Cannabis use and sleep outcomes among National Guard and Reserve soldiers.

= 485). Generalized estimating equations were used to examine relationships between current cannabis use and sleep outcomes, over six waves of data. Separate generalized estimating equation models examined the overall Pittsburgh Sleep Quality Index sleep score and component subscores, including duration, quality, latency, efficiency, sleep disturbances, sleep medication use, and daytime dysfunction. Final models controlled for biological sex, age, and current/former military service. The adjusted generalized estimating equation model demonstrated that cannabis use (adjusted incidence rate ratio [aIRR] = 1.01, 95% confidence interval, CI [1.01, 1.02]) was significantly associated with worse global sleep scores. When examining the Pittsburgh Sleep Quality Index subscales, current cannabis use was significantly associated with sleep latency (aIRR = 1.15, 95% CI [1.02, 1.29]), sleep disturbances (aIRR = 1.09, 1.01, 1.18), and use of sleeping medication (aIRR = 1.40, 95% CI [1.10, 1.77]). Over time, cannabis use was associated with global sleep scores and appears to have especially negative effects on sleep latency, disturbances, and use of medications for sleep. Understanding the effects of cannabis use on outcomes of importance to U.S. Army Reserve and National Guard members, such as sleep, is important, particularly in a time of evolving state-level cannabis legislation. (PsycInfo Database Record (c) 2026 APA, all rights reserved).