The impact of perceived sleep quality and sleep efficiency/duration on cannabis use during a self-guided quit attempt

Poor sleep quality may play a significant role in observed high rates of sustained cannabis use among veterans attempting to quit. We investigated whether individuals with poorer perceived sleep quality (rather than sleep efficiency/duration), as measured via the Pittsburgh Sleep Quality Index (Buysse, Reynolds, Monk, & Berman, 1989), would have less of a reduction in cannabis use (measured via Timeline FollowBack; Sobell and Sobell, 1992) during the first 6 months following a self-guided quit attempt. We expected these effects to remain significant after adjusting for baseline age, posttraumatic stress symptoms, as well as alcohol, tobacco, and opioid use, and cannabis withdrawal severity over the course of 6 months following the cannabis cessation attempt. Generalized linear mixed modeling using a Poisson distribution was employed to test the hypotheses among 102 cannabis dependent, primarily male, military veterans. Results indicated that veterans with poor perceived sleep quality had less of a reduction in mean cannabis use following a self-guided cannabis cessation attempt compared to those with good perceived sleep quality, while efficiency/duration was unrelated to cannabis use outcomes. Conclusions from this study should be considered in light of limitations including the use of self-report measures and generalizability to non-veterans and women.