Cannabis Use for Sleep May Lead to Dependency, According to Neurologist

Consider two scenarios: a 15-year-old girl unable to sleep past midnight, despite efforts such as shutting off her phone and trying melatonin. She takes a cannabis gummy recommended by a friend and falls asleep within 20 minutes. In a different case, a 34-year-old veteran, plagued by nightmares and chronic sleep deprivation, turns to cannabis due to a lengthy wait for a sleep consultation at a medical center.

Both individuals report success with cannabis for their sleep issues, yet many remain unaware of the underlying effects on their brains. As a neurologist focused on sleep and cognitive function, I see patients whose sleep deteriorates after extended cannabis use, particularly teenagers and veterans.

Teenagers’ brains are in a developmental phase that makes them particularly susceptible to the effects of THC, the psychoactive compound in cannabis. A 2021 study on 799 teenagers found a link between cannabis use and thinning of the prefrontal cortex, responsible for decision-making and impulse control. This can lead to impulsivity and poor judgment. Additionally, puberty alters sleep patterns, making teens reliant on cannabis to sleep, especially when facing early school start times.

Sleep involves distinct stages, with REM sleep being crucial for emotional processing and overall brain health. THC may initially aid in falling asleep but does not necessarily improve sleep quality over time. Repeated use causes the body to adapt, leading to a dependency cycle where individuals feel they need cannabis to sleep, despite experiencing poorer sleep quality.

Withdrawal from cannabis can bring about sleep disturbances and other symptoms that in turn drive people to continue using it. This cycle affects not only individuals but also veterans with post-traumatic stress disorder (PTSD). A significant percentage of veterans struggle with sleep disturbances, and many resort to cannabis as a quick solution. However, about 25% of veterans using cannabis nonmedically develop cannabis use disorder, which can exacerbate depression and anxiety.

Cognitive behavioral therapy for insomnia (CBT-I) is the recommended treatment for persistent sleep issues and has been shown to outperform medications, including cannabis. However, access to such therapies is limited due to the scarcity of trained providers and long wait times.

Individuals like the teenage girl and veteran deserve accurate information about cannabis's effects on their brains and improved access to evidence-based care addressing their underlying sleep issues.