Cannabis Sleep Aid Use in Daily College Life: An Intensive Longitudinal Assessment Approach

Objective: Emerging evidence suggests that college cannabis sleep aid use may increase vulnerability to diurnal impairment, despite proximal sleep-related benefits. In contrast, relatively little is known about proximal precipitants of cannabis sleep aid use in daily college life. The identification of modifiable, situational intervention points preceding cannabis sleep aid use in daily college life is critical to accelerate the development of college harm reduction efforts. This 14-night mixed methods study tested temporal associations of THC-based cannabis sleep aid use with cognitive arousal-based precipitants (consistent with cognitive theory of insomnia) and sleep outcomes. Method: Daily diary (pre-sleep and waking) and actigraphy data were collected from n = 81 college students across 14 nights. Eligible participants (Mage = 19.96 [SD = 1.18]; 65% women [100% cisgender]; 72% White) reported at least bimonthly THC-based cannabis use for sleep aid. Results: Multilevel models demonstrated that cognitive pre-sleep arousal did not predict cannabis sleep aid use day-to-day over and above individual average arousal levels. In turn, nights of cannabis sleep aid were associated with (a) improved same-night subjective sleep efficiency and (b) shorter next-night objective wake-time after sleep onset and sleep duration, after controlling for general daily-level cannabis use quantity. Mediational models indicated that associations of cognitive pre-sleep arousal with same-night sleep were not explained by cannabis sleep aid use. Conclusions: Pre-sleep arousal does not appear to predict cannabis use for sleep aid in daily college life, which in turn demonstrates potential proximal sleep-related benefits. Continued research is needed exploring modifiable within-person precipitants to inform ongoing harm reduction efforts