Abstract Rationale Research has found inconsistent associations with cannabis use proximal to sleep and sleep architecture, leaving uncertainty regarding the impact of cannabis on sleep architecture. People living with HIV (PLWH) tend to have higher rates of substance use, including cannabis use, than their peers without HIV. There is limited data regarding the relationship between cannabis use and either subjective or objective sleep outcomes in this population who might be at higher risk for poor sleep. We hypothesized that cannabis use would be prevalent among PLWH and that cannabis use proximal to sleep might be associated with increased rem latency and wake after sleep onset (WASO) as well as lower perceived sleep quality. Methods This cross-sectional study in the Multicenter AIDS Cohort Study included participants who underwent home polysomnography testing, reported use of cannabis prior to sleep, and completed the Pittsburgh Sleep Quality Index (PSQI). Outcomes for this study were rem latency, WASO, and perceived sleep quality as measured by the PSQI. To assess the relationship between cannabis use prior to sleep and the above outcomes, we created linear regression models for the above outcomes, with cannabis use prior to sleep as the primary predictor of interest and adjusting age, race, education level, use of a sleep aid, and depression symptoms (CES-D 20 scale). Sensitivity analyses were conducted, replacing cannabis use prior to sleep with frequency of cannabis use over the previous four study visits. Results A total of 792 participants were included in this analysis, 418 (52.7%) of whom LWH. Average age was 57.5 years, 469 (59.3%) were White, and mean PSQI score was 6.8 Seventy-nine (9.9%) reported using cannabis use on the night of the sleep study; 50 (63.3%) of the participants reporting use were men LWH. Cannabis use prior to sleep was associated with a 33.1 min increase in rem latency (95% CI 8.7 -57.4 min, p = 0.007). There was no relationship between cannabis use and WASO or PSQI sleep quality (p = 0.074 and 0.96, respectively). Increased use of cannabis over the previous four study visits was similarly associated with increased rem latency (ß1 1.2, 95% CI 0.3-2.0) but not associated with WASO or PSQI sleep quality. Conclusions In the first study with a large sample of men LWH with polysomnography and cannabis use data, cannabis use prior to sleep was associated with increased rem latency but had no relationship with WASO or perceived sleep quality. This abstract is funded by: Data in this manuscript were collected by the Multicenter AIDS Cohort Study (MACS), now the MACS/WIHS Combined Cohort Study (MWCCS). The contents of this publication are solely the responsibility of the authors and do not represent the official views of the National Institutes of Health (NIH). MWCCS (Principal Investigators): Atlanta CRS (Cecile Lahiri, Anandi Sheth, and Gina Wingood), U01-HL146241; Baltimore CRS (Todd Brown and Joseph Margolick), U01-HL146201; Bronx CRS (David Hanna and Anjali Sharma), U01-HL146204; Brooklyn CRS (Deborah Gustafson and Tracey Wilson), U01-HL146202; Data Analysis and Coordination Center (Gypsyamber D’Souza, Stephen Gange and Elizabeth Topper), U01-HL146193; Chicago-Cook County CRS (Mardge Cohen, Audrey French, and Ryan Ross), U01-HL146245;
Rzewnicki et al. (Fri,) studied this question.