Walsh Claire A, Euler Erin, Do Lauren A, Zheng Amy, Eckel Sandrah P, Harlow Bernard L, Leventhal Adam M, Barrington-Trimis Jessica L, Harlow Alyssa F
Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, CA, Los Angeles, USA.
Institute for Addiction Science, University of Southern California Keck School of Medicine, CA, Los Angeles, USA.
Addiction. 2025 Apr;120(4):688-696. doi: 10.1111/add.16705. Epub 2024 Oct 30.
Young adult cannabis use is common; while cannabis is often marketed as a product that can improve sleep, evidence supporting these claims is limited, and effects may differ for individuals with underlying mental health issues. This study measured the association between cannabis use and sleep problems among young adults and determined whether associations differ by mental health status.
DESIGN, SETTING AND PARTICIPANTS: Using two waves of a young adult cohort study (baseline: March-September 2020; follow-up: January-June 2021), we measured the association of cannabis use frequency with subsequent sleep problems overall and stratified by baseline sleep quality and mental health status in separate moderation analyses. This study was conducted in Southern California, USA, and included 1926 participants aged 20-23 years (mean age = 21; 61% female, 46% Hispanic).
Exposure was baseline cannabis use frequency (never use, prior use, 1-5 days/month, 6-19 days/month, ≥ 20 days/month). The outcome was sleep problems at follow-up (range = 4-24, higher score indicating worse sleep). Models were adjusted for socio-demographic factors, baseline sleep problems, mental health symptoms (depression and/or anxiety versus neither) and past 30-day nicotine or alcohol use. In moderation analyses, models were additionally stratified by mental health symptoms and baseline sleep quality (excellent versus imperfect sleep).
Among the young adult sample, 11% used cannabis ≥ 20 days/month at baseline. For participants without baseline anxiety or depression symptoms, using cannabis ≥ 20 days/month (versus never use) was associated with greater sleep problems at follow-up [mean difference (MD) = 1.66, 95% confidence interval (CI) = 0.59-2.74]. Among participants with anxiety and/or depression and pre-existing sleep problems at baseline, using cannabis ≥ 20 days/month (versus never use) was associated with fewer sleep problems at follow-up (MD = -1.42, 95% CI = -2.81 to -0.02).
The effects of cannabis use on sleep appear to differ by underlying mental health symptoms. Frequent cannabis use may improve sleep for young adults with depression and/or anxiety who have pre-existing sleep problems, but worsen sleep for young adults without depression and/or anxiety.
年轻成年人使用大麻的情况很常见；虽然大麻常被宣传为一种有助于改善睡眠的产品，但支持这些说法的证据有限，而且对于有潜在心理健康问题的个体，其效果可能有所不同。本研究测量了年轻成年人中大麻使用与睡眠问题之间的关联，并确定这种关联是否因心理健康状况而异。
设计、地点与参与者：利用一项年轻成年人队列研究的两波数据（基线：2020年3月至9月；随访：2021年1月至6月），我们在单独的调节分析中测量了大麻使用频率与随后总体睡眠问题之间的关联，并按基线睡眠质量和心理健康状况进行分层。本研究在美国南加州进行，纳入了1926名年龄在20 - 23岁的参与者（平均年龄 = 21岁；61%为女性，46%为西班牙裔）。
暴露因素为基线大麻使用频率（从不使用、既往使用、每月1 - 5天、每月6 - 19天、每月≥20天）。结局指标为随访时的睡眠问题（范围 = 4 - 24，分数越高表明睡眠越差）。模型针对社会人口学因素、基线睡眠问题、心理健康症状（有抑郁和/或焦虑与无抑郁和/或焦虑）以及过去30天的尼古丁或酒精使用情况进行了调整。在调节分析中，模型还按心理健康症状和基线睡眠质量（优质睡眠与非优质睡眠）进行了分层。
在年轻成年人样本中，11%在基线时每月使用大麻≥20天。对于无基线焦虑或抑郁症状的参与者，每月使用大麻≥20天（与从不使用相比）与随访时更严重的睡眠问题相关[平均差异（MD）= 1.66，95%置信区间（CI）= 0.59 - 2.74]。在基线时有焦虑和/或抑郁且已有睡眠问题的参与者中，每月使用大麻≥20天（与从不使用相比）与随访时较少的睡眠问题相关（MD = -1.42，95% CI = -2.81至 -0.02）。
大麻使用对睡眠的影响似乎因潜在的心理健康症状而异。频繁使用大麻可能会改善已有睡眠问题的抑郁和/或焦虑年轻成年人的睡眠，但会使无抑郁和/或焦虑的年轻成年人睡眠恶化。
