Sleep as a Mediator Between Cannabis Use and Psychosis Vulnerability: A Longitudinal Cohort Study
Julien Ouellet, Sean Spinney, Roxane Assaf, Elroy Boers, Audrey Livet, Stéphane Potvin, Patricia Conrod
Schizophrenia Bulletin Open 2023 DOI: 10.1093/schizbullopen/sgac072 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Longitudinal study Peer reviewed |
|---|---|
| Sample size | 3,801 |
| Population | Adolescents who entered seventh grade in 31 schools in the Greater Montreal area, followed from grades 7 to 11 |
| Duration | Annual data collection from September 2012 to September 2018, spanning grades 7 to 11 |
| Measures | Detection of Alcohol and Drug Problems in Adolescents questionnaire, sleep quality Likert scale, Psychotic-Like Experiences Questionnaire for Children |
| Topics | Cannabis |
| Key findings | Cannabis use and sleep quality showed reciprocal one-year cross-lagged effects, as did sleep quality and psychotic-like experiences (PLEs). A two-year indirect effect of cannabis use on PLEs was mediated by one-year sleep quality. The authors suggest sleep disruption may both aggravate and be aggravated by cannabis use and PLEs, and propose sleep as a potential therapeutic target for preventing cannabis-related psychosis. |
Abstract
Abstract Objectives Increasing evidence implicates cannabis consumption as a key risk factor in the development of psychosis, but the mechanisms underpinning this relationship remain understudied. This study proposes to determine whether sleep disruption acts as a mediator of the cannabis-to-psychosis relationship. Study Design This longitudinal study assessed measures of cannabis use frequency, sleep quality (SQ), and psychotic-like experiences (PLEs) were collected using self-reported questionnaires. Data were collected from September 2012 to September 2018. Data were collected from a general population sample of adolescents who entered the seventh grade in 31 schools in the Greater Montreal area. The study uses data collected on an annual basis from 3801 high school students from grades 7 to 11. The aforementioned measures were measured using the Detection of Alcohol and Drug Problems in Adolescents questionnaire, a SQ Likert scale, and measures the Psychotic-Like Experiences Questionnaire for Children. Study Results Results show a reciprocal 1-year cross-lagged effect of cannabis use and sleep (β = −0.076, 95% CI = −0.037 to −0.018, P = .000), of sleep on cannabis use (β = −.016, 95% CI = −0.025 to −0.006, P = .007), of sleep on PLEs (β = −0.077, 95%CI = −0.014 to −0.051, P = .000), and of PLEs on sleep (β = −0.027, 95% CI = −0.037 to −0.018, P = .000). We additionally found a 2 years indirect lagged-effect of cannabis use on PLEs (β = 0.068, 95% CI = 0.024 to 0.113, P = .011) mediated by 1-year sleep (β = 0.006, 95% CI = 0.003 to 0.009, P = .001). Conclusions Our results suggest sleep disruptions simultaneously aggravate, and are aggravated by, cannabis addiction and PLEs. The longitudinal sleep-mediated effect of cannabis use on PLEs encourages further research into the role of sleep as a potential therapeutic target in the prevention of cannabis-related psychosis.
Comparable studies
Other observational and cohort studies on cannabis, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| High-potency cannabis and the risk of psychosis People with first episode of psychosis and healthy controls from the local population | 2009 | Case-control study | n = 454 |
| Ayahuasca-Assisted Therapy for Addiction: Results from a Preliminary Observational Study in Canada Rural aboriginal population | 2013 | Observational study | |
| Impaired cognitive performance in drug free users of recreational ecstasy (MDMA) Otherwise healthy young people | 2000 | Observational | |
| Continued cannabis use and risk of incidence and persistence of psychotic symptoms: 10 year follow-up cohort study Individuals from the general population in Germany aged 14-24 at baseline | 2011 | Observational cohort | n = 1,923 |
| Cannabis-induced psychosis and subsequent schizophrenia-spectrum disorders: follow-up study of 535 incident cases Patients treated for cannabis-induced psychotic symptoms in Denmark between 1994 and... | 2005 | Observational cohort | n = 535 |