When used as sleep aids, alcohol and cannabis use are associated with a range of health risks. For teens, however, the risks may be especially high. This study examined how commonly teens “self medicated” sleep difficulties with alcohol and cannabis, and how this related to later sleep difficulties and substance use problems.
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Addressing sleep difficulties by using alcohol and cannabis can be problematic at any age, though it may be especially problematic for adolescents, who are already in a developmental period characterized by higher risk for poor sleep and substance use consequences. Some studies suggest that the prevalence of alcohol use for sleep problems in adolescents is around 10%, while the prevalence of cannabis use for sleep problems in this population is around 8%. Previous research has also explored associations between substance use and sleep problems in adolescents, generally finding that while alcohol and cannabis may help adolescents get to sleep in the short term, in the long-run these drugs can worsen sleep problems by disrupting sleep architecture and circadian rhythms and leading to development of substance use disorder and related problems.
This study sought to inform intervention efforts by examining the prevalence of use of alcohol and cannabis that was used for the express purpose of improving sleep among Spanish adolescents in the community, while also examining associations between use of these substances to try and help with sleep, substance use, and sleep quality.
This was a 2-stage study that included an initial cross-sectional survey and subsequent 6-month longitudinal assessment of alcohol and cannabis use, and sleep problems in 2 samples of Spanish community youth aged 15-18 years. The researchers documented the prevalence of alcohol use and cannabis use for sleep in their samples, and examined how use of these drugs for sleep subsequently predicts actual sleep quality and later more intense problematic use.
In Study 1, the researchers conducted a cross-sectional assessment that surveyed 1,121 Spanish adolescents (57% female), with an average age of 16 years. Participants’ past-month substance use was assessed as number of standard drinks and number of cannabis joints. Participants were also assessed for alcohol and cannabis related problems using validated substance use disorder screeners, sleep quality, pre-sleep arousal, daytime sleepiness, and anxiety and depression.
In Study 2, the researchers recruited 221 adolescents (56% female) with a mean age of 16 years who were assessed twice, 6 months apart, using the same measures included in Study 1.
Many teens that use alcohol or cannabis do so to try and help with sleep
Alcohol use was fairly common among study participants, with past-month prevalence of drinking around 50% across Studies 1 and 2. Conversely, cannabis use was less common, with past-month use around 10%.
The prevalence of alcohol or cannabis use for sleep was 6-9% across the full samples in Studies 1 and 2, with 2% of participants in Study 1 endorsing using both drugs in the past month for sleep. However, among those using cannabis in the past month, 44% endorsed using it for sleep, while 15% of those reporting past-month alcohol use endorsed using alcohol for sleep.
Those using cannabis for sleep had worse cannabis use problems later
In Study 2, endorsing alcohol for sleep was correlated with greater alcohol related problems but this alcohol “self-medication” was not associated with worsening alcohol use problems over time. On the contrary, using cannabis for sleep was correlated with slightly more cannabis use problems while this cannabis “self-medication” also worsened later cannabis problems (see graph below).
Using cannabis for sleep also worsened sleep quality
Use of cannabis for sleep was associated with around double the likelihood of worse sleep quality 6 months later. Importantly, though, the reverse was also true – that worse sleep quality predicted using cannabis for sleep 6 months later. In other words, worse sleep quality and using cannabis for sleep have reciprocal effects on each other. Conversely, use of alcohol for sleep was not associated with worse sleep quality 6 months later.
The researchers’ findings are notable in that although adolescents in their sample were much more likely to endorse past-month alcohol use relative to cannabis use, those using cannabis were much more likely to endorse using it for sleep relative to those using alcohol. Additionally, cannabis use for sleep was associated with cannabis use problems as well as worse sleep 6 months later. Importantly though, worse sleep initially was also associated with later use of cannabis for sleep (i.e., “self-medicating” sleep difficulties with cannabis). This finding is consistent with previous research that indicates cannabis use alters circadian rhythms which then may negatively impact sleep. The study also suggests reciprocal effects where poor sleep made teens more likely to use cannabis to address their sleep difficulties, in turn, producing a further worsening of sleep difficulties, then greater likelihood of using cannabis to help with the worse sleep problems, and so on. Of note, these findings persisted even after they adjusted for anxiety and depression symptoms which are also known to affect sleep quality.
