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<p>Purpose of Review: Evidence accumulated over several decades suggests a complex bidirectional relationship between sleep disturbance and substance use, particularly alcohol and cannabis use. The current review focuses on research from 2019 to 2025 on the effects of alcohol, cannabis, and their co-use on sleep based on stage of use and sleep measurement type (i.e. objective sleep disturbances derived from actigraphy or polysomnography (PSG) versus self-reported sleep disturbances). A total of 100 articles were considered and 73 were included in this manuscript based on the authors’ predefined inclusion criteria. Articles were identified through APA PsycNet and PubMed using combinations of keywords including “alcohol,” “cannabis,” “AUD,” “CUD,” “CBD,” “THC,” “co-use,” “sleep,” “sleep disturbance,” “motivation,” “acute use,” “chronic use,” and “withdrawal.” For each substance category (alcohol, cannabis, and co-use) we provide a current literature overview of (1) sleep as a motivation for use; (2) sleep changes in acute use; (3) sleep changes in chronic use; and (4) sleep changes during withdrawal. Recent Findings: Overall, alcohol misuse across the stages of addiction has a negative impact on both subjective and objective measures of sleep. In contrast, cannabis may have acute sleep-enhancing effects, especially at low doses, but high doses and chronic use lead to sleep disturbances, particularly on objective measures. Most striking, however, is the paucity of literature on alcohol and cannabis co-use across the stages of substance use. Summary: Exploring cannabis and alcohol co-use is relevant due to specific patterns and context that can result in substitution and complementary effects of this common substance combination, especially when considering their possible bidirectional and compounding interactions with sleep disturbances.</p>

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Sleep Disturbances Across the Addiction Stages: A Review of Alcohol, Cannabis and their Co-Use

  • 期刊论文

  • 发表日期：

    2025年10月23日

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  • Claudia B. Padula,
  • Ariel Grayson,
  • Sarah Izabel,
  • Lea-Tereza Tenekedjieva,
  • Emma Zhang,
  • Andrea N. Goldstein-Piekarski

摘要

Purpose of Review: Evidence accumulated over several decades suggests a complex bidirectional relationship between sleep disturbance and substance use, particularly alcohol and cannabis use. The current review focuses on research from 2019 to 2025 on the effects of alcohol, cannabis, and their co-use on sleep based on stage of use and sleep measurement type (i.e. objective sleep disturbances derived from actigraphy or polysomnography (PSG) versus self-reported sleep disturbances). A total of 100 articles were considered and 73 were included in this manuscript based on the authors’ predefined inclusion criteria. Articles were identified through APA PsycNet and PubMed using combinations of keywords including “alcohol,” “cannabis,” “AUD,” “CUD,” “CBD,” “THC,” “co-use,” “sleep,” “sleep disturbance,” “motivation,” “acute use,” “chronic use,” and “withdrawal.” For each substance category (alcohol, cannabis, and co-use) we provide a current literature overview of (1) sleep as a motivation for use; (2) sleep changes in acute use; (3) sleep changes in chronic use; and (4) sleep changes during withdrawal. Recent Findings: Overall, alcohol misuse across the stages of addiction has a negative impact on both subjective and objective measures of sleep. In contrast, cannabis may have acute sleep-enhancing effects, especially at low doses, but high doses and chronic use lead to sleep disturbances, particularly on objective measures. Most striking, however, is the paucity of literature on alcohol and cannabis co-use across the stages of substance use. Summary: Exploring cannabis and alcohol co-use is relevant due to specific patterns and context that can result in substitution and complementary effects of this common substance combination, especially when considering their possible bidirectional and compounding interactions with sleep disturbances.