Sleep quality, problematic cannabis use and posttraumatic stress symptoms among medical cannabis users

Abstract

This study aimed to investigate the interactive influence of problematic cannabis use on the relation between sleep quality and posttraumatic stress symptoms (PTSS). Hypotheses were tested cross-sectionally among 151 medical cannabis users with PTSS. Consistent with hypotheses, we found sleep quality to be associated with PTSS severity. In addition, results indicated a significant interaction such that individuals with poor sleep quality and problematic cannabis use had the highest PTSS severity (particularly hyperarousal symptoms). Results suggest that medical cannabis users with the greatest risk of severe PTSS may be those with a combination of poor sleep quality and problematic cannabis use.

• Cannabis
• marijuana
• posttraumatic stress disorder
• sleep quality

Declaration of interest

Funding for the conduct of this study (i.e. materials, study travel costs and participant payment) was provided by the San Francisco Patient and Resource Centre, though no authors received any direct or indirect financial gain from this funding source. Furthermore, no agents of the above-mentioned funding sources were involved in the preparation or review of this manuscript. The expressed views do not necessarily represent those of the Department of Veterans Affairs.

This work was supported, in part, by the following: A VA Clinical Science Research and Development (CSR&D) Career Development Award-2 (Bonn-Miller), a donation from the San Francisco Patient and Resource Center (Bonn-Miller) and VA Health Services Research and Development Service funds (Babson).

Results from this article were presented at the 28th annual meeting of the International Society for Traumatic Stress Studies, Los Angeles, CA, 1–3 November 2012, and the 46th annual meeting of the Association for Behavioral and Cognitive Therapies, National Harbor, MD, 15–18 November 2012.

Notes

¹To examine the impact of covariates on outcomes, we also ran analyses including only symptoms of depression as a covariate. We retained depressive symptoms as a covariate given that depression often co-occurs with PTSD and is thus a common covariate in PTSD research (e.g. Boals & Schuettler, 2009; Inslicht et al., 2006; Robinaugh & McNally, 2001). Results indicated that both primary and subsidiary findings remained unchanged. Indeed, the interaction between problematic cannabis use and sleep quality significantly predicted total PTSS severity, such that the slope for individuals with high (β = 0.29, p < 0.001) but not low levels of problematic cannabis use was significant.