# Longitudinal reciprocal relationships between cannabis use, sleep, and the HPA-axis

> **NIH DA R01** · OREGON HEALTH & SCIENCE UNIVERSITY · 2026 · $395,690

## Abstract

Summary
Cannabis use disorder (CUD) affects at least 10% of the 193 million individuals that use cannabis worldwide.
Cannabis is frequently promoted as a sleep aid despite conclusive evidence to support such benefits. Further,
abrupt cessation of regular cannabis use is associated with sleep disturbances, often leading to reinitiating
cannabis use. Thus, while the mechanisms by which cannabis regulates sleep remains unclear, the escalation
and/or maintenance of hazardous levels of cannabis use likely involve a bidirectional (and mutually reinforcing)
relationship between sleep and cannabis use. In this prospective mechanistic randomized control study, we will
determine the impact of sleep restriction or extension on the amount of cannabis use and in turn the impact of
this cannabis use on sleep continuity and sleep homeostasis, a pivotal component of sleep regulation. To
examine this bidirectional relationship between sleep and cannabis use, as well as the hypothalamic-pituitary-
adrenal (HPA) axis as a potential mediator, 60 participants (20 healthy controls, 20 with moderate cannabis
use, and 20 with severe CUD) aged 21-29 years (a demographic with the highest prevalence of risky cannabis
use and CUD) will complete a three-week randomized control study that includes: (1) an ecological momentary
assessment, involving daily surveys delivered via phone four to five times per day to record daily sleep
behaviors (time in/out of bed, napping), cannabis use (time, method, product), and motivation for cannabis use;
(2) continuous actigraphy to objectively measure sleep; and (3) two 4-night in-laboratory sleep protocols to
assess systematic responses to both sleep restriction and sleep extension, utilizing a randomized,
counterbalanced, crossover design. Laboratory measurements will include sleep quality, quantity and
dynamics (via full polysomnography; PSG), circulating cannabinoids before and after sleep (via venous blood),
and cortisol (via saliva). This mixed-method ap

## Key facts

- **NIH application ID:** 11353872
- **Project number:** 5R01DA061251-02
- **Recipient organization:** OREGON HEALTH & SCIENCE UNIVERSITY
- **Principal Investigator:** Nicole P Bowles
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** DA
- **Fiscal year:** 2026
- **Award amount:** $395,690
- **Award type:** 5
- **Project period:** 2025-06-15T00:00:00 → 2030-04-30T00:00:00

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11353872

## Citation

> US National Institutes of Health, RePORTER application 11353872, Longitudinal reciprocal relationships between cannabis use, sleep, and the HPA-axis (5R01DA061251-02). Retrieved via AI Analytics 2026-06-26 from https://api.ai-analytics.org/grant/nih/11353872. Licensed CC0.

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