Nearly 1 in 5 young adults use cannabis to fall asleep, according to new findings in JAMA Pediatrics. 

The study of data from 1473 young adults aged between 19 and 30 years also found 7.2% of those surveyed reported drinking alcohol to induce sleep.

The extent of use was “pretty striking,” said Megan Patrick, PhD, a research professor at the Institute for Social Research at the University of Michigan in Ann Arbor, who helped conduct the study. 

But using cannabis “may not actually support them getting high-quality sleep,” Patrick said. “It might help them fall asleep in the short term, but in the long term, it can backfire if it leads to worsening sleep problems and increases in substance use.” 

Patrick and her colleagues analyzed survey data from 2022 to 2023 of a nationally representative sample of 12th grade students who were followed starting in 2010 (51% female; 54.8% White). Among all respondents, 18.3% used cannabis to get to sleep (P < .001). 

Daily or near-daily cannabis use (adjusted odds ratio [aOR], 3.58; 95% CI, 2.10 -6.09) and being female or another gender identity (aOR, 1.99; 95% CI, 1.25-3.16) were associated with higher odds of using the drug to fall sleep.

Those who used alcohol daily or near daily had higher odds of using the substance to get to sleep (aOR, 3.31; 95% CI, 1.12-9.78), as did those who identified as Black (aOR, 3.03; 95% CI, 1.46-6.29; P = .003).

More than 20% of young adults in the United States struggle to fall or stay asleep. Some research has shown many people build gradual cannabis tolerance when consumed for sleep, leading to more use and potentially substance-use disorder. 

But research is mixed on whether cannabis can help with insomnia. A 2023 qualitative scoping literature review found the use of cannabis worsened sleep (48%), improved sleep (21%), had no effect (17%), or produced mixed results (14%). A clinical outcomes analysis published earlier this year demonstrated improvements in patient-reported measures in individuals prescribed cannabis-based medicinal products for insomnia. 

Clinicians should ask young adults about their substance use, issues with falling asleep, and recommend alternatives, Patrick said. 

Treatments mentioned in other studies include sleep hygiene — such as keeping a consistent bedtime and exercising daily — cognitive behavioral therapy, and acupressure. 

Emerson Wickwire, PhD, a professor of psychiatry and section head of sleep medicine at University of Maryland School of Medicine in Baltimore, said the new analysis is a welcome addition to the literature. 

“Results suggest that clinicians and researchers should pay increased attention to sleep problems and related self-medication among young adults,” Wickwire, a member of the board of directors of the American Academy of Sleep Medicine, said.

Meanwhile, the evidence for using alcohol to get to sleep shows clear, detrimental effects. A review of 27 studies on the impact of alcohol consumption on subsequent sleep in healthy adults found consumption of two standard drinks disrupted REM sleep. 

“Although alcohol reduces sleep latency and helps us fall asleep faster, it subsequently worsens sleep architecture and alters the ways that our brain functions during sleep,” Wickwire said. “Further, alcohol relaxes our breathing muscles, causing snoring and obstructive sleep apnea.” 

Wickwire said he tells patients “alcohol worsens sleep and absolutely should be avoided close to bedtime. No drinking before bed!”

Patrick reported receiving funding from the National Institute on Drug Abuse for the study. Wickwire reported no relevant financial disclosures. 

Brenda Sandburg is a freelance journalist based in New York City. She has written about the biopharmaceutical industry and legal issues for The Pink Sheet and The American Lawyer.