A new survey of cannabis consumers with sleep issues found that most preferred to use marijuana instead of other sleep aids to help get to bed, reporting better outcomes the next morning and fewer side effects. Smoking joints or vaping products that contained THC, CBD and the terpene myrcene were especially popular.
Compared to using conventional sleep aids or no sleep aids at all, respondents reported that cannabis made them feel more refreshed, focused and better able to function the morning after, with fewer headaches and less nausea. But they also reported some side effects from marijuana use, including waking up feeling sleepy, anxious and irritable.
The study, conducted by a pair of psychology researchers at Washington State University (WSU), was published late last month in the journal Exploration of Medicine. Authors say they believe it’s the first research comparing cannabis to prescription sleep aids (PSAs) and over-the-counter (OTC) sleep aids.
“In general, the use of cannabis for sleep-related issues was perceived as more advantageous than over-the-counter medications or prescription sleeps aids,” Carrie Cuttler, a WSU professor and one of the study co-authors, said in a press release on Monday. “Unlike long-acting sedatives and alcohol, cannabis was not associated with a ‘hangover’ effect, although individuals reported some lingering effects such as sleepiness and changes in mood.”
The WSU researchers surveyed 1,216 people for the study using the medical marijuana app Strainprint. Nearly two thirds (64.9 percent) of participants reported that they’d been suffering from sleep issues for at least five years, while nearly 70 percent said they’d been using cannabis to help with sleep for at least a year. A plurality of respondents (38 percent) said they’d been using marijuana for sleep for between one and three years.
Nearly 82 percent of the cannabis consumers said they do not currently use prescription or over the counter sleep medications, though more than half reported doing so in the past, indicating that they have some to see marijuana as a better option.
More than half the sample reported that they use cannabis every night to help fall asleep. Most respondents said they either smoke joints (46.1 percent), vape flower (42.6 percent) or use some form of cannabis oil (42.5 percent) before bed, although nearly a third said they use edibles and/or vape pens. Another 14.6 percent said they use cannabis in capsule form.
While inhaled forms of cannabis tend to be more popular among most consumers in general, authors said that those with sleep issues may prefer smoking and vaping “because of the short latency of onset with inhalation and the high percentage of respondents who indicated difficulty falling asleep.” They said they were surprised that edibles or capsules weren’t more popular “as these are longer lasting and as such may be more beneficial for maintaining sleep.”
In terms of product makeup, most respondents used high-THC products (60.0 percent), although 21.7 percent opted for a balanced THC–CBD blend. Asked about cannabinoids used for sleep, 78.8 percent said choose THC, 47.1 percent said CBD and 18.1 percent pointed to CBN.
As for terpenes, myrcene was the most popular (49.0 percent) followed by linalool (26.9 percent), limonene (24.7 percent) and beta caryophyllene (19.1 percent).
“One of the findings that surprised me was the fact that people are seeking the terpene myrcene in cannabis to assist with sleep,” Cuttler said in the WSU press release. “There is some evidence in the scientific literature to support that myrcene may help to promote sleep, so cannabis users seemed to have figured that out on their own.”
Asked to report how cannabis helps with their sleep, respondents said it relaxed their body (81.0 percent) and mind (83.0 percent), helped prevent interruptions in sleep (36.3 percent) and promoted a deeper (56.2 percent), longer (41.6 percent) sleep.
Of the 526 people who reported using prescription and OTC sleep aids in addition to marijuana, “significantly more reported that they feel more refreshed, more focused, and better able to function in the morning after using cannabis relative to OTC sleep aids, PSAs, or no sleep aids. Participants also reported fewer headaches and less nausea the morning after.”
“Participants reported feeling more refreshed, focused, better able to function, fewer headaches, and less nausea the morning after using cannabis for sleep than after using more conventional sleep aids or no sleep aids.”
Among those who used all three types of sleep aids, the report continues, “significantly more participants reported that they experience nausea, anxiety, and racing heart when using OTC sleep medications or PSAs compared to cannabis.”
Some side effects reported by participants are no surprise. Cannabis was more likely than other sleep aids, for example, to cause a dry mouth and red eyes. Other unintended consequences, however, were more noteworthy. For example, “significantly more participants endorsed feeling more sleepy, more anxious, and more irritable the morning after using cannabis relative to other sleep aids or no sleep aids,” the study says.
Those findings align with takeaways from past research that marijuana use can lead to longer sleep durations and fewer middle-of-the-night awakenings, but also more next-day fatigue.
Notably, researchers found that more than 60 percent of study participants reported getting six to eight hours of sleep when they used cannabis alone. Less than 20 percent, however, reported getting six to eight hours of sleep when using a prescription or OTC sleep aid, regardless of whether it was used in combination with marijuana.
“Overall the literature suggests that cannabis can be beneficial for some aspects of sleep,” authors wrote, “however, additional objective research is needed to determine which aspects of sleep are positively affected and which are negatively affected by cannabis.”
Despite marijuana’s potential side effects, researchers said they might be more tolerable for participants than side effects of other, more traditional sleep aids.
“These side effects may be less severe or impairing than the side effects they experience with other sleep aids,” the study says, “and therefore, contribute to the perception that cannabis is superior to more conventional sleep aids.”
Authors noted that their survey had a strong selection bias toward people who were already using cannabis because they perceive it to be helpful. “Not everyone is going to find that cannabis helps with their sleep,” Cuttler said in a statement, “and future research needs to employ more objective sleep measures to provide a more comprehensive understanding of the effects of cannabis for sleep.”
A 2019 study, meanwhile, found that people tended to purchase fewer OTC sleep medications when they have legal access to marijuana. In particular, authors of that study noted, “cannabis appears to compete favorably with OTC sleep aids, especially those containing diphenhydramine and doxylamine, which constitute 87.4% of the market for OTC sleep aids.”
