The Sleep "hacks" that can Backfire
Why Using Alcohol or Cannabis for Sleep May Backfire
Sleep problems are incredibly common among young adults, with more than one in five struggling to fall or stay asleep. When faced with tossing and turning at night, many turn to what seems like an easy solution: a nightcap or cannabis. But new research suggests this “sleep hack” could actually make your sleep problems worse in the long run.
The Prevalence of Self-Medicating for Sleep
A recent study published in JAMA Pediatrics examined sleep habits among nearly 1,500 young adults and found 22.4% reported using cannabis or alcohol to help them fall asleep. Other studies have also found many older adults also use both these drugs as sleep aids.
The Short-Term Illusion: Why It Seems to Work
Both alcohol and cannabis can initially appear to help with sleep, which explains their popularity as sleep aids. But understanding what’s actually happening reveals a more complex and troubling picture.
Alcohol’s Temporary Sleep Benefits
Research shows that alcohol can reduce the time it takes to fall asleep and create more consolidated sleep in the first half of the night. Alcohol increases slow wave sleep (the deepest, most restorative sleep stage) during the first part of the night. This is why many people feel they sleep better after drinking.
Cannabis’s Initial Effects
Cannabis, particularly THC (the psychoactive component), can help reduce the time it takes to fall asleep and may increase deep sleep in some cases. Early studies showed that acute exposure to cannabis decreased sleep onset latency, decreased waking after sleep onset, and increased slow-wave sleep.
The Long-Term Reality: Why It Backfires
The problem is that these initial benefits don’t last, and continuing to use substances for sleep can lead to a cascade of negative effects.
Alcohol Disrupts Sleep Architecture
While alcohol may help you fall asleep faster, it consistently causes sleep disruption in the second half of the night, when the body has metabolized the alcohol. Even low doses of alcohol negatively impact REM sleep, with disruptions progressively worsening at higher doses.
Studies have shown that drinking momentarily increases sleepiness but later causes frequent nighttime and early morning awakenings. Heavy alcohol use can contribute to insomnia, with as many as three-quarters of people with alcohol dependence experiencing insomnia symptoms when they drink.
Cannabis Creates Tolerance and Dependence
While cannabis may help people fall asleep in the short term, experts believe it could make sleep worse in the long run, with improvements waning and insomnia potentially returning with more frequent use.
Heavy chronic cannabis use is associated with a host of sleep deficits, including insomnia, lower sleep duration, sleep-quality issues, and longer time to fall asleep. Chronic use is thought to cause desensitization of CB1 receptors in the brain, which regulate sleep processes like the sleep-wake cycle.
Research shows that chronic cannabis use is associated with sleep deficits, despite acute use potentially improving sleep. A large study of university students found that daily cannabis users had double the insomnia rates.
The Vicious Cycle: Tolerance and Withdrawal
As Dr. Patrick explained, “Over the long term, regularly using substances to get to sleep may lead to worse sleep problems.” This happens because the body develops tolerance to these substances over time, meaning you need more to achieve the same effect. This increased tolerance raises the risk for substance use disorder.
Withdrawal from cannabis use can lead to significant sleep disruption, including difficulties with both falling asleep and staying asleep, which increases the risk of relapse to cannabis use. People can rapidly develop tolerance to the sedative effects of alcohol, creating a dangerous cycle of escalating use.
Are There Any Real Benefits?
The research does suggest some limited contexts where cannabinoids might have therapeutic potential:
CBD (cannabidiol, the non-psychoactive component) may have therapeutic potential for treating insomnia
Cannabis may be more effective for people struggling with sleep due to chronic pain, restless legs, PTSD, or multiple sclerosis
Synthetic cannabinoids may have short-term benefits for sleep apnea and may reduce nightmares associated with PTSD
However, CBD can be less effective at higher doses, and any sleep benefits from cannabis appear to work better with short-term or occasional use rather than nightly use.
What Experts Recommend Instead
Dr. Andrew Hyatt from Harvard Medical School cautioned: “Given the clinical challenges that the long-term risks of prescribed sleep medications pose, health professionals should caution that the use of cannabis for sleep is unlikely to help in the medium to long term, and likely increases risk of problematic use.”
Sleep experts recommend avoiding alcohol at least 3 hours before bedtime to minimize its disruptive effects on sleep architecture.
Instead of turning to substances, consider these evidence-based approaches for better sleep:
Cognitive Behavioral Therapy for Insomnia (CBT-I): This is considered the gold standard treatment for chronic insomnia
Sleep hygiene practices: Maintaining a consistent sleep schedule, creating a dark and cool bedroom environment, and limiting screen time before bed
Addressing underlying issues: Treating anxiety, depression, or pain that may be contributing to sleep problems
Relaxation techniques: Meditation, progressive muscle relaxation, or breathing exercises
The Bottom Line
While that glass of wine or cannabis edible might seem like a quick fix for sleepless nights, the science is clear: these substances create more sleep problems than they solve. The initial drowsiness masks underlying disruptions to sleep architecture, and regular use leads to tolerance, dependence, and potentially worse insomnia.
If you’re struggling with sleep try lifestyle changes first. Good books to read are Matthew Walker’s “Why We Sleep”, and/or Shawn Stevenson’s “Sleep Smarter.”
