Cannabis use alters sleep stages in people with chronic pain

The most frequently reported reasons for medicinal cannabis use are for pain relief and improvements in sleep. Although cannabis is believed to have an interconnected role with both pain and sleep, its effects on chronic pain and sleep architecture have been studied largely in isolation. New research from UT Dallas' Center for BrainHealth aims to fill this gap.

"Interactions Between Cannabis Use and Chronic Pain on Sleep Architecture: Findings from In-Home EEG Recordings" was recently published in Neurotherapeutics.

A total of 339 nights of in-home sleep electroencephalogram (EEG) recordings were collected from 60 adults. One-third (32%) of the participants self-reported chronic pain and 47% self-reported cannabis use.

EEG recordings were collected over seven consecutive nights per participant, measuring total sleep time, sleep onset latency, slow-wave sleep (SWS), rapid-eye movement (REM) sleep, and number of sleep disruptions.

Results revealed that cannabis use by those experiencing chronic pain may promote SWS, which is deep, physically restorative sleep critical for physical restoration and immune function that can indirectly provide pain relief.

However, the research suggests a tradeoff between SWS and REM sleep, where the increased SWS comes at the cost of less REM sleep – the kind of sleep that is critical for emotional regulation and memory integration. Additionally, while cannabis may initially enhance SWS, benefits diminish with chronic use.

For the first time in an in-home setting, we were able to observe how cannabis use and chronic pain interact to influence the brain's sleep stages. What we found was not a simple story of benefit or harm, but a complex pattern that highlights the need for personalized approaches to sleep and pain management."

Francesca Filbey, PhD, director of the Neuroimaging of Reward Dynamics Lab

"Although those who use cannabis often report subjective improvements to their sleep, our study looked at the objective changes to a specific stage of sleep important for pain regulation," added lead author Tracy Brown, a UT Dallas cognition and neuroscience PhD student. "Our results indicated that the potential pain-alleviating benefit from increasing SWS comes with the side effect of reducing REM sleep, which may hinder other aspects of quality of life. This nuanced understanding of changes to sleep architecture may help clinicians and individuals who use cannabis understand the full picture of medicinal cannabis use."