Cannabis Was Linked to Better Self-Reported Sleep Than Alcohol in Adults Using It for Anxiety
A 2023 study found that adults who used cannabis to cope with anxiety reported better sleep after cannabis-only days than after days when they used alcohol alone or neither substance. The findings, published in Drug and Alcohol Review, describe an association—not proof that cannabis improves sleep or treats anxiety.
Researchers from the University of Haifa and the University of Colorado Boulder analyzed daily reports from 347 adults with at least mild anxiety symptoms who intended to use cannabis for anxiety relief. Participants recorded their cannabis and alcohol use, along with their perceived sleep quality, for 30 consecutive days.
The researchers compared four types of days: no cannabis or alcohol use, cannabis-only use, alcohol-only use, and use of both substances. Relative to non-use days, participants reported better sleep after cannabis-only days and after days involving both cannabis and alcohol. Alcohol-only days were not associated with better sleep. Participants also rated their sleep more favorably after cannabis-only days than after co-use days.
People who reported using cannabis more frequently showed a stronger association between cannabis-only use and better perceived sleep. The researchers did not find evidence that this relationship weakened among more frequent cannabis or alcohol users. However, they treated frequency of use as an indirect and exploratory measure related to tolerance and cross-sensitization—not as a direct test of tolerance.
The study measured subjective sleep quality with a single daily rating rather than using sleep laboratory measures, actigraphy, or other objective assessments. Participants also chose whether and how to use cannabis, so factors such as anxiety severity, expectations, product dose, timing, and other lifestyle differences could have influenced the results. The design therefore cannot establish that cannabis caused the reported improvement.
The findings are consistent with the study’s narrower conclusion: in this particular group, cannabis use was associated with better perceived sleep on the following night, while alcohol alone was not. That result does not mean cannabis is a proven treatment for insomnia or anxiety. Cannabis products vary substantially in their THC and CBD content, and the study could not determine which doses, formulations, or cannabinoid combinations might produce different effects.
Alcohol can make people fall asleep more quickly while still disrupting sleep later in the night. The National Institute on Alcohol Abuse and Alcoholism notes that alcohol-related sleep is often fragmented and may end with earlier waking. Meanwhile, the American Academy of Sleep Medicine says evidence is insufficient to recommend cannabis or its synthetic extracts for treating obstructive sleep apnea and emphasizes the need for further research.
Controlled clinical trials using objective sleep measurements are needed to determine whether cannabis has meaningful benefits for people with anxiety-related sleep problems—and to clarify its potential risks, including impairment, dependence, and sleep disruption during withdrawal.
