Background: Drinking and poor sleep quality combine to produce adverse consequences. As alcohol use may occur in combination with cannabis, and the combination of alcohol consumption, poor sleep quality, and cannabis use was examined with a goal of (1) replicating previous findings in which sleep moderated between drinking and adverse consequences, and (2) expanding this model by examining cannabis as a moderator of the interaction between sleep and alcohol use on adverse substance use onsequences.Method: Seventy-five alcohol-using first-year undergraduate students (44 women; 58.7%) completed questionnaires about sleep quality, alcohol and cannabis use, and adverse substance use consequences (Rutgers Alcohol Problems Index; RAPI).Results: Alcohol use was measured as Blood Alcohol Concentration (BAC), Days Drinking (Days), or Drinks per Drinking Day (DDD). Hierarchical regression models that used BAC to predict RAPI replicated prior interaction between alcohol use and sleep; the other models did not. Triple interactions between cannabis, sleep quality, and alcohol (measured as BAC or ^d>, but not Days) predicted adverse consequences.Conclusion/Importance: The triple interactions supported the hypothesis that cannabis use increased the deleterious combination of alcohol and poor sleep quality on adverse consequence.
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