Background

Veterans often use cannabis for sleep despite limited evidence of its efficacy. Moreover, how sleep disturbances impact cannabis use longitudinally is unclear. We applied a behavioral economic framework to examine whether sleep disturbances and cannabis demand (i.e., relative value) were related risk-factors for future cannabis use and problems.

Methods

Veterans deployed post-9/11/2001 who reported past 6-month cannabis use at baseline (n = 126) completed surveys on their sleep disturbances, demand via the Marijuana Purchase Task (MPT), and cannabis use. Mediation analyses using Hayes’ PROCESS Macro and zero-inflated negative binomial models tested indirect effects of baseline sleep disturbances on 12-month cannabis use frequency, quantity, and problems via 6-month cannabis demand (i.e., intensity, O_max, P_max, and breakpoint).

Results

Only O_max (i.e., maximum expenditure for cannabis) was a significant mediator for 12-month cannabis use quantity and problems when examined concurrently with other demand indices after controlling for covariates. Intensity (i.e., purchase at zero cost) was a significant mediator for 12-month cannabis use frequency when examined concurrently with other demand indices in models controlling for lifetime cannabis use, but not past 30-day use at baseline.

Conclusion

Cannabis demand, specifically intensity and O_max, may help to identify Veterans with sleep disturbances who are at increased risk for escalating their cannabis use. Subsequent research should assess the extent that sleep disturbances impact cannabis demand in the context of withdrawal, which will inform novel prevention and intervention strategies geared toward reducing negative cannabis-related outcomes among Veterans.

中文翻译：

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退伍军人睡眠障碍与大麻使用之间的前瞻性关联：行为经济学方法

 背景

尽管大麻功效的证据有限，但退伍军人经常使用大麻入睡。此外，睡眠障碍如何纵向影响大麻的使用尚不清楚。我们应用行为经济学框架来研究睡眠障碍和大麻需求（即相对价值）是否是未来大麻使用和问题的相关风险因素。

 方法

2001 年 9 月 11 日后部署的退伍军人，报告过去 6 个月的基线大麻使用情况（ n = 126）完成了有关睡眠障碍、大麻购买任务 (MPT) 的需求和大麻使用的调查。使用 Hayes 的 PROCESS 宏观和零膨胀负二项式模型进行中介分析，测试了基线睡眠障碍对 12 个月大麻使用频率、数量和 6 个月大麻需求问题的间接影响（即强度、 O _max 、 P _max 、和断点）。

 结果

在控制协变量后与其他需求指数同时检查时，只有O _max （即大麻的最大支出）是 12 个月大麻使用数量和问题的重要中介因素。当与控制终生大麻使用的模型中的其他需求指数同时进行检查时，强度（即以零成本购买）是 12 个月大麻使用频率的重要中介因素，但不是过去 30 天使用的基线。

 结论

大麻需求，特别是强度和最大耗氧_量，可能有助于识别患有睡眠障碍的退伍军人，他们增加大麻使用的风险增加。后续研究应评估睡眠障碍在戒断情况下影响大麻需求的程度，这将为旨在减少退伍军人中与大麻相关的负面后果的新预防和干预策略提供信息。