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. 2024 Oct 1;20(10):1615-1625.
doi: 10.5664/jcsm.11212.

The impact of cannabis use proximal to sleep and cannabinoid metabolites on sleep architecture

Meghan D Althoff  1 , Gregory L Kinney  2 , Mark S Aloia  3 , Cristina Sempio  4 , Jost Klawitter  4 , Russell P Bowler  3
Affiliations

The impact of cannabis use proximal to sleep and cannabinoid metabolites on sleep architecture

Meghan D Althoff et al. J Clin Sleep Med. .

Abstract

Study objectives: Cannabis is a common sleep aid; however, the effects of its use prior to sleep are poorly understood. This study aims to determine the impact of nonmedical whole plant cannabis use 3 hours prior to sleep and measured cannabis metabolites on polysomnogram measures.

Methods: This is a cross-sectional study of 177 healthy adults who provided detailed cannabis use history, underwent a 1-night home sleep test and had measurement of 11 plasma and urinary cannabinoids, quantified using mass spectroscopy, the morning after the home sleep test. Multivariable models were used to assess the relationship between cannabis use proximal to sleep, which was defined as use 3 hours before sleep, and individual home sleep test measurements. Correlation between metabolite concentrations and polysomnogram measures were assessed.

Results: In adjusted models, cannabis use proximal to sleep was associated with increased wake after sleep onset (median 60.5 vs 45.8 minutes), rate ratio 1.59 (1.22, 2.05), and increased proportion of stage 1 sleep (median 15.2% vs 12.3%), effect estimate 0.16 (0.06, 0.25). Compared to nonusers, frequent cannabis users (> 20 days per month) also had increased wake after sleep onset and stage 1 sleep, in addition to increased rapid eye movement latency and decreased percent sleep efficiency. Δ9-tetrahydrocannabinol metabolites correlated with these home sleep test measures.

Conclusions: Cannabis use proximal to sleep was associated with minimal changes in sleep architecture. Its use was not associated with measures of improved sleep including increased sleep time or efficiency and may be associated with poor quality sleep through increased wake onset and stage 1 sleep.

Citation: Althoff MD, Kinney GL, Aloia MS, Sempio C, Klawitter J, Bowler RP. The impact of cannabis use proximal to sleep and cannabinoid metabolites on sleep architecture. J Clin Sleep Med. 2024;20(10):1615-1625.

Keywords: cannabinoid; cannabis; metabolite; polysomnography; sleep.

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Conflict of interest statement

All authors have seen and approved the manuscript. Institution where work was performed: National Jewish Health and University of Colorado Anschutz Medical Campus. This work was supported by grant funding from the Colorado Department of Public Health & Environment, Denver, Colorado starting in 2015. Grant title “Colorado Cannabis Cohort: Efficacy, Safety, and Usage Patterns of Medical Marijuana for Sleep.” M.D.A. is supported by the National Institutes of Health/National Center for Advancing Translational Sciences Colorado Clinical and Translational Science Awards Grant Number K12 TR004412. Dr. Aloia reports holding stock in Philips. The other authors report no conflicts of interest.

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