Recent and Long-Term Cannabis Use in Relation to Sleep Among Middle-Aged Adults

By
Thanh-Huyen T. Vu
Kristen L. Knutson
Reto Auer
Julian Jakob
Donald M. Lloyd-Jones
Mercedes R. Carnethon
October 9, 2026

Jama Network Open

Overview

This CARDIA cohort study examined associations between cannabis use over 35 years and sleep outcomes measured in middle age. The supplied article context and related report describe greater cumulative and recent recreational cannabis use as associated with poorer objectively measured sleep quality; the provided material does not include the study’s detailed numerical results.

Background

Cannabis use, including use as a sleep aid, has increased in the United States, while sleep difficulties are common among adults. Sleep health includes duration, efficiency, and quality, and has been associated bidirectionally with substance use. Prior evidence on cannabis and sleep has been limited and inconsistent, with much of the research relying on short-term trials, cross-sectional designs, or self-reported sleep. Longitudinal evidence on recreational cannabis use and sleep outcomes has been scarce.

Data Highlights

Study feature	Details reported in the supplied material
Study	Coronary Artery Risk Development in Young Adults (CARDIA), with follow-up through 2020–2022
Original cohort	5,115 Black and White adults aged 18–30 years at enrollment in 1985–1986, recruited at four US sites
Analytic cohort	1,266 participants; objective-sleep analyses included 891 and subjective-sleep analyses included 1,128, with 753 in both
Cannabis exposure	Repeated self-reports of lifetime and recent nonmedical use; cumulative exposure expressed in cannabis-years
Sleep assessment	Sleep outcomes assessed at the year-35 examination; objective and subjective measures were collected
Reported association	The related article summary describes greater cumulative and recent recreational cannabis use as associated with poorer objectively measured sleep quality among middle-aged adults

Key Findings

The study used longitudinal CARDIA data spanning 35 years to examine cumulative and recent cannabis use in relation to sleep during middle age.
The original cohort enrolled 5,115 Black and White adults aged 18 to 30 years at four US locations in 1985–1986.
After exclusions, 1,266 participants were included; 891 contributed to objective-sleep analyses and 1,128 to subjective-sleep analyses.
Cannabis exposure was assessed repeatedly through self-reported lifetime and past-30-day use, with cumulative exposure summarized in cannabis-years.
The related article summary reports that greater cumulative and recent recreational cannabis use may be associated with poorer objectively measured sleep quality.
The supplied study context states that prior evidence on cannabis and sleep has been limited and inconsistent, and that longitudinal evidence has been scarce.

Clinical Implications

The supplied study material describes an observational association and does not establish that cannabis use causes poorer sleep. For chronic insomnia, the American College of Physicians recommends cognitive behavioral therapy for insomnia as initial treatment, and the 2025 VA/DoD guideline suggests against cannabis or its derivatives for treatment of chronic insomnia disorder.

Conclusion

In this middle-aged CARDIA sample, greater cumulative and recent recreational cannabis use was reported as associated with poorer objectively measured sleep quality. The supplied material does not provide detailed effect estimates or establish causality.