Notably, in this study, cannabis use for sleep was associated with worse subsequent sleep quality, but alcohol was not. It is well known that alcohol and cannabis can disrupt sleep architecture, circadian rhythms, and reliance on these substances to sleep can lead to increasing difficulties sleeping without assistance from drugs. It is possible that cannabis is more likely to impair subsequent sleep in adolescents, though other studies have shown strong evidence that alcohol also disrupts sleep in this and other age groups and alcohol use to help people sleep is commonly reported. It can’t be known from this study’s reported results why these findings differ from previous research, but it may be a function of dose and frequency of use, which was not assessed across the full 6 months that participants were enrolled in Study 2. Teens may have an easier time, for example, obtaining more cannabis at higher levels of potency than drinks with high volume alcohol.
Findings from this and other studies indicate alcohol and cannabis use for sleep among adolescents can worsen sleep problems and lead to more harmful use. In turn, more sleep difficulties caused by substance use can reinforce using alcohol and other drugs like cannabis to cope. Strategies to help teens experiencing sleep difficulties without substances may help interrupt this negative feedback loop.
Sancho-Domingo, C., Carballo, J. L., Coloma-Carmona, A., Muñoz, A. P., & van-der Hofstadt, C. (2025). Alcohol and cannabis as sleep aids among adolescents and associations with sleep quality and problematic use. Addictive Behaviors, 165. doi: 10.1016/j.addbeh.2025.108304.
l
Addressing sleep difficulties by using alcohol and cannabis can be problematic at any age, though it may be especially problematic for adolescents, who are already in a developmental period characterized by higher risk for poor sleep and substance use consequences. Some studies suggest that the prevalence of alcohol use for sleep problems in adolescents is around 10%, while the prevalence of cannabis use for sleep problems in this population is around 8%. Previous research has also explored associations between substance use and sleep problems in adolescents, generally finding that while alcohol and cannabis may help adolescents get to sleep in the short term, in the long-run these drugs can worsen sleep problems by disrupting sleep architecture and circadian rhythms and leading to development of substance use disorder and related problems.
This study sought to inform intervention efforts by examining the prevalence of use of alcohol and cannabis that was used for the express purpose of improving sleep among Spanish adolescents in the community, while also examining associations between use of these substances to try and help with sleep, substance use, and sleep quality.
This was a 2-stage study that included an initial cross-sectional survey and subsequent 6-month longitudinal assessment of alcohol and cannabis use, and sleep problems in 2 samples of Spanish community youth aged 15-18 years. The researchers documented the prevalence of alcohol use and cannabis use for sleep in their samples, and examined how use of these drugs for sleep subsequently predicts actual sleep quality and later more intense problematic use.
In Study 1, the researchers conducted a cross-sectional assessment that surveyed 1,121 Spanish adolescents (57% female), with an average age of 16 years. Participants’ past-month substance use was assessed as number of standard drinks and number of cannabis joints. Participants were also assessed for alcohol and cannabis related problems using validated substance use disorder screeners, sleep quality, pre-sleep arousal, daytime sleepiness, and anxiety and depression.
In Study 2, the researchers recruited 221 adolescents (56% female) with a mean age of 16 years who were assessed twice, 6 months apart, using the same measures included in Study 1.
Many teens that use alcohol or cannabis do so to try and help with sleep
Alcohol use was fairly common among study participants, with past-month prevalence of drinking around 50% across Studies 1 and 2. Conversely, cannabis use was less common, with past-month use around 10%.
The prevalence of alcohol or cannabis use for sleep was 6-9% across the full samples in Studies 1 and 2, with 2% of participants in Study 1 endorsing using both drugs in the past month for sleep. However, among those using cannabis in the past month, 44% endorsed using it for sleep, while 15% of those reporting past-month alcohol use endorsed using alcohol for sleep.
Those using cannabis for sleep had worse cannabis use problems later
In Study 2, endorsing alcohol for sleep was correlated with greater alcohol related problems but this alcohol “self-medication” was not associated with worsening alcohol use problems over time. On the contrary, using cannabis for sleep was correlated with slightly more cannabis use problems while this cannabis “self-medication” also worsened later cannabis problems (see graph below).
