Around 12% of Americans have been diagnosed with insomnia, though many more struggle with falling asleep, staying asleep, or simply getting good quality sleep. [1] In an effort to help them get more rest, many people turn to cannabis or alcohol. While they may cause short-term improvements, these substances majorly impact sleep quality and can lead to dependence, substance use disorders, and health complications. A recent study found this trend is growing, especially among youth, making it essential to understand and properly manage substance use disorders and co-occurring sleep problems.
1 in 5 young adults use alcohol or marijuana to sleep
Research published in the Journal of the American Medical Association showed that many young adults rely on cannabis/marijuana or alcohol to help them get to sleep. This study surveyed nearly 1,500 individuals between the ages of 19 and 30.
In total, 7% of participants reported using alcohol to fall asleep, while 18% of participants reported using cannabis for the same purpose. [2] Around 40% of individuals who have used cannabis in the past year said they have used this substance to enhance their sleep. Out of those who drank alcohol in the past year, 9% noted their consumption was aimed at helping them sleep better.
In addition, participants who consumed cannabis or alcohol on a near-daily or daily basis demonstrated an increased likelihood of reliance on the substance for sleep. This supports the notion that regular use of these substances for any reason can lead to dependence.
Why so many young adults use alcohol or cannabis to sleep
Individuals who currently and regularly consume cannabis tend to report higher expectations about its ability to improve their sleep. [3] Over the past decade, the age of onset for the most commonly used substances (including nicotine, cannabis, and alcohol) has steadily decreased and is now within the adolescent period. [4] Therefore, it’s possible that social pressure along with increased access and society’s generally more accepting view of substances such as cannabis have all contributed to this change.Â
However, assumptions and societal views can also lead to the spread of misinformation. For example, some young adults may incorrectly focus on the sedative properties of cannabis and alcohol, assuming they are beneficial for sleep. Yet this doesn’t account for how these substances negatively impact vital processes such as sleep.
Effects of cannabis and alcohol on sleep
Studies show that healthy individuals who consume alcohol before sleep have delayed and lower duration rapid eye movement (REM) sleep. This occurred even with low doses of alcohol, though effects continued to worsen as the amount of alcohol consumed increased. [5]
REM sleep is essential for cognitive and emotional health, as it assists with skills such as memory, learning, and emotion regulation. Another study confirms this, emphasizing the impact of nighttime alcohol use on daytime performance. [6] Alcohol use (regardless of the time of day) also increases the risk of sleep apnea by 25%. [7]
Young adults who frequently consumed cannabis edibles reported lower sleep duration and poorer sleep efficiency. Youth who reported using any form of cannabis also personally felt their sleep quality was poor. [3] These effects likely stem from the negative effects of cannabis and alcohol on the body’s natural sleep-wake cycles, called circadian rhythms.
The sleep disturbance-substance use cycle
Research supports the idea of a bidirectional relationship between sleep-wake disturbances (such as insomnia) and substance use/dependence risk across the lifespan. [8][3][4] However, these bidirectional trends are especially prevalent in young adults between the ages of 18 and 30. [6] This means that changes in substance habits and related factors have an impact on sleep disturbances and vice versa.
Variations in the type of substance used, sleep timing, sleep routines, sleep satisfaction, daytime alertness, and a person’s natural tendency toward certain sleep and wake times all impact this relationship. [6] There is a similar relationship between substance use and total sleep duration. [9]
When using alcohol or cannabis to sleep becomes a warning sign
There are several warning signs that may indicate a young adult is self-medicating to assist with sleep or is developing a dependence on alcohol or cannabis. Some concerning signs include:
- Not being able to fulfill work, school, or household obligations due to substance use
- Behaving differently socially, including isolating or feeling detached from others
- Experiencing strong cravings for substances
- Being unable to sleep, even for short periods of time, without a substance
- Displaying personality changes that don’t seem to have another cause
If someone has already developed a reliance on substances to sleep, they should discuss their concerns with a medical or mental health professional. They can provide more personalized recommendations based on a person’s medical history.
Healthy alternatives for sleep improvement
Sleep hygiene is widely regarded as one of the best ways to improve sleep. This involves developing a routine to assist with getting better rest. Sleep hygiene tips include:
- Engaging in relaxing activities before bed, such as meditation, yoga, deep breathing, drinking herbal tea, gently stretching, taking a warm bath or shower, or reading a book
- Setting the room to the ideal temperature for sleep, which is between 60 and 67 degrees
- Choosing a quiet, comfortable, and private place to sleep
- Keeping a consistent sleep schedule (including bedtime and wake time) as much as possible
- Avoiding strenuous activities such as physical exercise around 1 hour before bedtime
- Putting electronic devices (including tablets, TVs, and cellphones) away and dimming the room’s lights at least 90 minutes before bedtime
Try developing a routine before bedtime that involves several of the above tips. You can experiment with a few of them and stick with what works best for you and your environment.
Support and treatment options
If you are in search of support for sleep disorders, contact a healthcare professional. Your primary care physician can explore potential medical causes for your sleep difficulties and may refer you to a specialist to treat them. Mental health professionals can also jointly help with insomnia as well as substance use disorder, as it is important to receive treatment that properly addresses both for the best results.
Depending on your specific needs, whether or not you have developed a dependence on substances, and the goals you create with the help of your provider, you may receive any number of treatments to address your concerns. Your plan of care may include prescription medications, outpatient or inpatient substance use disorder treatment, talk therapy methods such as Cognitive Behavioral Therapy for Insomnia (CBT-I), and more.
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