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Millions of Americans use cannabis products as sleep aids, but a new Northwestern Medicine study suggests marijuana may not improve sleep the way many people believe it does.

The study found both lifetime and recent cannabis use were associated with poorer objectively measured sleep quality, even though participants generally did not perceive their sleep to be worse.

The scientists followed participants from young adulthood into middle age for nearly 35 years, repeatedly tracking their cannabis use over time. In middle age, participants wore a wrist-based sleep monitor for a week and completed sleep surveys, allowing the scientists to compare objective measures of sleep with participants' own perceptions of how well they slept.

The study found both long-term and recent cannabis use were associated with poorer sleep quality when the wrist-worn monitoring device objectively measured participants' sleep. However, participants who used cannabis generally did not report sleeping worse than people who didn't use it. The findings suggest cannabis-related sleep disruptions may go unnoticed by users themselves, the study authors said.

"This study challenges the common belief that cannabis helps people sleep better," said corresponding author Dr. Thanh-Huyen T. Vu, research associate professor of preventive medicine (epidemiology) at Northwestern University Feinberg School of Medicine. "Our findings suggest cannabis may actually be associated with poorer sleep quality, even if people don't perceive those changes."

While the study was not designed to determine whether cannabis directly causes sleep problems, it provides some of the strongest evidence to date that long-term recreational cannabis use and better sleep quality may not be as closely aligned as commonly believed.

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