Using cannabis for sleep also worsened sleep quality
Use of cannabis for sleep was associated with around double the likelihood of worse sleep quality 6 months later. Importantly, though, the reverse was also true – that worse sleep quality predicted using cannabis for sleep 6 months later. In other words, worse sleep quality and using cannabis for sleep have reciprocal effects on each other. Conversely, use of alcohol for sleep was not associated with worse sleep quality 6 months later.
The researchers’ findings are notable in that although adolescents in their sample were much more likely to endorse past-month alcohol use relative to cannabis use, those using cannabis were much more likely to endorse using it for sleep relative to those using alcohol. Additionally, cannabis use for sleep was associated with cannabis use problems as well as worse sleep 6 months later. Importantly though, worse sleep initially was also associated with later use of cannabis for sleep (i.e., “self-medicating” sleep difficulties with cannabis). This finding is consistent with previous research that indicates cannabis use alters circadian rhythms which then may negatively impact sleep. The study also suggests reciprocal effects where poor sleep made teens more likely to use cannabis to address their sleep difficulties, in turn, producing a further worsening of sleep difficulties, then greater likelihood of using cannabis to help with the worse sleep problems, and so on. Of note, these findings persisted even after they adjusted for anxiety and depression symptoms which are also known to affect sleep quality.
Notably, in this study, cannabis use for sleep was associated with worse subsequent sleep quality, but alcohol was not. It is well known that alcohol and cannabis can disrupt sleep architecture, circadian rhythms, and reliance on these substances to sleep can lead to increasing difficulties sleeping without assistance from drugs. It is possible that cannabis is more likely to impair subsequent sleep in adolescents, though other studies have shown strong evidence that alcohol also disrupts sleep in this and other age groups and alcohol use to help people sleep is commonly reported. It can’t be known from this study’s reported results why these findings differ from previous research, but it may be a function of dose and frequency of use, which was not assessed across the full 6 months that participants were enrolled in Study 2. Teens may have an easier time, for example, obtaining more cannabis at higher levels of potency than drinks with high volume alcohol.
Findings from this and other studies indicate alcohol and cannabis use for sleep among adolescents can worsen sleep problems and lead to more harmful use. In turn, more sleep difficulties caused by substance use can reinforce using alcohol and other drugs like cannabis to cope. Strategies to help teens experiencing sleep difficulties without substances may help interrupt this negative feedback loop.
Sancho-Domingo, C., Carballo, J. L., Coloma-Carmona, A., Muñoz, A. P., & van-der Hofstadt, C. (2025). Alcohol and cannabis as sleep aids among adolescents and associations with sleep quality and problematic use. Addictive Behaviors, 165. doi: 10.1016/j.addbeh.2025.108304.
l
Addressing sleep difficulties by using alcohol and cannabis can be problematic at any age, though it may be especially problematic for adolescents, who are already in a developmental period characterized by higher risk for poor sleep and substance use consequences. Some studies suggest that the prevalence of alcohol use for sleep problems in adolescents is around 10%, while the prevalence of cannabis use for sleep problems in this population is around 8%. Previous research has also explored associations between substance use and sleep problems in adolescents, generally finding that while alcohol and cannabis may help adolescents get to sleep in the short term, in the long-run these drugs can worsen sleep problems by disrupting sleep architecture and circadian rhythms and leading to development of substance use disorder and related problems.
This study sought to inform intervention efforts by examining the prevalence of use of alcohol and cannabis that was used for the express purpose of improving sleep among Spanish adolescents in the community, while also examining associations between use of these substances to try and help with sleep, substance use, and sleep quality.
This was a 2-stage study that included an initial cross-sectional survey and subsequent 6-month longitudinal assessment of alcohol and cannabis use, and sleep problems in 2 samples of Spanish community youth aged 15-18 years. The researchers documented the prevalence of alcohol use and cannabis use for sleep in their samples, and examined how use of these drugs for sleep subsequently predicts actual sleep quality and later more intense problematic use.
