Around 66% of college students report experiencing a traumatic event during their lifetime. Trauma exposure and posttraumatic stress symptoms (PTS) can increase one’s risk for cannabis use and alcohol use problems. Alcohol and cannabis may be used for PTS symptom management to reduce intrusive symptoms, reduce tension, and increase sleep quality. Sleep difficulties are particularly common among college students, especially in those with PTS, and may lead to problematic substance use. This study examines the relationship between PTS symptoms, sleep quality, and substance use behavior among college students.  

The study’s sample consisted of 2,767 college students from two west coast universities. Respondents were asked to report number of drinks in a typical week, peak number of drinks on the heaviest drinking occasion, and cannabis use during the past month. Participants were also asked to rate their sleep quality during the past month. Lastly, the Post Traumatic Stress Disorder Checklist for DSM-IV was used to assess for PTS symptoms in the past month. Data was analyzed using hierarchical multiple regression analyses to assess for relationships between sleep quality, PTS symptoms, assigned sex, and substance use.  

Results of the data analysis showed that the effect of PTS on weekly drinks was stronger and statistically significant for students who reported poorer sleep quality and was non-significant for those reporting good sleep quality. For females, poorer sleep quality was associated with a reduced relationship between PTS symptoms and alcohol consumption while an increased relationship was observed for males. Regarding cannabis use, for females the association between PTS symptoms and use frequency was positive irrespective of perceived sleep quality. For males, PTS symptoms had a greater effect on cannabis use frequency for those with better sleep quality and the inverse association was observed for those with poorer sleep quality.  

Takeaway: Posttraumatic stress symptoms and sleep quality may impact alcohol and cannabis use among college students.  

Lehinger, E.A., Graupensperger, S., Song, F., Hultgren, B.A., Jackson, D., Larimer, M.E.. Posttraumatic Stress Symptoms and Substance Use Among College Students: Exploring Interactions with Sleep Quality and Assigned Sex. Addictive Behaviors. 2022;107482. Doi: 10.1016/j.addbeh.2022.107482