensitivity during monitored abstinence. Results All participants (N=56) completed the protocol, and 69% of marijuana users (n=18 of 26) were confirmed abstinent for 28-days, with all users showing decreasing marijuana use. Reductions in subsyndromal depression, positive marijuana use expectancies, and poor sleep quality were observed by the end of the monitored abstinence period (n=26, ps<.05). Marijuana users also reported more attentional impulsivity and less responsiveness to reward stimuli during the second week of abstinence compared to controls. Later age of onset of regular marijuana use and more cumulative lifetime use was associated with a greater degree of emotional change and increased recognition of the negative effects of marijuana use. Conclusions Monitored abstinence programs may be beneficial in reducing marijuana use, subsyndromal emotional distress symptoms, and changing beliefs about marijuana use. Future prevention and intervention efforts may consider targeting reward sensitivity and impulsivity, in addition to marijuana use, expectancies, and emotional functioning.

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Section: Discussionsupporting

confidence: 56%

Changes in marijuana use symptoms and emotional functioning over 28-days of monitored abstinence in adolescent marijuana users

et al. 2017

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“…Another intriguing possibility is that sleep-related cannabis use is effective in the short-term but ineffective over the long term for reducing sleep disturbance (Angarita et al, 2016), and the results are indicative of more frequent sleep-related cannabis use aimed at reducing sleep problems that may have become intractable. This pattern of results could reflect a problematic cycle of cannabis use to reduce sleep problems, followed by exacerbation of sleep problems (perhaps due to cannabis cessation) and subsequent increases in use (Angarita et al, 2016; Babson et al, 2017). Importantly, because of the potential cyclical nature of sleep problems, increased cannabis use for sleep and greater frequency of sleep-related cannabis withdrawal symptoms, it is essential to examine longitudinal data to better understand how cannabis use and sleep interrelate over time.…”

Section: Discussionmentioning

confidence: 98%

“…These encouraging findings are tempered by concerns that chronic cannabis use could lead to increases in cannabis use disorders (Babson et al, 2017; Benbadis et al, 2014), exacerbation of sleep problems (Babson and Bon-Miller, 2014), and other adverse outcomes (D’Souza and Ranganathan, 2015). For example, using marijuana for sleep-related motives was correlated to greater frequency of use and marijuana-related problems among nonmedical cannabis users (Lee et al, 2009), and using cannabis to improve sleep was associated with higher frequency of cannabis use among medical users with probable PTSD (Bonn-Miller et al, 2014b).…”

Section: Introductionmentioning

confidence: 99%

“…For example, using marijuana for sleep-related motives was correlated to greater frequency of use and marijuana-related problems among nonmedical cannabis users (Lee et al, 2009), and using cannabis to improve sleep was associated with higher frequency of cannabis use among medical users with probable PTSD (Bonn-Miller et al, 2014b). There is also evidence that cannabis withdrawal has negative effects on self-reported and PSG measures of sleep (Angarita et al, 2016; Babson et al, 2017; Benbadis et al, 2014). …”

Section: Introductionmentioning

confidence: 99%

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Prevalence and correlates of sleep-related problems in adults receiving medical cannabis for chronic pain

Cranford

Arnedt

Conroy

et al. 2017

Drug and Alcohol Dependence

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Purpose To examine the prevalence and correlates of sleep problems in a sample of medical cannabis patients. Procedures Adults ages 21 and older (N = 801, M age = 45.8) who were seeking medical cannabis certification (either for the first time or as a renewal) for chronic pain at medical cannabis clinics in southern Michigan completed baseline measures of cannabis use, sleep, pain, and other related constructs. Findings Over half of the sample (59%) met criteria for past 1-month sleep disturbance, defined as at least one sleep problem occurring on 15 or more nights in the past month. Most participants (86%) reported that sleep problems were due to their current pain. Approximately 80% of participants reported using cannabis in the past 6 months to improve sleep and, among these participants, cannabis was rated as helpful for improving sleep. Sleep-related cannabis side effects were rare (35%), but sleep-related cannabis withdrawal symptoms were relatively common (65%). Statistically significant correlates of past 1-month sleep disturbance included a) being female, b) being white, c) being on disability, d) not having a medical cannabis card, and e) frequency of using cannabis to help sleep. Conclusions Sleep problems are highly prevalent and frequent in medical cannabis patients and are closely tied to pain. Sleep-related cannabis withdrawal symptoms are relatively common but their clinical relevance is unknown. The association between frequency of cannabis use to help sleep with higher odds of sleep problems will need to be clarified by longitudinal studies.

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“…Alcohol use shortened sleep onset latency, but led to sleep disruptions in the second half of sleep (Ebrahim et al, 2013). Cannabis intake likewise resulted in reduced sleep onset latency, but the effects of cannabis on sleep quality were less clear (Babson et al, 2017). Although smokers often cite its relaxing effects, nicotine intake was found to actually disturb sleep (Irish et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Causal relationships between substance use and insomnia

Pasman

Smit

Kingma

et al. 2020

Preprint

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BackgroundPoor sleep quality and insomnia have been associated with the use of tobacco, alcohol, and cannabis, but it is unclear if there is a causal link. In this Mendelian Randomization (MR) study we examine if insomnia causes substance use and/or if substance use causes insomnia.MethodsMR uses summary effect estimates from a genome-wide association study (GWAS) to create a genetic instrumental variable for a proposed ‘exposure’ variable and then identifies that same genetic instrument in an ‘outcome’ GWAS. With data of GWAS of insomnia, smoking (initiation, heaviness, cessation), alcohol use (drinks per week, dependence), and cannabis initiation, bi-directional causal effects were tested. Multiple sensitivity analyses were applied to assess the robustness of the findings.ResultsThere was strong evidence for positive causal effects of insomnia on all substance use phenotypes (smoking traits, alcohol dependence, cannabis initiation), except alcohol per week. The effects on alcohol dependence and cannabis initiation were attenuated after filtering out pleiotropic SNPs. In the other direction, there was strong evidence that smoking initiation increased chances of insomnia (smoking heaviness and cessation could not be tested as exposures). We found no evidence that alcohol use per week, alcohol dependence, or cannabis initiation causally affect insomnia.ConclusionsThere were unidirectional effects of insomnia on alcohol dependence and cannabis initiation, and bidirectional effects between insomnia and smoking measures. Bidirectional effects between smoking and insomnia might give rise to a vicious circle. Future research should investigate if interventions aimed at insomnia are beneficial for substance use treatment.

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Cannabis, Cannabinoids, and Sleep: a Review of the Literature

Cited by 373 publications

References 60 publications

Changes in marijuana use symptoms and emotional functioning over 28-days of monitored abstinence in adolescent marijuana users

Changes in marijuana use symptoms and emotional functioning over 28-days of monitored abstinence in adolescent marijuana users

Prevalence and correlates of sleep-related problems in adults receiving medical cannabis for chronic pain

Causal relationships between substance use and insomnia

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