Off the top of your head, how many people do you know that use marijuana regularly? Or people who have at least tried it at some point?

Chances are, you know someone who has used it at least once, whether you know it or not. After alcohol, marijuana is the most commonly used psychotropic drug in the United States. In 2019, 12% of US adults said they smoke marijuana (Gallup, 2021), and in 2018, over 11.8 million young adults in the US reported using marijuana in the previous year (National Institute on Drug Abuse, 2020). Marijuana use also varies by demographic; 40-75% of adults age 18 to 45 report using it at some time during their life, and 35% of college-attending 18 to 25 year olds report using it in the past year (Conroy & Arnedt, 2014). Marijuana use has not always been this common, however. Particularly among young people, the rate of use is the highest it has been in 30 years (Weiler, 2017). A likely reason for, or at least contributor to, this high level of marijuana use is its increased legalization across the country. The use of cannabis for medical reasons is now legal in 35 US states, and recreational use is legal in 14 states and the District of Columbia (Wikipedia, 2021). All of this is to say that marijuana use is popular in the US, and that its popularity has increased in recent years.

So clearly marijuana is a widely-used substance, but some people actually use it for a specific purpose: to help them sleep. The app Sleep Cycle conducted a nationwide survey of adults, and found that 14 percent of American adults use marijuana as a sleep aid (Business Wire, 2018). This is equivalent to the number of people who use milk and cookies to fall asleep, and greater than the number of people who use Nyquil, alcohol, or sleeping pills to get to sleep at night. People who use marijuana as a sleep aid often report improved sleep onset and decreased sleep disturbance as a result of using, but how much does it really help?

While some studies have shown that marijuana appears to help facilitate falling asleep and increase Stage 4 sleep (the deepest level of sleep) (Schierenbeck et al., 2008), there is much more to it than that. For one thing, marijuana use appears to be associated with increased sleep disturbance. One study showed that adolescents who used any illicit drug, but marijuana in particular, were over 2.5 times as likely to report a sleep problem compared to adolescents who were substance-free (Conroy & Arnedt, 2014). Furthermore, adolescents with insomnia are 1.75 times more likely to report marijuana use compared to adolescents without insomnia. As for the claim by marijuana users that it helps them to fall asleep more quickly and experience less sleep disturbances, studies have actually shown that the opposite may be true; polysomnography, or technology used for sleep studies, have shown that sleep latency and wake-after-sleep-onset are either the same or worse with marijuana use compared to non-use. Essentially, people think that they’re getting better sleep, but in reality, their sleep is the same or worse. Other studies have shown that greater marijuana use is associated with greater difficulty getting a full night’s sleep and a somewhat longer period of time taken to fall asleep (Drazdowski et al., 2019). In addition to these sleep disturbances, marijuana use reduces REM (rapid-eye-movement) sleep (Schierenbeck et al., 2008), which as I will get into later, is important for a variety of functions.

And if all of that weren’t bad enough, marijuana abstinence after using causes problems as well. After two weeks of abstinence, total sleep time, amount of REM sleep, wake-after-sleep-onset, and sleep efficiency (ability to get a good night’s sleep) all worsen (Conroy & Arnedt, 2014). These sleep disturbances are shown to last for more than 45 days into a period of abstinence, meaning over a month and a half of ongoing sleep disturbance. Reduced slow wave sleep, sleep onset latency, and strange dreams have also been reported as symptoms of marijuana withdrawal. 

But what does this really mean?

Matthew Walker starts off his book, Why We Sleep, describing the myriad of ways in which a lack of sleep can negatively impact a person. These include an increased risk of cancer, diabetes, Alzheimer’s, stroke, cardiovascular disease, and a number of psychiatric diseases, among other things. So, for starters, because using marijuana as a sleep aid can cause a variety of sleep disturbances and reduce your total sleep time, it can also put you at an increased risk for a wide variety of mental and physical ailments. Additionally, increased sleep onset latency, or the time it takes to fall asleep, can cause issues via loss of NREM (non-REM) sleep. NREM sleep is the period of sleep during which brain waves are synchronized and relatively slow, and it is the deepest part of sleep. It is also the first sleep stage at night, so losing sleep on the front end of the night can mean a loss of NREM sleep. Its vital functions include removing unnecessary neural connections (synaptic pruning), transferring memory from short-term to long-term, and facilitating brain maturation, particularly in adolescents. Especially given that adolescents and young adults are the largest demographic of marijuana users, increased sleep onset latency could cause issues with brain maturation and memory. 

Let’s return now to REM sleep, which is the more active part of sleep that is typically associated with dreaming (this is not entirely the case, but that’s a conversation for another time). The  function of REM sleep largely concerns connecting memories, strengthening neural connections, and helping to build a model of how the world works. It is therefore associated with creativity, insight, and ingenuity. It also plays a role in the ability to recognize and appropriately respond to socioemotional signals such as facial expressions and group behaviors. As you might have guessed, the loss of REM sleep that results from marijuana use can lead to a decreased ability to make neural connections and think creatively, as well as difficulty understanding and responding to emotional signals (i.e., a low emotional IQ). 

Ultimately, even though the use of marijuana as a sleep aid may be tempting because of the subjective feelings of improved sleep, we can see that it may actually cause more harm than good. Depending on the sleep disturbance that results from marijuana use, one may experience difficulty with memory retention, creativity, socioemotional processing, or brain maturation, not to mention an increased risk of a number of different physical and mental issues. All in all, I would argue that cookies and milk are a much better option if you need help falling asleep.

References:

Conroy, D. A., & Arnedt, J. T. (2014). Sleep and substance use disorders: An update. Current Psychiatry Reports, 16(10). doi:10.1007/s11920-014-0487-3

Drazdowski, T. K., Kliewer, W. L., & Marzell, M. (2019). College students’ using marijuana to sleep relates to frequency, problematic use, and sleep problems. Journal of American College Health, 1-10. doi:10.1080/07448481.2019.1656634

Hrynowski, Z. (2021, March 02). What percentage of Americans Smoke marijuana? Retrieved March 05, 2021, from https://news.gallup.com/poll/284135/percentage-americans-smoke-marijuana.aspx

Legality of cannabis by U.S. jurisdiction. (2021, February 28). Retrieved March 05, 2021, from https://en.wikipedia.org/wiki/Legality_of_cannabis_by_U.S._jurisdiction

National Institute on Drug Abuse. (2020, April 08). What is the scope of marijuana use in the United States? Retrieved March 05, 2021, from https://www.drugabuse.gov/publications/research-reports/marijuana/what-scope-marijuana-use-in-united-states

Schierenbeck, T., Riemann, D., Berger, M., & Hornyak, M. (2008, March 03). Effect of illicit recreational drugs upon sleep: Cocaine, ecstasy and marijuana. Retrieved March 05, 2021, from https://www.sciencedirect.com/science/article/pii/S1087079207001670

Sleep cycle Survey: Americans Prefer Bedtime tea to marijuana and ice cream to sleeping pills. (2018, March 29). Retrieved March 05, 2021, from https://www.businesswire.com/news/home/20180329005317/en/Sleep-Cycle-Survey-Americans-Prefer-Bedtime-Tea

Walker, M. (2017). Why We Sleep. Scribner.

Weiler, E. (2017, November 01). Daily marijuana use increasing among young adults. Retrieved March 05, 2021, from https://www.thenationshealth.org/content/47/9/E44