This study focused on the effects of cannabis and alcohol on patients using cannabis to treat anxiety symptoms. It was published in November 2023 in the Drug and Alcohol Review from the Australasian Professional Society on Alcohol and other Drugs (APSAD).
They included 347 participants whose Generalised Anxiety Scale-7 score was 5 or greater who intended to use cannabis to treat their anxiety symptoms. Participants self-reported their sleep quality, alcohol use, and cannabis use daily for 30 days via a dairy. The average age was 33 and 64% were women.
This analysis originates from an ongoing longitudinal study (prior results) with the same participants. Initial results concluded participants experienced better sleep after cannabis use, "especially in those with higher initial emotional symptoms".
Participants chose the form of cannabis they preferred (64.8% flower, 35.2% edibles) and were randomly allocated to THC-dominant, CBD-dominant or balanced THC/CBD ratio groups. The cannabinoid ratio analyses were not part of this article, but are part of the broader ongoing study using these participants. The Pittsburgh Sleep Quality Index was used to assess sleep changes.
The data again showed that when people used cannabis, they reported better sleep. But when they used only alcohol, they did not get better sleep. Those who used both alcohol and cannabis reported getting better sleep, however the cannabis-only users had "notably better" sleep quality than those who combined alcohol and cannabis.
In the authors' words:
cannabis is associated with higher subjective sleep quality.
participants reported better sleep after 'cannabis-use-only' and after 'co-use', but not after 'alcohol-use-only'.
Sleep quality was notably better after cannabis-only days compared to co-use days.
The full text article is here at the Wiley Online Library.
Sznitman SR, Martin-Willett R, Ma W, Karoly HC, Bidwell LC. Daily diary study of associations between alcohol, cannabis, co-use and sleep quality in individuals with intentions to use cannabis to cope with anxiety. Drug Alcohol Rev. 2023 Nov 20. doi: 10.1111/dar.13778. Epub ahead of print. PMID: 37985016.