0408 Insomnia Severity Differences by Psilocybin, LSD, and DMT Use Status Among Young Adult Daily Cannabis Consumers in the Herbal Heart Study

Among daily cannabis consumers aged 18–35, about 56% reported lifetime psychedelic use, with psilocybin most common (50%), followed by LSD (29%) and DMT (3.5%). Overall, 33% had subthreshold insomnia, 3.2% moderate-severity clinical insomnia, and 1.6% severe clinical insomnia. LSD and DMT were associated with moderate-to-severe clinical insomnia: 17.7% of LSD users vs. 0.0% of non-users, and 50.0% of DMT users vs. 3.6% of non-users. Psilocybin showed no significant association. LSD users also reported more frequent sleep-related interference with daily functioning. No differences were found in cannabis use for sleep or demographics by psychedelic use.

Study at a glance

Abstract

Abstract Introduction Psychedelic use and interest in its therapeutic potential are rapidly increasing; yet its relationship with insomnia remains poorly understood. This study aims to estimate differences in insomnia severity by type of psychedelic consumed among a cohort of 18-to-35-year olds. Methods Data are from the Herbal Heart Study - Sleep Ancillary (N=100) cannabis consumers. Psilocybin, lysergic acid diethylamide (LSD), and N,N-dimethyltryptamine (DMT) was self-reported. Insomnia and sleep problems were assessed via the Insomnia Severity Index: no clinical insomnia ( < 7), subthreshold clinical insomnia (8-10), moderate-severity clinical insomnia (15-21), and severe clinical insomnia (> 22). Measures were self-reported via REDCap. Chi-square tests, Fisher’s Exact tests, and independent t-tests were conducted where appropriate. Results Among daily cannabis consumers, 55.6% reported lifetime history of psychedelics, of which 42.9% reported past-year consumption. Psilocybin was the most prevalent (50.0%), followed by LSD (29.3%) and DMT (3.5%). Overall, 33.3% met criteria for subthreshold insomnia; 3.2% for moderate severity clinical insomnia; and 1.6% for severe clinical insomnia. There were differential associations between insomnia and psychedelic types (p< 0.05). LSD: 17.7% had moderate-to-severe-clinical-insomnia vs. 0.0% of non-LSD, p=0.006); DMT: 50.0% had moderate-to-severe-clinical-insomnia vs. 3.6% of non-DMT (p= 0.004); Psilocybin: 10.3% had moderate-to-severe-clinical-insomnia vs. 0.0% of non-psilocybin (p=0.07). Sleep problems interfered with daily functioning more frequently among LSD consumers (16.6%) than non-LSD consumers (2.8%, p=0.01). There were no differences consuming cannabis for sleep (p=0.70), or demographics [age: 26.9y (SD: 4.56) vs. 27.2y (SD: 5.56), p= 0.81, sex: 60.0% vs 60.7% female, p=0.95; or ethnicity: 68.6% vs. 57.1% Hispanic/Latino, p=0.26] by psychedelic use. Conclusion LSD and DMT were associated with clinical insomnia; and LSD consumers reported greater sleep problem interference in daily functioning. Longitudinal studies are warranted to evaluate causal effects and long-term sleep outcomes. Given the high burden of insomnia in this population, understanding psychedelic-specific associations with insomnia is essential for clinical and harm-reduction guidelines. Support (if any) R01HL153467 (Vidot); T37MD008647 (Diggs); T32 DA007292 (Baral).