Can pot help you sleep better?

Sarah Moe's patients have been talking about weed a lot lately.

Many have told the Twin Cities sleep health specialist that gummies containing THC, which is newly legal in Minnesota, have helped them fall sleep more quickly.

"The vast majority of reports from my clients and patients have been overwhelmingly positive," she said. "People are having fun trying it and people are having positive responses and feeling better and recommending it to friends and neighbors."

But Moe's not recommending it. At least not yet.

Despite the positive "self-reports," little is known about how cannabis affects sleep because scientific studies have been limited.

And many doctors, including Dr. Michael Howell, founder of the Sleep Performance Institute and head of sleep medicine at the University of Minnesota, caution that regularly taking any sleep aid — whether it's pot, an over-the-counter sedative or sleeping pills — can mask the real problem.

And consistently using pot to promote sleep may even make sleeplessness worse.

"In some cases, you're going to be making the problem worse, chronically, over time, instead of fundamentally fixing the underlying issue that's going on," Howell said.

Still want to give it a try?

Many of the sleep-deprived do. In fact, a 2022 survey published in the journal Psychopharmacology of cannabis users in the U.S. and Canada found that of those who used the drug for medical reasons, 46% said sleep was the reason.

So here's what to know:

It's no sure cure

Talk to your doctor before taking anything to help you sleep. Start with the lowest recommended dose, said Moe, and begin on a Friday night. That way, if pot backfires as a sleep aid, the consequences will be less dire.

Keep in mind that what helps one person's sleep may not have the same impact on you.

"What works for Nancy might not work for Sue," Moe said. "It's great to be optimistic and give things a try, but just know that for every person who says it was a game changer, there's going to be somebody that says it didn't help, or that it had the opposite effect and was harmful."

Additionally, there are also all kinds of variables that can impact your experience, from whether you smoke or try an edible, to the strength and strain.

Howell cautioned that when it's eaten, THC is metabolized by the liver, which can give it a greater psychoactive effect than when inhaled.

"Especially for novice users, it can be very stimulating," he said. "They're like, 'Oh, I'm going to take this, I'm going to calm down and get sleepy. It's going to be super great.' And then they're in for kind of a rude surprise."

Potential downsides

The type of sleeper who could benefit most from weed, Moe said, is someone who uses it once in a while on nights when they are having trouble winding down and falling asleep.

That's how Bobbi Stark of Hopkins uses it. She's found THC to be more reliable than the sleep supplement she tried and more effective than the melatonin she used to take when she was in college.

"I struggle with falling asleep and staying asleep, even when I'm incredibly tired. On nights like those, I smoke and it helps me fall asleep pretty nicely," she said.

However, being able to easily drift off can evaporate with regular, long-term use, Moe said.

People report that the time it takes them to fall asleep, what experts call "sleep latency," reverts back to what it was before they began taking it, Moe said. "It is a short-term solution for many, definitely not something we would want to have continued use."

And, as your tolerance for THC increases, some people may need to take a higher dose to have the same impact.

"Regular use can result in tolerance. When this happens, if you stop using cannabis your sleep becomes disrupted, which can set up a vicious cycle that can result in ongoing use of THC to deal with these disruptions without in fact getting much benefit," said Dr. Bhanu Kolla, a Mayo Clinic psychiatrist with specialty training in sleep medicine.

And continued use of pot to help you get to sleep may also lead to sleep troubles if or when you decide to stop.

If you' have a persistent sleep issue, it's a much better idea to see a specialist to determine what's happening instead of self-medicating, Howell said.

You could be suffering from an iron or Vitamin D deficiency, for example. And there are proven treatments for disorders like sleep apnea, restless leg syndrome, circadian rhythm woes and insomnia.

There are also many simple changes to improve sleep, such as making sure your bedroom is dark, going to bed and waking up at the same times each day, meditating to wind down and avoiding electronic screens at night.

"I don't have anything fundamentally against THC, but I would ask people to try to understand: What is the underlying nature of their sleep problem?" Howell said. "There's no one out there who has an underlying deficiency of cannabis or THC in their brain."

It seems to help with pain

If pain is what's keeping you awake, medical marijuana research has shown that pot can have a positive impact, Howell said.

"It's pretty clear that THC is a compound that's really helpful for people who are living in chronic pain. And many people who are dealing with chronic pain also, understandably, have trouble sleeping," he said.

A 2017 research paper published in the Journal of the International Association for the Study of Pain surveyed chronic pain patients who were using medical marijuana. They reported that pain relief was the primary benefit and improved sleep was the second, with patients saying it helped them fall asleep, stay asleep and have fewer nightmares.

Research that focused directly on pot and sleep has been less conclusive, however.

It's better than booze

Drinking alcohol is clearly worse for your sleep than pot, both Moe and Howell agreed. That's because a nightcap before bed can lead to being wide awake in the middle of the night.

"Alcohol is notoriously and immediately a sedative, but then four or five, six hours later, it acts a stimulant as you're withdrawing from it," Howell said. "You get less of that effect from cannabis."

The unknowns

How pot impacts the quality of sleep and the ways we cycle through sleep stages is little understood.

Some who smoke or take an edible before bedtime say they notice fewer dreams, while others say they have more bizarre dreams. So far, studies have involved very small numbers of people.

"We have not been ministering these things and then actually studying people's sleep," said Moe. "But that is on the horizon. And I myself can't wait to see the physiological changes that happen in our brain."