: Despite associations between sleep problems and substance use, many adults use alcohol and cannabis as sleep aids. However, little is known about the potential reciprocal relations among problems with sleep, alcohol use, cannabis use, and their co-use over time. : This is a secondary analysis from a nationally representative adults (N[unweighted] = 26,072) from the first four waves (2013-2018) of the Population Assessment of Tobacco and Health (PATH) Study.