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Cannabis, chronic pain and sleep: A complex relationship uncovered by new research

Medicinal cannabis is commonly used to alleviate pain and enhance sleep quality.

Medicinal cannabis is commonly used for pain relief and improving sleep, yet scientists have only recently begun to examine how these effects intersect.

New research from the University of Texas at Dallas’ Center for Brain Health sheds light on this intricate relationship, offering an unprecedented look at how cannabis use and chronic pain interact to influence sleep architecture.

The study, titled “Interactions Between Cannabis Use and Chronic Pain on Sleep Architecture: Findings from In-Home EEG Recordings,” was published in Neurotherapeutics. Researchers gathered 339 nights of in-home sleep electroencephalogram (EEG) data from 60 adults.

Among the participants, 32% reported experiencing chronic pain, while 47% reported using cannabis. Each participant’s sleep was recorded over seven consecutive nights, measuring total sleep time, sleep onset latency, slow-wave sleep (SWS), rapid-eye movement (REM) sleep, and the number of sleep disruptions.

The findings revealed a nuanced picture. Cannabis use among individuals with chronic pain appeared to increase slow-wave sleep (SWS)—the deep, restorative stage of sleep critical for physical recovery and immune function. Since SWS is closely linked to pain modulation, this increase may offer indirect pain relief.

However, the boost in SWS came with a cost: reduced REM sleep, a stage essential for emotional regulation and memory consolidation. In addition, while SWS initially increased with cannabis use, these benefits waned with prolonged or chronic use, suggesting that long-term effects may differ from short-term relief.

“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,” said Francesca Filbey, PhD, director of the Neuroimaging of Reward Dynamics Lab at UT Dallas. “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.”

Lead author Tracy Brown, a UT Dallas cognition and neuroscience PhD student, added, “Although those who use cannabis often report subjective improvements to their sleep, our study looked at objective changes in a specific stage of sleep important for pain regulation. The potential pain-alleviating benefit from increased SWS comes with the side effect of reducing REM sleep, which may hinder other aspects of quality of life.”

This study provides critical insights for clinicians and individuals using medicinal cannabis. By highlighting the trade-offs between deep restorative sleep and REM sleep, it underscores the importance of a balanced, personalized approach when considering cannabis for chronic pain and sleep management.

As research continues to unravel the complex interplay between cannabis, pain, and sleep, patients and healthcare providers alike may benefit from understanding not just whether cannabis improves sleep, but how it changes the architecture of the brain’s sleep stages.

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