Effect of illicit recreational drugs upon sleep: cocaine, ecstasy and marijuana.
Level 5 - mechanism / opinion, no new human data
Narrative review without systematic search or meta-analytic methodology
PubMed 18313952 · doi:10.1016/j.smrv.2007.12.004
What was done
This review synthesized literature regarding the effects of illicit recreational drugs—specifically cocaine, MDMA (ecstasy), and cannabis (smoked marijuana and oral Delta-9-THC)—on subjective sleep quality and objective polysomnographic parameters during acute use, withdrawal, and sustained abstinence.
What was found
The abstract reports no numerical data or effect sizes. Acute cocaine administration increases wakefulness and suppresses REM sleep, acute withdrawal brings sleep disturbances and unpleasant dreams, and sustained abstinence shows deteriorating polysomnography parameters despite subjective perceptions of unchanged or improved sleep quality. Heavy MDMA consumption is associated with persistent sleep disturbances and altered sleep architecture during abstinence. Cannabis and oral THC reduce REM sleep, facilitate falling asleep, and increase Stage 4 sleep acutely, while cannabis withdrawal leads to difficulty sleeping, strange dreams, longer sleep onset latency, reduced slow wave sleep, and REM rebound.
Why it matters
This review summarizes how common recreational substances alter sleep architecture and identifies a clinical disconnect between objective sleep deterioration and subjective perception during cocaine abstinence.
Limits
The abstract is a narrative review that provides no sample sizes, numerical effect estimates, or systematic search methodology. It lacks details regarding drug dosages, polydrug use, and precise definitions of abstinence duration.