Daily-level associations between sleep hygiene, cannabis use, and sleep health outcomes.

Abstract

Objective: Many use cannabis to promote sleep despite insufficient evidence to recommend cannabis as a sleep-aid. Sleep health may instead be promoted through sleep hygiene, though research among those using cannabis is nascent. This study evaluated daily within-person associations among aggregate and individual sleep hygiene behaviors, cannabis use, and sleep outcomes.

Method: Adults with regular cannabis use (N = 85) completed baseline measures and up to 14 daily diaries (n = 1,021) on cannabis use and sleep.

Results: Multilevel models indicated that aggregate sleep hygiene engagement was associated with greater same-night total sleep time, sleep efficiency, and sleep quality. Absence of pre-bedtime arousal was associated with greater same-night total sleep time, sleep efficiency, and sleep quality; only using the bed for sleep/sex was associated with greater same-night sleep efficiency and sleep quality; and greater sleep timing variability was associated with poorer sleep quality. There were significant interactions between cannabis and alcohol use on total sleep time and cannabis use and sleep timing variability on sleep quality. The effect of alcohol on same-night total sleep differed based on cannabis use; total sleep was shorter following alcohol-only use and longer following co-use. The negative association between sleep timing variability and sleep quality was attenuated on cannabis use nights.

Conclusions: This study highlights associations between sleep hygiene behaviors and more favorable sleep health outcomes among those with frequent cannabis use, supporting sleep hygiene as a first-line approach for this population. (PsycInfo Database Record (c) 2026 APA, all rights reserved).