One of the more common things I hear from patients who use marijuana regularly is:
“I need it to sleep.”
And I understand why they feel that way.
For some people, THC can initially make it easier to relax, feel sleepy, and fall asleep. If your mind is racing at night, that can feel like you've finally found something that works.
But there's another question I like to ask:
Is marijuana actually improving your sleep or is it just helping you fall asleep?
Those aren't necessarily the same thing.
Good sleep isn't simply about becoming unconscious for seven or eight hours.
Your brain moves through different stages of sleep throughout the night, and those stages are important for physical recovery, memory, emotional regulation, hormones, and how you feel the next day.
Cannabis (particularly THC) can influence normal sleeping patterns.
With frequent use, tolerance can also develop. What worked occasionally may gradually become something you feel like you need every night.
Then an interesting cycle can develop.
“I can't sleep unless I smoke.”
But sometimes the marijuana itself has become part of the reason sleeping without it is so difficult.
This is where I pay attention to the pattern.
Frequent marijuana use can be associated with sleep disturbances, and some people begin experiencing changes in motivation, concentration, anxiety, or mood.
The relationship isn't identical for everyone. Dose, THC concentration, frequency, individual susceptibility, underlying mental health, and other factors all matter.
But I become concerned when marijuana changes from something a patient occasionally enjoys into something they feel they
need in order to feel normal, relax, eat, or sleep.
“I Tried Stopping and Couldn't Sleep”
I hear this one too.
When someone who has been using marijuana frequently suddenly stops, sleep can temporarily get worse.
They may experience difficulty falling asleep, vivid dreams, irritability, anxiety, restlessness, or disrupted sleep.
Then they use marijuana again and finally sleep.
Naturally, the conclusion becomes:
“See? Marijuana helps my sleep.”
But what we're sometimes seeing is withdrawal and the brain readjusting after chronic THC exposure.
That's a very different conversation.
This is usually where I want to dig deeper.
Why weren't you sleeping in the first place?
Is it stress? Anxiety? Sleep apnea? Poor sleep habits? A racing mind? Alcohol? Caffeine? Medications? Hormones? An inconsistent schedule?
If we only use something to knock ourselves out every night, we may never address the reason sleep became difficult.
I'm not interested in judging someone because they use marijuana.
I'm interested in understanding
what role it is playing in their health.
If you use marijuana every night because you believe you can't sleep without it, that may be worth taking a closer look at.
Sometimes the thing helping you fall asleep can eventually become part of what's keeping you from sleeping well.
- Dr. C
