Sleep Initiation and Maintenance Disorders Clinical Trial
Official title:
The Impact of CBT-I on Cannabis Cessation Outcomes
The purpose of this study is to investigate the efficacy of a group-based behavioral sleep intervention, and the incremental benefit provided by an adjunct sleep mobile app, on cannabis and sleep outcomes among cannabis dependent Veterans.
The Prevalence of cannabis use disorder (CUD) has been steadily increasing within the Veteran
Health Administration (VHA), along with the related significant physical, cognitive, and
psychological sequelae. Even in patients with a strong motivation to quit and the presence of
empirically-supported interventions, Veterans who receive treatment for CUD have high rates
of lapse (63% by 6-months post-treatment) and relapse (71% within 6-months post-treatment).
Thus, identifying strategies to improve response to CUD treatment is in the interest of all
VHA stakeholders.
Disturbed sleep is common among individuals with CUD and has been shown to result in
increased rates of lapse/relapse to cannabis. Providing a behavioral sleep intervention
within the context of CUD treatment, and prior to a cessation attempt, has the potential to
improve these cessation outcomes.
Cognitive behavioral therapy for insomnia (CBT-I) is a well-established first-line treatment
for insomnia. While CBT-I is being disseminated throughout VHA, it is rarely received by
Veterans with substance use disorders (SUDs) and, among those that do receive it, it is
almost always delivered following a cessation attempt. While CBT-I has been shown to be an
effective treatment for improving sleep among individuals with insomnia and co-occurring
conditions, including SUDs, there has yet to be an investigation of the impact of providing
CBT-I prior to CUD treatment with the goal of improving cessation outcomes. In addition, the
development of an adjunct behavioral intervention delivered via mobile app technology within
VA holds great promise to bolster outcomes.
The current study seeks to fill this gap by conducting a randomized prospective study
designed to evaluate the efficacy of CBT-I, as well as the incremental benefit of including
an adjunct sleep mobile app (CBT-I-MA), on both cannabis and sleep outcomes among Veterans
with CUD.
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