Sleep Motives and Expectancies for Cannabis Use in Pregnancy

Abstract

Objective: Sleep difficulties are a common motive for cannabis use during pregnancy. However, evidence supporting cannabis use as an effective sleep aid is limited, while substantial research demonstrates the efficacy of cognitive behavioral treatments. This study characterized the sleep complaints of adults using cannabis during pregnancy to inform prevention and intervention efforts. Method: Pregnant adults reporting cannabis use (a) in the month prior to or (b) after becoming pregnant were recruited from across the United States between May and August of 2025. Participants completed a cross-sectional research survey, and those who passed all fraudulent responding criteria were included in data analysis. Descriptive statistics, chi-square, and t-tests compared the demographic and clinical characteristics of pregnant adults who did and did not report using cannabis to help their sleep. Results: Of the 210 valid respondents (100% assigned female at birth, 93% cisgender; age M = 29.3 years; 53% White, 38% Black; 58% in second trimester), 185 persisted in cannabis use during pregnancy and 119 reported using “mostly” or “almost always” to help their sleep. Those using cannabis for sleep reported greater insomnia severity, earlier bedtimes, and more wake after sleep onset than those using cannabis for other reasons, but they were less likely to report taking >30 minutes to fall asleep, consistent with expectancies that cannabis would help their sleep. Three out of four using cannabis for sleep (78%) expressed interest in alternative sleep treatments. Conclusions:Sleep is a common reason for cannabis use during pregnancy that appears to be a promising target for prevention and intervention efforts.