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This study investigates how different types of cannabis products relate to sleep quality and mental health symptoms.

June 23, 2026Open Access

Beyond cannabis use severity: associations of cannabis product type with sleep quality and mental health

Key Points

This study investigates how different types of cannabis products relate to sleep quality and mental health symptoms.
Naturalistic study with Danish adults using cannabis on average 26 days/month (N=197).
Participants completed an online survey assessing cannabis use, related problems (CUDIT-R), sleep quality (B-PSQI), and anxiety/depression symptoms (PHQ-4).
OLS regression models were utilized to explore associations and moderation effects.
Higher severity of cannabis use and related problems correlated with poorer sleep quality and increased anxiety/depression (p<0.05).
Use of hash only and multiple THC-dominant products resulted in worse sleep quality compared to flower users, independent of cannabis severity levels.
Product type explained additional variance in sleep quality, but did not influence anxiety/depression symptom levels.

Abstract

Abstract Rationale People who use cannabis often report using it to improve sleep and/or manage mental health symptoms. Cannabis products differ in their typical cannabinoid composition, particularly in their relative THC and CBD content, which may impact health outcomes differently. Objectives This naturalistic study investigated associations between cannabis use and related problems, sleep quality, and symptoms of anxiety/depression among people who use cannabis near daily and examined the role of cannabis product types. Methods Danish adults who reported using cannabis on 26.15 ± 6.23 days/month completed an online survey (197 participants; 64.5% men, M age 30.7 ± 10.63 years) measuring past-month use of cannabis (including product types), severity of cannabis use and related problems (CUDIT-R), sleep quality (B-PSQI), and symptoms of anxiety/depression (PHQ-4). OLS regression models were used to examine associations and interaction terms were used to test moderation. Results Severity of cannabis use and related problems, as indexed by CUDIT-R, was associated with poorer sleep quality and higher levels of anxiety/depression symptoms, which was not moderated by cannabis product type. Product type explained additional variance in sleep quality, but not in anxiety/depression symptoms. Individuals who reported using hash only and multiple THC-dominant product types exhibited poorer sleep quality compared with those who used flower only, independent of severity of cannabis use and related problems. Conclusions Severity of cannabis use and related problems was linked with sleep and mental health problems, and product type did not alter the strength of these associations. Use of hash or multiple THC-dominant product was associated with more sleep problems than use of flower, adding to the literature showing that products with greater THC concentration are more harmful. Longitudinal studies are needed to establish causal relationships.

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