In Study 1, the researchers conducted a cross-sectional assessment that surveyed 1,121 Spanish adolescents (57% female), with an average age of 16 years. Participants’ past-month substance use was assessed as number of standard drinks and number of cannabis joints. Participants were also assessed for alcohol and cannabis related problems using validated substance use disorder screeners, sleep quality, pre-sleep arousal, daytime sleepiness, and anxiety and depression.
In Study 2, the researchers recruited 221 adolescents (56% female) with a mean age of 16 years who were assessed twice, 6 months apart, using the same measures included in Study 1.
Many teens that use alcohol or cannabis do so to try and help with sleep
Alcohol use was fairly common among study participants, with past-month prevalence of drinking around 50% across Studies 1 and 2. Conversely, cannabis use was less common, with past-month use around 10%.
The prevalence of alcohol or cannabis use for sleep was 6-9% across the full samples in Studies 1 and 2, with 2% of participants in Study 1 endorsing using both drugs in the past month for sleep. However, among those using cannabis in the past month, 44% endorsed using it for sleep, while 15% of those reporting past-month alcohol use endorsed using alcohol for sleep.
Those using cannabis for sleep had worse cannabis use problems later
In Study 2, endorsing alcohol for sleep was correlated with greater alcohol related problems but this alcohol “self-medication” was not associated with worsening alcohol use problems over time. On the contrary, using cannabis for sleep was correlated with slightly more cannabis use problems while this cannabis “self-medication” also worsened later cannabis problems (see graph below).
Using cannabis for sleep also worsened sleep quality
Use of cannabis for sleep was associated with around double the likelihood of worse sleep quality 6 months later. Importantly, though, the reverse was also true – that worse sleep quality predicted using cannabis for sleep 6 months later. In other words, worse sleep quality and using cannabis for sleep have reciprocal effects on each other. Conversely, use of alcohol for sleep was not associated with worse sleep quality 6 months later.
The researchers’ findings are notable in that although adolescents in their sample were much more likely to endorse past-month alcohol use relative to cannabis use, those using cannabis were much more likely to endorse using it for sleep relative to those using alcohol. Additionally, cannabis use for sleep was associated with cannabis use problems as well as worse sleep 6 months later. Importantly though, worse sleep initially was also associated with later use of cannabis for sleep (i.e., “self-medicating” sleep difficulties with cannabis). This finding is consistent with previous research that indicates cannabis use alters circadian rhythms which then may negatively impact sleep. The study also suggests reciprocal effects where poor sleep made teens more likely to use cannabis to address their sleep difficulties, in turn, producing a further worsening of sleep difficulties, then greater likelihood of using cannabis to help with the worse sleep problems, and so on. Of note, these findings persisted even after they adjusted for anxiety and depression symptoms which are also known to affect sleep quality.
Notably, in this study, cannabis use for sleep was associated with worse subsequent sleep quality, but alcohol was not. It is well known that alcohol and cannabis can disrupt sleep architecture, circadian rhythms, and reliance on these substances to sleep can lead to increasing difficulties sleeping without assistance from drugs. It is possible that cannabis is more likely to impair subsequent sleep in adolescents, though other studies have shown strong evidence that alcohol also disrupts sleep in this and other age groups and alcohol use to help people sleep is commonly reported. It can’t be known from this study’s reported results why these findings differ from previous research, but it may be a function of dose and frequency of use, which was not assessed across the full 6 months that participants were enrolled in Study 2. Teens may have an easier time, for example, obtaining more cannabis at higher levels of potency than drinks with high volume alcohol.
Findings from this and other studies indicate alcohol and cannabis use for sleep among adolescents can worsen sleep problems and lead to more harmful use. In turn, more sleep difficulties caused by substance use can reinforce using alcohol and other drugs like cannabis to cope. Strategies to help teens experiencing sleep difficulties without substances may help interrupt this negative feedback loop.
Sancho-Domingo, C., Carballo, J. L., Coloma-Carmona, A., Muñoz, A. P., & van-der Hofstadt, C. (2025). Alcohol and cannabis as sleep aids among adolescents and associations with sleep quality and problematic use. Addictive Behaviors, 165. doi: 10.1016/j.addbeh.2025.108304.
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